Bottling it up 'can ease trauma'

[caroline brazier]

This article came from BBC web site. What do people think?

People's reactions to the 9/11 attacks were recorded
People who do not talk about traumatic experiences can fare better than those who "let it all out", say researchers.

The University at Buffalo study compared the progress of 3,000 people who took different approaches over two years following the 9/11 attacks.

It found people initially unwilling to talk were less likely to be adversely affected two years later.

But a UK psychologist said that other studies had suggested that for many people talking did help.

We should be telling people there is likely nothing wrong if they do not want to express their thoughts and feelings after experiencing a collective trauma

Dr Mark Seery
University at Buffalo

The popular advice that it is better to talk about your feelings after a trauma has been the subject of dozens of different research projects.

This latest one involved 3,000 people who completed online surveys in the days immediately following the 2001 attacks and over the course of the next two years.

Those taking part had not lost a loved one or friend.

People who took part were allocated to different groups depending on whether they said that they felt ready to express their feelings or not.

If the assumption that it is healthier to talk about feelings is correct, then the researchers, led by Dr Mark Seery, would expect to see those who were initially uncommunicative coping worse over time with their traumatic memories.

However, the reverse was true, and those who chose not to talk appeared to be in better psychological shape.

Coping well

Dr Seery, whose work was published in the Journal of Consulting and Clinical Psychology, said: "We should be telling people there is likely nothing wrong if they do not want to express their thoughts and feelings after experiencing a collective trauma.

"In fact, they can cope quite successfully and, according to our results, are likely to be better off than someone who does want to express his or her feelings."

Professor Stephen Joseph, who specialises in trauma following disasters, said that it was important not to generalise about the "right" approach for all patients.

He said that other studies had suggested that for many people, talking about their experiences with the support of proper counselling, was the correct road to recovery.

He said: "Those people who wanted to express their feelings immediately after 9/11 may have been those who were most deeply affected by it, so it is not entirely unsurprising that they may still have symptoms two years later."

[Kazuo Yamashita]

Hello Caroline, Thank you for posting. Yes, I have a thought about this issue. We also discuss this issue in Japan. It is interesting. I need time to read your post and think about it. I will post it soon. Kazuo

[Joan McCann]

Yes, this is very interesting & I will also spend some time thinking about it before I reply. From my own experience of trauma or difficulties in life I find talking immediately after the event extremely helpful, and feel that for me what is more important than talking is who is doing the listening and how they listen.
Namo Amida Bu

[Perry Dyson]

this is very inetersting, for me it about is there healthy denail ? i think it may be more about getting the right distance from the trauma if if something like 9/11 it is just too big, so not talking could serve to distance your self to a pint in which you come to the edge of your comvert zone which is possibly the optioum distance to work on an trama.

[Dharmavidya]

Thanks for this Perry. Yes, the idea of 'distance' probably does have relevance here and so it is probably not as simple as 'talk' or 'not talk'. As Joan says, a lot depends on who listens and what kind of listening goes on. Again, Modgala's point about there being a difference between TV voyeurs and people who actually lose somebody has to be important. The former are probably not deeply involved whereas the latter may be significantly under-distanced for a long time and may need help in the process of getting perspective.

[Modgala Duguid]

A key thing that was pulled out by a critique of the report on the study was that the participants were voyeurs of the 9/11 events and not intimitely connected by escaping it or losing people in the event.
I remember watching the piper alpha disaster occurring in scotland knowing my friends husband might be on the burning rig where 160 died. I did not feel traumatised. Many people in Aberdeen were affected - shocked, angry and saddened but I think few observers via the television were traumatised. However a couple of years later I counselled a woman whose husband had died on the rig. She had a severe alcohol problem. she had been separated from her husband at the time which possible exascerbated the "survivor guilt". She was still traumatised despite counselling. However there were many others who managed to pick up their lives fully after it. Modgala

[Joan McCann]

I've been thinking quite a bit about this article since reading it but as I'm a bit slow at putting my thoughts in writing I will just add a few of these thoughts to my first reply:
From my own experience of trauma I know that what helps me is if I am able to talk to friends who believe me, take me seriously, who do not try to make it all better by looking at the positives but are not overwhelmed by hearing what I have to say - who can contain my overwhelming feelings. In the past when I didn't know anyone that could listen in this way I guess that I learnt to “bottle it all up” rather than run the risk of re-living a past trauma only to create another traumatic experience.
Also, I wonder if this article, whose headline appears, to me, to favour “bottling it all up”, is written more from the viewpoint of the potential listeners/readers rather than, as I first thought, from the talkers' point of view: if people think that bottling it all up is better for them then no one has to hear/read about the trauma.
I've also been thinking a lot about the Four Noble Truths - the fact that they are called Noble - that suffering is nothing to be ashamed of & that the feelings that arise from suffering can be contained & transformed. I know that when I feel ashamed this strengthens my delusion that suffering is somehow a personal affliction, to be kept to myself, best “bottled up”, rather than being something that “just is” - an encounter with what is other. Shame also means I can delude myself that I have some kind of control over (“I just have to try harder etc etc...”) things which are outside of my control and prevents me from accepting the reality that we all suffer, it's universal.
Namo Amida Bu
Joan

[Sundari]

Thanks Joan. I felt heartened by what you said.

