Interior Integration for Catholics

In this episode, we gain a deeper understanding of the experience of trauma, the impact of trauma. we clarify definitions of different aspects of trauma, various categories of trauma, the immediate and delayed signs and symptoms of trauma, and the effects of trauma. Then I share an experiential exercise with you to help you discover potential areas that might be fruitful for future exploration of your own internal experience.

Show Notes

  1. Summary: In this episode, we gain a deeper understanding of the experience of trauma, the impact of trauma. we clarify definitions of different aspects of trauma, various categories of trauma, the immediate and delayed signs and symptoms of trauma, and the effects of trauma.  Then I share an experiential exercise with you to help you discover potential areas that might be fruitful for future exploration of your own internal experience.  
  2. Opening Dramatic Short
     
    1. Brief descriptions of the experience of trauma
  3.  
    1. “Outside, the sun shines. Inside, there’s only darkness. The blackness is hard to describe, as it’s more than symptoms. It’s a nothing that becomes everything there is. And what one sees is only a fraction of the trauma inflicted.” 
― Justin Ordoñez
  1. “My current life, I realized, was constructed around an absence; for all its richness I still felt as if the floors might give way, as if its core were only a covering of leaves, and I would slip through, falling endlessly, never to get my footing.” ― Esi Edugyan, Washington Black
  2. “I wish I’d fallen softly. Light and graceful like a feather drifting slowly to the earth on a warm and dreamy summer’s day. I wish that I’d landed softly too. But there is nothing soft or graceful about that devastating moment when the worst has come to pass. The unavoidable truth is that it is hard, cold and brutal. All that you know to be true and good in life shatters in an instant. You feel like a delicate pottery bowl violently tossed from your place of rest, watching yourself crash and scatter across the hostile dark earth. The sound is deafening. Time stops. Inside, the quiet ache of shock and heartbreak slowly makes its grip known. They cut deep, these jagged edges of broken sherds. You gasp for air hungrily, yet somehow forget how to breathe.”― Jodi Sky Rogers
  3. Introduction
     
    1. We are born into a not only a fallen world, but a traumatized world
  4.  
    1. We not only share in a fallen human condition, but a traumatized condition.  
      1. “No matter what kind of childhood we’ve had, nobody escapes trauma while growing up.”― Kenny Weiss
      2. The Fall goes way back, before the world was even created, to the fall of the Lucifer, the light-bearer, the morning star and his angels -- and then the fallenness entered our world through original sin, the sin of Adam and Eve, and these are the original traumas, the fall of the angels and original sin.  

    1. You and I are together in the adventure of this podcast, Interior Integration for Catholics, we are journeying together, and I am thankful to be with you.
  5.  
    1. I am Dr. Peter Malinoski, clinical psychologist and passionate Catholic and together, We bring the best of psychology and human formation and harmonize it with the perennial truths of the Catholic Faith. 
    2. This podcast, Interior Integration for Catholics is part of our broader outreach, Souls and Hearts bringing the best of psychology grounded in a Catholic worldview to you and the rest of the world through our website soulsandhearts.com.  
    3. Trauma.  We are just beginning a whole series of episodes on trauma.  You’ve been asking for this -- so many requests for us to address trauma head on.  It's such a tough topic and such an important topic, and we are taking on the tough and important topics that matter to you.
    4. Really important to understand the inner experience of trauma -- so you can recognize it in your own life and recognize it an empathetic and attuned way in others' loves.  Part of loving them.  
    5. Today, we're going to get an overview of the best of the secular understandings of trauma.  
      1. So much has changed since I entered graduate school in 1993 -- back then there was one seminal text on trauma, Judith Herman's Trauma and Recovery.  Now, especially in the last 10-15 years, there has been an upsurge of new, fresh and much better ways of understanding trauma.  
    6. Outline
       
      1. Impact of Trauma
    7.  
      1. Definitions of terms
         
        1. Definition of  trauma
      2.  
        1. Definition of Attachment injury
      3.  
        1. Definition of relational hurt
      4.  
        1. Definition of adverse experience. 


