CADD CORNER: Re-stor(y)ing Trauma

 

By Ronnie Swartz, PhD, LCSW, Professor and Chair, Humboldt State University Department of Social Work Director, Altruistic Behavior Institute

 

If you label it this, then it can’t be that. Tom Wolfe, The Electric Kool-Aid Acid Test

I crashed my car when I moved out West after finishing up my MSW program in Michigan. I shouldn’t have been so focused on getting to Oregon as soon as I could because it was snowing heavily and the roads were icy and I was pulling a small trailer with everything I owned stuffed inside. I got to the top of one of the hills in the Columbia River Gorge just short of my final destination, looked down, and quietly swore. Below me was a mess of cars all crumpled together and all I could do was break sufficiently to slide down that frozen slope at a slow enough speed to be fairly certain I wouldn’t sustain any major injuries (but fast enough to know that my car wasn’t going to fare as well). After I joined the melee below at least two additional vehicles crashed into me from behind, ensuring I got it from all sides.

My trailer tore open and all my things were strewn about the snowy road amidst the blizzard wind. My computer, one of the first with an internal hard drive, now had an external hard drive that wasn’t supposed to be external. The turntable for my record player lay in the median like a hubcap from another vehicle involved in this mess. My ten-speed bicycle now looked like one of those recumbent bikes. I could see the cathode ray tubes on my small television (remember those?). Both my acoustic and electronic guitars looked like Pete Townshend had taken to them. And the bright green pillow that eased me through six years of collegiate reading now guided me like a personal beacon to where the freeway road stripes would have been if I could see them. My car was wrecked too.

So it was that I started my professional social work career as a freshly minted 23-year-old MSW with few intact possessions. My clothes were fine, my books readable, if a bit damp, and my stellar collection of Grateful Dead tapes was saved by their now shattered cassette cases. The rest of all I owned was pieces. In my journal I wrote,

A storm raged through Oregon yesterday, leaving several inches of snow on the streets of Portland. This unusual event had far-reaching effects. A storm raged through Ronnie’s life yesterday, leaving his treasured possessions ravaged on the surface of the freeway. This unusual event had far-reaching effects. Now the snow has all melted away, rain and sun eroding the atmospheric residue. And I have grasped the intrinsic value of life and the impermanence from whence it comes. Not without a price, mind you. There is more to an acoustic guitar than all the screws and transistors and microchips that make up a computer, a stereo, or a television. I’ll start my work as an MSW knowing I have a clean slate.

Similar to the late Australian social worker Michael White (2004), I understand trauma as an experience or set of experiences that disconnects a person from what is known and familiar. Trauma is a subjective experience where the severity of a single event or the duration of multiple events has an individual effect. Though there are common, shared effects of trauma, the totality of effects is specific to a person. Trauma is an exceptional event or series of events. By that I mean trauma is an event or series of events that stands outside of our dominant narrative or way of understanding the world, one’s self and one’s relationship to the world.

These days trauma is frequently conceptualized materialistically and deterministically (Supin, 2016). I understand that trauma can be described in relation to neurological effects. This perspective is of tremendous help in liberating people, particularly young people and parents, from the sort of blame, shame, and guilt that comes along with failed attempts at navigating life’s difficult circumstances. Defining trauma in the context of neuropathways provides helpful interventions for people who have directly experienced trauma as well as those that care for and support them professionally and personally. Yet, there is risk that we may totalize trauma as electrochemical. Trauma easily can be localized inside a person’s brain. When that happens, very real social and cultural contexts related to trauma can be rendered invisible, such as patriarchy, racism, homophobia, cisgender privilege, colonialism, and classism to name a few technologies of power that lead to disproportionate incidences of trauma that involve women; people of color; people who identify as gay, lesbian, bisexual, transgender and other gender identities; Indigenous Peoples; and people without enough money to get by (e.g., Funchess, 2015; Parto, et al., 2011; Roberts, et al., 2010; Roberts, et al., 2011). Trauma can certainly be understood in terms of the formation, deterioration, and reinforcement of neuropathways and the ways in which different sets of neurons fire simultaneously. But this is not the only option.

As social and language-centered beings we are constantly making meaning of the information, communication and exchanges we are part of. In general, it’s pretty easy to make sense of so-called “everyday” events. It doesn’t take a whole lot of effort. The stories that help us make meaning of everyday events are everywhere to be found. They are embedded in historical, social, and cultural discourses (Foucault, 1982). From a biology-based perspective, I’d say that the neuropathways for everyday experiences are well formed and firing quite regularly.

But everything we experience has to be storied. Experiences only have meaning through story. So the meaning that is constructed for exceptional events, such as trauma, has to have a narrative structure too. If it didn’t, there would be no way of fitting these events into the mind’s narrative orientation (Bruner, 1990). As a consequence of this construction of meaning, we have what we call “reasons” for the extraordinary, exotic or strange that allow them to make sense. It is quite difficult to story these events in ways that are consistent with existing narratives of one’s life because they stand so far outside them. The story that is constructed has to mitigate or at least make comprehensible a deviation from the dominant socio-cultural stories which are deeply embedded in the narrative structure of our lives.