Dr Seery's conclusions, and perhaps the motivation behind his study, seem to be in reaction to something - an idea that people 'should' talk - some kind of obligation. I sometimes hear this as a popularised and inaccurate view of the benefits of talking. So I think that's an agenda behind the study, or perhaps it was an overt purpose. From the account given, we can't really tell what the other variables were for people involved, as the quoted piece from Stephen Joseph says.

I am currently learning to work with trauma, and so am very interested in these questions. I hope you don't mind if I take a theoretical tack.

Theoretically, and from what I have learned from my supervisors and from my own experience, my thought would be that the telling which creates witnessing is healing and important. Then there are many questions about re-telling: the benefits and disbenefits of cycling, the human system's repeated attempts to deal with something just beyond its present capacity, the re-treading of a groove, identity loss, identity formation. All these are wrapped up in it I think.

Namo Amida Bu
Sundari

[caroline brazier]

Thank you everyone, I'm interested in these comments.

Of course, how we deal with trauma is significant in Buddhist terms. Trauma is dukkha, the driving force of the human psyche. It holds the route to self-creation but also to self-transcendence.

One aspect of this issue which we have not discussed is that of timing. It does seem to me that there has been a move towards offering counselling immediately after a trauma has occurred, and I've heard the view expressed that it is important to catch people within a few days of the event.

My own sense is that during this time, naturalistically, people often feel compelled to repeat their story over and over or they conversely may feel disconnected and unreal about the whole thing. It seems to me that both these are strategies which push away the experience. In terms of Buddhist psychology they boil down to positive and negative sensory distraction. The repetition is a sort of compulsive re-living of feeling emotion, a greed type reaction in which the feelings of the event are used as sensory stimulation to dull the real impact of the event. I don't think this is the only function of the repetition - it also seems it may be about trying to make reality different from what it is, and trying to find a story about the reality which can be absorbed into the self-story. The denial also seems to have elements of maintaining the self-story and of changing the reality of what happened, but I think has a element of simply creating a sensory blanket (rejective or hate based) to blot out the reality.

My real sense is nature knows what she is doing - people need a period of dulling immediately after a trauma in which such behaviours create a sort of scab over the incident. Sometimes at this early stage they need to talk, it is good to listen. Such listening provides an anchor for chaotic thoughts and feelings, grounding rhem into something more real. As listener at this stage it may help to encourage the person to take things in small doses and not just go round in circles with it. It may also be that, having "given" the experience to another the person feels the memory is being held, and des not need to cling on so tightly, can take respite.

Later on, when a little it is probably useful to go back and look at the feelings and deal with emotion, particularly if they have left psychological symptoms - anxiety, flash-backs etc Even here, I think learning to look at the experience for a while and then put it aside and look at other things is valuable. I often feel this is a bit like learning to drive a car - discovering where the accellerator and brakes are.

Yes, witnessing is very valuable. Having another share the experience. Seeing the reality of the horror of an incident reflected in another's face can break the bubble of unreality which may be involved in re-telling the story in one's own mind or the loneliness of one's own misery. It gives perspective - emphasising the seriousness or conversely showing it is not as bad as it might have been.

A few thoughts on an interesting topic
Prasada

[Lisa Winett]

Just to add a couple of thoughts from someone who has not worked with people in trauma, but has experienced trauma as a child and smaller traumas as an adult, talking about what happend may help momentarily, but talking and moving thoughts doesn't quite change the reality of the emotional effects of trauma.

If the trauma was a great loss like that of a parent, then the life long effects of not having that person in your life goes on until death. Likewise if the trauma was an assault, or a physical injury that resulted in the loss of a limb or something of that nature.

I tend to agree with the notion of counseling the person as soon as possible. Even if for a time the person decides they don't want counseling and choses to remain quiet, I think getting to the person initially could lay down a foundation for them so that if they ever felt lost or confused, they could recall a feeling of safety, nurturing, and counseling that could ground them and give them comfort.

Of course, after being counseled they still have to go on living. And how should they do that? I find the complimentary therapies like art and yoga help to address the issues of loss of recipricated feeling that a person experiences when they lose a close relative. These therapies give back. They can be shared, and they can be given. They are also NON-verbal ways to communicate.

just some thoughts.