      1. Categories of Trauma 

      1. Recognizing Trauma from the Reactions, signs and symptoms.  

      1. Discuss commonly accepted effects of trauma
    8.  
      1. Go over the traumatic effects of what didn't happen, what was missing
    9.  
      1. Experiential exercise to help you identify areas of your internal experience that are impacted by trauma
    10.  
  6. Impact of Trauma
     
    1. From the North Dakota Department of Human Services Fact Sheet
  7.  
• People who have experienced trauma are:
◉ 15 times more likely to attempt suicide
◉ 4 times more likely to abuse alcohol
◉ 4 times more likely to develop a sexually transmitted disease 
◉ 4 times more likely to inject drugs
◉ 3 times more likely to use antidepressant medication
◉ 3 times more likely to be absent from work
◉ 3 times more likely to experience depression
◉ 3 times more likely to have serious job problems
◉ 2.5 times more likely to smoke
◉ 2 times more likely to develop chronic obstructive pulmonary 
disease (COPD)
◉ 2 times more likely to have serious financial problems
  1. 16-minute TED MED talk from How childhood trauma affects health across a lifetime | Pediatrician Nadine Burke Harris  September 2014
  2. Definitions of Trauma
     
    1. Lots of confusion
  3.  
    1. Briere & Scott (2006) Principles of Trauma Therapy: people use the term trauma to refer to
       
      1.  either a traumatic experience or event
    2.  
      1. the resulting injury or stress, 

      1. or the longer-term impacts and consequences 


    1. American Psychological Association Website: Trauma is an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea.
       
      1. Problem in emphasizing the emotional aspects. It's much more than that
    2.  
      1. Misses the overwhelming aspect.  

      1. Does get the "response" part right.  


    1. Integrated Listening Systems website:  Trauma is the response to a deeply distressing or disturbing event that overwhelms an individual’s ability to cope, causes feelings of helplessness, diminishes their sense of self and their ability to feel a full range of emotions and experiences.
  4.  
    1. DSM-5  PTSD, Acute Stress Disorder.  Not going to address those here, not worth the time.
       
      1. Highly criticized by many professionals for being very limited and behind the curve, not recognizing the nuances and categories of trauma responses.  


  5. Attachment Injury 
    1. Definition: Dr. Sue Johnson defines an attachment injury as “a feeling of betrayal or abandonment during a critical time of need.” 
      1. Very relational.  
    2. Uniformed Services University Human Performance Resources sheet:  An attachment injury is an emotional wound to an intimate, interdependent relationship. It usually happens after a breach of trust—particularly in a time of need or a moment of loss or transition. Once an attachment injury occurs, it can leave one or both partners feeling betrayed or abandoned.
    3. Examples of causes of attachment injuries from John Gottman "What Makes Love Last: How to build trust and avoid betrayal"
       
      1. Conditional Commitment:  You or your partner are one the lookout for someone more attractive, more desirable, someone who is a better soul mate.  

      1. A Nonsexual Affair: sometimes emotional affairs - emotional connection in an exclusive relationship with someone else.  

      1. Lying: Deception, dishonesty, little white lies.  

      1. Forming a Coalition Against the Partner:  Pulling the kids in, trying to isolate the other person.  No longer collaborative.  

      1. Absenteeism or Coldness: Not prioritizing each other at a time of need -- distancing instead -- can have a devastating impact. Whether failing to support during highly stressful events or consistently missing opportunities to turn towards each other during the rigors of life, both are destructive.
    4.  
      1. Withdrawal of Sexual Interest: This can really be wounding.  Sometimes one spouse is ok with this and the other is not.  

      1. Disrespect:  quote by John Gottman… “A loving relationship is not about one person having the upper hand – it’s about holding hands.” This includes refusing to acknowledge hurting your partner and a lack of willingness to apologize to your partner. 

