traumatic

Miriam is upset. Her voice is stretched and I can't look at her. Perhaps they beat something out of her she didn't get back.

Our work calls on us to confront, with our patients and within ourselves, extraordinary human experiences. This confrontation is profoundly humbling in that at all times these experiences challenge the limits of our humanity and our view of the world...

The symptomatology of PTSD.In PTSD a traumatic event is not remembered and relegated to one's past in the same way as other life events. Trauma continues to intrude with visual, auditory, and/or other somatic reality on the lives of its victims. Again and again they relieve the life-threatening experiences they suffered, reacting in mind and body as though such events were still occurring. PTSD is a complex psychobiological condition.

Other personalities are created to handle new traumas, their existence usually occurring one at a time. Each has a singular purpose and is totally focused on that task. The important aspect of the mind's extreme dissociation is that each ego state is totally without knowledge of the other. Because of this, the researchers for the CIA and the Department of Defense believed they could take a personality, train him or her to be a killer and no other ego stares would be aware of the violence that was taking place. The personality running the body would be genuinely unaware of the deaths another personality was causing. Even torture could not expose the with, because the personality experiencing the torture would have no awareness of the information being sought. Earlier, such knowledge was gained from therapists working with adults who had multiple personalities. The earliest pioneers in the field, such as Dr. Ralph Alison, a psychiatrist then living in Santa Cruz, California, were helping victims of severe early childhood trauma. Because there were no protocols for treatment, the pioneers made careful notes, publishing their discoveries so other therapists would understand how to help these rare cases. By 1965, the information was fairly extensive, including the knowledge that only unusually intelligent children become multiple personalities and that sexual trauma endured by a restrained child under the age of seven is the most common way to induce hysteric dissociation.

When I got out of prison, I was basically no longer human,' Miriam says.

Blame is a Defense Against PowerlessnessBetrayal trauma changes you. You have endured a life-altering shock, and are likely living with PTSD symptoms_ hypervigilance, flashbacks and bewilderment__ith broken trust, with the inability to cope with many situations, and with the complete shut down of parts of your mind, including your ability to focus and regulate your emotions.Nevertheless, if you are unable to recognize the higher purpose in your pain, to forgive and forget and move on, you clearly have chosen to be addicted to your pain and must enjoy playing the victim.And the worst is, we are only too ready to agree with this assessment! Trauma victims commonly blame themselves. Blaming oneself for the shame of being a victim is recognized by trauma specialists as a defense against the extreme powerlessness we feel in the wake of a traumatic event. Self-blame continues the illusion of control shock destroys, but prevents us from the necessary working through of the traumatic feelings and memories to heal and recover.

Some people with DID present their narratives of sadistic abuse in a quite matter-of-fact way, without perceptible affect. This may sometimes be done as a way of protecting themselves, and the listener, from the emotional impact of their experience. We have found that people describing trauma in a flat way, without feeling, are usually those who have been more chronically abused, while those with affect still have a sense of self that can observe the tragedy of betrayal and have feelings about it. In some cases, this deadpan presentation can also be the result of cult training and brainwashing. Unfortunately, when a patient describes a traumatic experience without showing any apparent emotion, it can make the listener doubt whether the patient is telling the truth. (page 119, Chapter 9, Some clinical implications of believing or not believing the patient)

Traumatized people chronically feel unsafe inside their bodies: The past is alive in the form of gnawing interior discomfort. Their bodies are constantly bombarded by visceral warning signs, and, in an attempt to control these processes, they often become expert at ignoring their gut feelings and in numbing awareness of what is played out inside. They learn to hide from their selves._ (p.97)

As I feel less overwhelmed, my fear softens and begins to subside. I feel a flicker of hope, then a rolling wave of fiery rage. My body continues to shake and tremble. It is alternately icy cold and feverishly hot. A burning red fury erupts from deep within my belly: How could that stupid kid hit me in a crosswalk? Wasn__ she paying attention? Damn her!A blast of shrill sirens and flashing red lights block out everything.My belly tightens, and my eyes again reach to find the woman__ kind gaze. We squeeze hands, and the knot in my gut loosens. I hear my shirt ripping. I am startled and again jump to the vantageof an observer hovering above my sprawling body. I watch uniformedstrangers methodically attach electrodes to my chest. The Good Samaritanparamedic reports to someone that my pulse was 170. I hear my shirt ripping even more. I see the emergency team slip a collar onto my neck and then cautiously slide me onto a board. While they strap me down, I hear some garbled radio communication. The paramedics arerequesting a full trauma team. Alarm jolts me. I ask to be taken to thenearest hospital only a mile away, but they tell me that my injuries mayrequire the major trauma center in La Jolla, some thirty miles farther.My heart sinks.

I__e seen daggers pierce the chest,Children dying in the road,Crawling things hooked and baited,Rapists bound and then castrated,Villains singed in public square.Yet none these sights did make me cringeLike when my Love cut all her hair.