[Ben Ross]

I'm drawn to the idea of non-verbal ways of communicating with someone who's experienced trauma. I've found that since my mom's death, I haven't really been able to talk about how I feel about it - I become paralyzed, somehow unable to connect to the reality of what happened. Many times I've longed to have someone just sit with me in silence and help hold the feeling of paralysis and helplessness. It reminds me of the Book of Job, when he wishes his friends would stop presenting him with arguments about the meaning of his suffering, and would just sit with him in silence. From my own experience and from working with clients, it seems part of the issue is that bringing up trauma itself can be traumatic. It's frightening to feel that maybe one's feelings will scare off the caretaker. And I think the emotions themselves can get stuck in a kind of loop, as if the trauma is being replayed, as if it hasn't stopped yet. I guess I tend to think a slow and gradual approach is good, but of course there are as many possible approaches as there are unique people and relationships.

[Lisa Winett]

I lost my father at age nine in a horrible building collapse. I don't know how other people who lost their family in the event have faired. For me, it is a life long loss. It effects how I relate to everyone I meet. I'm constantly compairing their level of success in life with what they had in the form of benefit from the their family and parents. So I can relate in a way to the "loop" effect.

I think there is a huge emphasis on being positive and having "good energy" or "good thoughts" but sometimes that is simply impossible and a better and more comfortable reality is to allow the negitive to live. The anger related to trauma I'm not sure if it ever goes away. It dulls but at times can resurface. I suppose if somehow there can be some kind of a fill in for what we've lost. But for me it seems like it would have to be the presence of a permanent human person of the caliber of a father or constant male person who is unconditional and singularly for me.

That is a very unique figure and not easily found.

The spiritual presence of the person lost for me is still huge, whether it is simply my own brain constructing a feeling of the presence of the person and how they would advise me, or whether it is a real metaphysical presence obviously I can't prove. I tend to go with it being my own construction based off of my memories and how I imagine that person would talk to and care about me. But it is a nonverbal presence.

I like yoga in terms of dealing with moving forward in the face of loss because yoga is a restorative science. Bikram yoga is one particular form that was designed to repair the body after a catastrophic auto accident that left Bikram Choudra's body in shambles. Likewise, yoga can offer the same repair for the subtle body that gets destroyed by emotional loss.

I haven't spent as much time meditating and finding out how the meditative guide can address the effects of loss. I know in yoga the chakra system addresses the functions of each chakra and how a healthy, balance chakra will affect your life and how an imbalanced chakra will show itself in your life. I don't know if Buddism has anything similar. I have read though that the Buddah did employ yoga along his path towards enlightenment.


Yoga is also a way of being in a room with a person who can address your particular needs. The sensitivity of the instructor and their experience with various human needs will depend on whether they can really give you the kind of relief you are needing. Thinking about the paralysis that happens, yoga and meditation are practices that actually allow you to hold a position, stay in one shape, and experience the thoughts and feelings that come to you in that position or moment. I think this would be good for processing trauma in a gradual way because it allows you to stay where you are until you are ready to move.

Likewise the association between the names of the yoga postures (like the warrior pose, the child pose, standing on mountain), your emotions, and the actual physical effects of the pose on your health and spirit help to move you in a very gentle way. So where you may feel paralyzed, you truely are making advances on some level. This is my feeling.


I've also been a part of group counseling for other issues like anger. Even if I felt like I was not on the same level as the other participants, I still could gage where I was at and just being a part of one group gave me a comparison with how I wanted my life to look and feel.

I think dealing with loss and trauma is a daily event. I think being at peace with trauma and loss for me comes from being in a place where I feel like I have accepted the loss and have found something that might fill that void. But it is hard in a world where there is so much wealth and enrichment from the people in your life. That is why I tend to go towards the arts and yoga because of the wealth of emotional content and complexity of and sophistication of both the practitioners and the audience.

I think makeing ourselves available to one another, and looking for truly compassionate ways to be on the planet and being compassionate towards others help me in dealing with trauma.



Namo Amida Bu and Namaste,

Lisa

[Ben Ross]

I'm sorry to hear about your loss. I also appreciate the honesty, care and depth of consideration in your comments here. I really relate to what you wrote about learning to be with a loss that can't be replaced, through meditation, yoga, communicating through imagination, and creating from the feelings. The bodily aspect of trauma is certainly difficult for me - like most men in industrialized societies, I tend to live in my head a lot. Finding a way to deeply but gently engage yoga and other somatic healing modalities has been an intention of mine for awhile now. I think that's the heart of the question, for me - how do I utilize meditation and somatic practices in a way that's deep enough to touch the suffering, yet gentle enough not to trigger intense and overwhelming feelings? I think this can be true for clients as well. Finding this balance point. Clients have commented that it can be so healing just to laugh and joke with me at times. Just a hodgepodge of thoughts here. One thing I know that's healing is seeing the universality of suffering and loss. Thanks for being open! Namaste Amida Bu,

Ben