      1. Unfairness: Dishonesty. Lack of balance in housework, lack of collaboration on finances.  

      1. Selfishness: When one partner lives mostly in a self-focused way; behaviors driven by self-absorption can be very wearing on relationship.
    5.  
      1. Breaking Promises:  Repeated disappointments around broken or unfulfilled promises results in disillusionment and undercuts trust between the spouses. The one breaking promises can unwittingly communicate the message, “You don’t matter.”
    6.  
    7. Additional examples from Lana Isaacson
       
      1. abuse (emotional- gaslighting, power and control, economic, verbal, physical, or sexual),
    8.  
      1. refusal to forgive or accept partner or let go of resentments (includes excessive criticism, moving out of your home and refusing to return, etc.) after your partner has done significant personal and relational growth work and demonstrating change.
  6. Relational Hurts  - Lori Epting at GoodTherapy.org Relational Hurt or Attachment Injury? How to Tell the Difference April 5, 2018
     
    1. Painful experiences in an attachment relationship inflicted by the other person, but that don't lead to rupture of the relationship
       
      1. Still a sense of love and connection between the people
    2.  
      1. Still trust and mutuality.  

      1. Still a capacity for the couple to move forward
    3.  
      1. Does the other spouse still love and care for you?  Answer:  Yes.  

      1. Examples: forgotten anniversaries, insults, or intense arguments.  


 
  1. Adverse Experiences:  Adverse Childhood Experiences
     
    1. Adverse Childhood Experiences (ACE) cover a wide range of difficult situations that children either directly face or witness while growing up, before they have developed effective coping skills. ACEs can disrupt the normal course of development and the emotional injury can last long into adulthood. The loss of a parent; neglect; emotional, physical, or sexual abuse; and divorce are among the most common types of Adverse Childhood Experiences.
  2.  
    1. Prevalence of Adverse Childhood Experiences:  
      1. Mental Health Connection of Tarrant County fact sheet -- with studies documenting each statistics.  
        1. Four of every 10 children in American say they experienced a physical assault during the past year, with one in 10 receiving an assault-related injury. (2)
        2. 2% of all children experienced sexual assault or sexual abuse during the past year, with the rate at nearly 11% for girls aged 14 to 17. (2)
        3. Nearly 14% of children repeatedly experienced maltreatment by a caregiver, including nearly 4% who experienced physical abuse. (2)
        4. 1 in 4 children was the victim of robbery, vandalism or theft during the previous year. (2)
        5. More than 13% of children reported being physically bullied, while more than 1 in 3 said they had been emotionally bullied. (2)
        6. 1 in 5 children witnessed violence in their family or the neighborhood during the previous year. (2)
        7. In one year, 39% of children between the ages of 12 and 17 reported witnessing violence, 17% reported being a victim of physical assault and 8% reported being the victim of sexual assault. (3)
        8. More than 60% of youth age 17 and younger have been exposed to crime, violence and abuse either directly or indirectly. (4
        9. More than 10% of youth age 17 and younger reported five or more exposures to violence. (4)
        10. About 10% of children suffered from child maltreatment, were injured in an assault, or witnessed a family member assault another family member. (4)
        11. About 25% of youth age 17 and younger were victims of robbery or witnessed a violent act. (4)
        12. Nearly half of children and adolescents were assaulted at least once in the past year. (4)
        13. Among 536 elementary and middle school children surveyed in an inner city community, 30% had witnessed a stabbing and 26% had witnessed a shooting. (5)
        14. Young children exposed to five or more significant adverse experiences in the first three years of childhood face a 76% likelihood of having one or more delays in their language, emotional or brain development. (6)
        15. As the number of traumatic events experienced during childhood increases, the risk for the following health problems in adulthood increases: depression; alcoholism; drug abuse; suicide attempts; heart and liver diseases; pregnancy problems; high stress; uncontrollable anger; and family, financial, and job problems. (6)
    2. According to the Centers for Disease Control -- root causes of many chronic diseases, most mental illnesses, and most violence.  
    Physical abuse
    Sexual abuse
    Verbal abuse
    Physical neglect
    Emotional neglect
    A family member who is depressed or diagnosed with other mental illness
    A family member who is addicted to alcohol or another substance
    A family member who is in prison
    Witnessing a mother being abused
    Losing a parent to separation, divorce or death
  1. 61% of adults across 25 states experienced oat least one ACE -- 
  2. Nearly one in six American adults experienced four or more.  
  3. Lead to increases in adulthood -- years down the road.  
    1. Physical injuries
       
      1. TBI
    2.  
      1. Fractures
    3.  
      1. Burns
    4.  
    5. Mental Health problems
       
      1. Depression
    6.  
      1. Anxiety
    7.  
      1. Suicide
    8.  
      1. PTSD
    9.  
    10. Maternal Health
       