When it’s hard to story an experience or set of experiences because the narrative is in such stark contrast to other narratives of a person’s life, we will pull from the canonical stories of culture that offer a way to make meaning, even if the real effect of this meaning-making is to limit other possible stories; stories that might offer other possibilities for living through trauma (Gergen, 2000). People may make sense of trauma through easily accessible and readily available explanations such as, “I am not worthy,” “I brought this on,” “I deserve this,” “I am crazy” and/or “I have PTSD.” Now this should make sense if we appreciate that dominant, colonized Western culture is filled with narratives of individualism; personal responsibility; measurement, diagnosis and scaling of normality; insurance codes; and institutional concerns of productivity, perfection, “pulling yourself up” and “just moving on.” While these explanations may help to make sense of traumatic experiences, they occlude stories of people’s preferences, their achievements, their values, what people stand for and people’s demonstrations of resistance and resilience. Stories that strengthen and protect us in the face of difficult circumstances. Stories that often existed before the experience of trauma.

Another concern about narratives that limit people’s access to their skills of living is that they are usually quite thin. By thin I mean that they rarely speak to a person’s particular trajectory of life, their unique experiences (Geertz, 1973). Typically, the canonical stories of culture that offer a way to make sense of troubling events are generalized and universalized. They don’t invite rich descriptions of people’s lives. They offer meanings that can explain what’s going on, sure, but not grounded in a locally-relevant, personal narrative.

This understanding of trauma, as a rift in the storyline of one’s life and our discursive attempts to make sense of experience, can explain why, though I was certainly shaken, I also was not oppressed by the accident when I moved out West. I was able to story it with resilience (along with some youthful pretentiousness): “I have grasped the intrinsic value of life and the impermanence from whence it comes.” The benefits I am granted via intersectional privileges helped as well (e.g., white privilege, cisgender privilege, male privilege, etc.). But when I got diagnosed with a muscle disorder a few years ago I had a much harder time storying the exceptional set of events in a way that stood outside the canon of options for making sense of medical crises.

Now when I lie down on the tray that inserts me into the CT machine every year to make sure the tumor implicated in the muscle disorder hasn’t started to grow back, I can be flooded with intense thoughts, feelings and memories. The canon might call this an “intrusion.” I know I couldn’t have done anything to prevent the development of my medical situation… but maybe if I had only done this? (eaten more kale?) Or not done that? (tried pot in college?) These could be considered “distorted cognitions about the cause” of the disorder. I had problems with my concentration when there was a norovirus outbreak in local schools a few weeks ago and I didn’t want to stay in crowds for very long because when I get sick — along with most everyone else who gets sick — my immune system kicks into high gear and part of the problem I’m dealing with is an immune system that targets my neuromuscular junction, not just pathogens. I am willing to go to great lengths to avoid getting sick because the last time I had a bad virus my voice muscles stopped working and I couldn’t swallow liquids without a good bit of it streaming out my nose. This could be understood as “avoidance.” While intrusion symptoms, avoidance of stimuli, negative alterations in cognition and mood, and marked alterations in arousal and reactivity are important criteria for a PTSD diagnosis, I don’t want to make sense of my experiences using clinical criteria from the Diagnostic and Statistical Manual of Mental Disorders, even if it is the newest, most accurate, most evidence-based 5th edition. This canonical narrative doesn’t seem to yield opportunities for me to persist in the face of adversity that are consistent with my values, what I hold precious, and my personal commitments.

Contesting essentialist understandings of trauma is in no way dismissing or minimizing the very real effects of trauma. People diagnosed with PTSD frequently experience significant distress, which can be understand in physical, emotional, psychiatric and spiritual contexts. Moreover, many people who meet the diagnostic criteria for PTSD deal with legal and economic challenges as well (McGuire & Clark, 2011). Challenging dominant ideas about trauma is not the same as doubting people’s suffering.

What I am suggesting here is that there are narratives of people’s lives — ways to make meaning — that emerge from people’s lived experience before, during and after trauma. Canonical narratives can help people make meaning but usually, maybe not always, these meanings render other powerful narratives invisible. Narratives that could be helpful in overcoming the troubling effects of trauma are pushed to the margins. Simply put, the diagnosis of 309.81 does not tell me very much about a person’s lived experience, their personal commitments, what is dear to them, what they stand for and what they have achieved. I don’t think it does very much to assist people in addressing the difficulties they face either.

References

Bruner, J. (1990). Acts of meaning. Cambridge, MA: Harvard University Press.

Foucault, M. (1982). The Subject and Power. Critical Inquiry, 8(4), 777–795.

Funchess, M. (2015). Through a Darker Lens: The Trauma of Racism in Communities of Color. Focal Point: Youth, Young Adults, & Mental Health. Trauma-Informed Care, 29, 21–23.

Geertz, C. (1973). The Interpretation of Cultures. New York: Basic Books.

Gergen, K. (2000). The saturated self. New York: Basic Books.

McGuire, J., & Clark, S. (2011). PTSD and the Law: An update. PTSD Research Quarterly, 22(1). 1–6.

Parto, J. A., Evans, M. K., & Zonderman, A. B. (2011). Symptoms of Posttraumatic Stress Disorder Among Urban Residents. The Journal of Nervous and Mental Disease, 199(7), 436–439.

Roberts, A. L., Austin, S. B., Corliss, H. L., Vandermorris, A. K., & Koenen, K. C. (2010). Pervasive Trauma Exposure Among US Sexual Orientation Minority Adults and Risk of Posttraumatic Stress Disorder. American Journal of Public Health, 100(12), 2433–2441.

Roberts, A. L., Gilman, S. E., Breslau, J., Breslau, N., & Koenen, K. C. (2011). Race/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States. Psychological Medicine, 41(1), 71–83.

Supin, J. (2016). The Long Shadow: Bruce Perry on the Lingering Effects of Childhood Trauma. The Sun, 4–13, Nov.

White, M. (2004). Working with people who are suffering the consequences of multiple trauma: A narrative perspective. The International Journal of Narrative Therapy and Community Work, 1, 45–76.

 

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