Whole-Person Recovery After Trauma
[Originally published in the January/February, 2019 San Gabriel Valley Psychological Association Newsletter, Analyze This!]
Research in trauma has focused predominantly on pathology that arises as a result of adversity (i.e., PTSD - decreased self-esteem, social withdrawal) for years. With the negative impact of trauma defined clearly, research focus has recently begun to shift away from pathology toward empowering the trauma survivor toward thriving and resiliency.
Despite this positive shift in clinical dialogue, there is still limited information surrounding resiliency processes for specific, diverse populations. For example, the physical disability population, including those who have sustained traumatically- acquired disabilities, has gone largely overlooked in trauma and resiliency literature. Altered functioning for such individuals arises most commonly through the occurrence of an injury or illness. Automobile accidents, spinal cord injuries, infection without medication adherence, stroke, and interpersonal violence serve as just a few examples.
Resiliency has been defined by many as a set of characteristics and processes that allow a person to withstand ongoing adversity. It implies an internal presence of fortitude that can be enacted and supported in many ways. Factors like social support, relationship stability, and access to resources can increase a person’s resiliency, but there are a few other processes that stand out in their ability to bolster resilience after the body is traumatically wounded.
Embodied personhood (i.e., life experienced through the body’s interactions with the world) is shaped through internal and external forces. For this reason, the body naturally plays an important role in the process of becoming. Bodies serve as vehicles for self-formation, as they house memory, emotional development, and spiritual exploration. Naturally, when the bodily experience is disrupted, the consequences are multi- faceted.
Neuroscientific research has shown that as the body interacts with the world through the senses, emotional experiences become tied to the concurrent bodily state. For the survivor of bodily trauma experiencing PTSD, this holds particular importance. Not only might the fear of recurring danger arise in daily life, but their bodily experience can become tied to triggers and emotional states as well. These associations might result in intrusive reenactments of experiences of powerlessness. In this way, disabling events can act as repeated obstacles in a person’s story, continuously disrupting the self-environment relationship.
For these reasons, bolstering a person’s whole-person recovery in the physical, emotional, and transcendent realms becomes a clear clinical imperative. A few important resiliency- boosting processes stand out when considering whole-person care. First, embodied people inherently have the capacity to conceptualize life as a narrative. Forming such a narrative in a cohesive manner allows a person to emerge with renewed conceptualization of the event, as well as their role as a character with agency to act.
Next, embodied life naturally involves searching for meaning as life unfolds. This search gives way to the emergence of meaning systems, or frameworks by which to interpret the world. According to researcher Crystal Park and colleagues, adverse situations can cause a person to question her understanding of justice and existential meaning at large, as well as her own personal sense of safety in their environment. This destabilization causes discrepancies between situational and global meaning systems, thwarting the sense of predicable reality (e.g., I thought the world was a safe place, but that sexual assault made me feel very unsafe, perhaps the world is not safe).
Lastly, as embodied personhood entails the capacity for spiritual curiosity, for some there is a benefit to accessing transcendent reality that can promote thriving and resilience. For many, world views informed by transcendent qualities like redemption, acceptance, and purpose can serve as the backbone for their global meaning systems.
Simply put, humans are whole persons, complete with motivations toward meaning, purpose, and narrative construction—each of which can experience disruption during bodily trauma. Recovery must therefore involve restoring resilient self-relationship in each dynamic aspect of personhood. Much like the experience of embodied self, meaning has both imminent and transcendent facets. In recovery from trauma, one must first make sense of changes in the imminent reality, here and now. Beyond this, there is a need for transcendent balance. To evolve, a person must be able to see him or herself as an object that can be dislodged to continue living. For many survivors, meditation on religious or spiritual concepts like redemption, transcendent themes of empowerment, or visualizations of rising out of one’s present circumstances etc., can be powerful tools for helping the body move forward.
The rise of therapeutic interventions utilizing the body in recovery has offered new tools and frameworks for supporting the above processes in such a way that they boost resiliency in the body, self-relationship, and the brain itself. Gendlin’s Focusing, EMDR, and Somatic Experiencing serve as just a few examples. In more recent years, the development of Havening Techniques has further expanded the use of the physical body in boosting the resiliency of the brain itself, by way of decreasing the activation of the amygdala and event-specific distress. In working with traumatic incidents that alter functioning, the body is a rich platform for symptom management as well as long-term healing. For this reason, embodied personhood is not to be forgotten in trauma work!