      1. Unintended pregnancy
    11.  
      1. Complications in pregnancy
    12.  
      1. Miscarriage
    13.  
    14. Infectious Disease
       
      1. HIV
    15.  
      1. STDs
    16.  
    17. Chronic disease
       
      1. Cancer
    18.  
      1. Diabetes
    19.  
    20. Risky Behaviors
       
      1. Alcohol and Drug abuse
    21.  
      1. Sexual acting out
    22.  
    23. Loss of opportunities
       
      1. Education
    24.  
      1. Occupation
    25.  
      1. Income
    26.  
  4. Categories of Trauma
     
    1. Acute vs. Chronic, Causes:  Natural vs. Human, Big T trauma vs. little t trauma, Secondary Trauma, Acknowledged vs. Unacknowledged.  

    1. Acute vs. Chronic vs. Complex Trauma
       
      1. Acute Trauma: Psychology Today article Acute trauma reflects intense distress in the immediate aftermath of a one-time event and the reaction is of short duration. Common examples include a car crash, physical or sexual assault, or the sudden death of a loved one.
    2.  
      1. Chronic Trauma:   can arise from harmful events that are repeated or prolonged. It can develop in response to persistent bullying, neglect, abuse (emotional, physical, or sexual), and domestic violence.
    3.  
      1. Complex Trauma: can arise from experiencing repeated or multiple traumatic events from which there is no possibility of escape. The sense of being trapped is a feature of the experience. Like other types of trauma, it can undermine a sense of safety in the world and beget hypervigilance, constant (and exhausting!) monitoring of the environment for the possibility of threat. 


    1. Big T trauma vs. little t trauma 
      1. Trauma here is used to describe the adverse experience
      2. Big T Trauma -- Big T Trauma is a reaction to a deeply disturbing, life-threatening event or situation 
        1. Powerlessness or helplessness is also a key factor of large ‘T’ traumas,
        2. Examples of Big T Trauma
           
          1. Violent crime
        3.  
          1. natural disaster
        4.  
          1. terrorist attack
        5.  
          1. sexual assault
        6.  
          1. Combat
        7.  
          1. a car or plane accident
        8.  
          1. Death of a parent for a child
        9.  
      3. Little T Trauma: Little 't' traumas are described as smaller, more personal distressing events that disrupt our functioning and compromise our capacity to cope. These distressing events are not inherently life or bodily-integrity threatening,Examples of Little T Trauma
         
        1. Interpersonal conflict
      4.  
        1. Infidelity
      5.  
        1. Conflict with a boss
      6.  
        1. Job change
      7.  
        1. Geographic relocation -- moving to a new part of the country
      8.  
        1. Romantic breakup
      9.  
        1. Abrupt or extended relocation
      10.  
        1. Death of a Pet
      11.  
        1. Legal trouble
      12.  
        1. Financial worries or difficulty
      13.  
      14. Problems -- these describe the event -- as though the event measures the experience.  Not so.  Originally had some support and still do, because of the emphasis on the importance of less obvious events.  

 
  1. Natural vs. Human Causes
     
    1. Naturally Caused (so called "Acts of God") Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services
       
      1. Separated into the four elements Earth, Water, Air and Fire
    2.  
      1. Earth
         
        1. Earthquakes
      2.  
        1. Landslides
      3.  
        1. fallen boulders 

        1. Meteorites
      4.  
      5. Water
         
        1. Floods
      6.  
        1. Tsunamis
      7.  
        1. Avalanches
      8.  
        1. Blizzards
      9.  
      10. Air
         
        1. Tornadoes
      11.  
        1. Cyclones
      12.  
        1. Typhoons
      13.  
        1. Hurricanes
      14.  
        1. dust storms
      15.  
        1. fallen trees
      16.  
      17. Fire
         
        1. volcanic eruptions
      18.  
        1. Lightning Strikes
      19.  
        1. Wildfires
      20.  
      21. Health
         
        1. physical ailments or diseases
      22.  
        1. Epidemics
      23.  
        1. Famines
      24.  

    1. Human Caused -- Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services
       
      1. Accidental Acts
         
        1. Train derailment, roofing fall, structural collapse, mountaineering accident, aircraft crash, car accident due to malfunction, mine collapse or fire, radiation leak, crane collapse, gas explosion, electrocution, machinery-related accident, oil spill, maritime accident, accidental gun shooting, and sports-related death.
      2.  

      1. Intentional Acts
         
        1. arson, terrorism, sexual assault and abuse,(see three episode IIC series on Rape, Incest, Shame and Silence, episodes 40, 43,and 44) homicides or suicides, mob violence or rioting, physical abuse and neglect, stabbing or shooting, warfare, domestic violence, poisoned water supply, human trafficking, school violence, torture, home invasion, bank robbery, genocide, and medical or food tampering, harassment, street violence, and bullying
      2.  

      1. Actions vs. Omissions
         
        1. e.g. abuse vs. neglect
      2.  


  2. Secondary Trauma:  Psychology Today Article:  Secondary or vicarious trauma arises from exposure to other people’s suffering and can strike those in professions that are called on to respond to injury and mayhem, notably physicians, first responders, and law enforcement. Over time, such individuals are at risk for compassion fatigue, whereby they avoid investing emotionally in other people in an attempt to protect themselves from experiencing distress.
  3. Acknowledged vs. unacknowledged trauma
     
    1. Frame of reference -- that just how it was
  4.  
    1. Defining trauma away -- Just because my Dad was a raging unemployed alcoholic and Mom was stressed out with her job and all the housework and we struggled financially and my parents fought all the time, that wasn't trauma, that was just normal.  I never was hit or nothing.   Not like my classmate Billy.  Billy suffered trauma.  His Dad used to hit him with a golf club and he came to school with bruises.  Now that's trauma.  Or the kids that were sexually abused.  That never happened to me.  I just had a rough childhood, but I've moved on, it's all in the past.  

  5. Recognizing Trauma from the Signs and Symptoms  -- So important.   Drawing from many sources here, but Substance Abuse and Mental Health Services Administration. Trauma-Informed Care in Behavioral Health Services. HHS Publication No. (SMA) 13-4801 2014.   Chapter 3 of Understanding the Impact of Trauma
     
    1. Emotional & psychological Symptoms of Trauma:
       
      1. Immediate
         
        1. Emotional overwhelm
           
          1. Characteristic of trauma
        2.  

        1. Shock
      2.  
        1. Denial, disbelief
      3.  
        1. Feeling disconnected or numb or detached
      4.  
        1. Anxiety or severe fear, even panic attacks
      5.  
        1. Guilt -- including survivor guilt
      6.  
        1. Anger, rage
      7.  
        1. Sadness
      8.  
        1. Helplessness
      9.  
        1. Mood swings -- exhilaration about surviving then survivor guilt
      10.  
        1. Emotional Constriction, Shutdown
      11.  

      1. Delayed Emotional Signs
         
        1. Irritability, hostility, edginess
      2.  
        1. Depression
      3.  
        1. Mood swings
      4.  
        1. Anxiety 
          1. Phobia
          2. Generalized anxiety

        1. Fears of trauma happening again
      5.  
        1. Grief
      6.  
        1. Shame
      7.  
        1. Feeling very fragile, vulnerable
      8.  
        1. Emotional detachment, disconnection -- in relationships
      9.  
        1. Hopelessness, despair
      10.  
        1. Anhedonia -- inability to enjoy anything
      11.  
        1. Difficulty experiencing positive emotions
      12.  


 
  1. Cognitive Symptoms of Trauma
     
    1. Immediate Cognitive Reactions
       
      1. Disorientation 

      1. Difficulty concentrating
    2.  
      1. Ruminating, obsessing
    3.  
      1. Racing thoughts
    4.  
      1. Intrusive thoughts -- e.g. Replaying the traumatic event over and over again
    5.  
      1. Visualizations of the event.  

      1. Time Distortion
    6.  
      1. Space Distortion
    7.  
      1. Extreme alertness; always on the lookout for warnings of potential danger
    8.  
      1.  New sensitivity to loud noises, smells, or other things around you
    9.  
      1. Memory problems -- unable to remember the event
    10.  
      1. Feeling out of control
    11.  
      1. Feeling unreal, depersonalized, not yourself, like you are watching someone else. 
        1. Depersonalization: Persistent or recurrent experiences of feeling detached from, and as if one were an outside observer of, one’s mental processes or body (e.g., feeling as though one were in a dream; feeling a sense of unreality of self or body or of time moving slowly). 

      1. Derealization: Persistent or recurrent experiences of unreality of surroundings (e.g., the world around the individual is experienced as unreal, dreamlike, distant, or distorted). 


    1. Delayed Cognitive Signs
       
      1. Dissociation is a mental process of disconnecting from one’s thoughts, feelings, body, from memories or sense of identity. This disconnection is automatic and completely out of the person's control.x
         
        1. Amnesia: Often described as "gaps" in memory that can range from minutes to years
      2.  
        1. Depersonalization: Feeling disconnected from your body or thoughts
      3.  
        1. Derealization: Feeling disconnected from the world around you
      4.  
        1. Identity alteration: The sense of being markedly different from another part of yourself
      5.  
        1. Identity confusion: A sense of confusion about who you really are
      6.  


we will have a lot more to say about dissociation in future episodes, but for now -- disconnection.  
  1. Alexithymia
     
    1. the inability to recognize or describe one's own emotions. -- Can't put my feelings into words.  The experience of trauma can initially defy speech.  

    1. “People who suffer from alexithymia tend to feel physically uncomfortable but cannot describe exactly what the problem is. As a result they often have multiple vague and distressing physical complaints that doctors can't diagnose. In addition, they can't figure out for themselves what they're really feeling about any given situation or what makes them feel better or worse. This is the result of numbing, which keeps them from anticipating and responding to the ordinary demands of their bodies in quiet, mindful ways. If you are not aware of what your body needs, you can't take care of it. If you don't feel hunger, you can't nourish yourself. If you mistake anxiety for hunger, you may eat too much. And if you can't feel when you're satiated, you'll keep eating.” 
― Bessel A. van der Kolk
 
  1. Intrusive memories -- keep coming and coming
  2. Reactivation of previous traumatic events -- those from before the most recent trauma
  3. Nightmares
  4. Confusion, distractions
  5. Highly critical of self -- blaming the self, what I could have done better
  6. Preoccupation with the event -- all I can think about
  7. Denial of the event 
“The conflict between the will to deny horrible events and the will to proclaim them aloud is the central dialectic of psychological trauma.” 
― Judith Lewis Herman, Trauma and Recovery: The Aftermath of Violence - From Domestic Abuse to Political Terror
 
  1. Difficulty with decision making
  2. Magical thinking that certain behaviors (including avoidance) will protect me against future harm
  3. Suicidal ideation, fantasies
  4. Physical symptoms:
     
    1. Quotes
       
      1. “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)” ― Bessel A. van der Kolk, 


 
  1. Immediate physical reactions
     
    1. Nausea, gastrointestinal distress
  2.  
    1. Sweating, shivering
  3.  
    1. Fainting
  4.  
    1. Muscle tremors, uncontrollable shaking
  5.  
    1. Racing heart, fast breathing, elevated blood pressure
  6.  
    1. Physical agitation
  7.  
    1. Extreme fatigue, exhaustion
  8.  
    1. Exaggerated startle responses
  9.  
    1. Headaches
  10.  
    1. Ringing in the ears
  11.  
  12. Delayed Physical symptoms
     
    1. Sleep disturbances, insomnia
  13.  
    1. Aches, pains, somatization of psychological distress
  14.  
    1. Appetite change
  15.  
    1. Difficult with digestion
  16.  
    1. Persistent fatigue
  17.  
    1. Elevated cortisol levels
  18.  
    1. Hyperarousal
  19.  
    1. Chronic muscle tension
  20.  
    1. Long-term health problems -- heart, liver, adrenal glands, autoimmune problems, COPD
  21.  
  22. Behavioral Symptoms:
     
    1. Immediate Behavioral Reactions
       
      1. Exaggerated startle responses
    2.  
      1. Restlessness
    3.  
      1. Argumentative behavior
    4.  
      1. Increased use of alcohol, drugs, and tobacco
    5.  
      1. Social withdrawal and relational apathy
    6.  
      1. Avoidant behaviors
    7.  

    1. Delayed Behavioral symptoms
       
      1. Avoidance of activities or places that trigger memories of the even
    2.  
      1. Social relationship disturbances
    3.  
      1. Decreased activity level
    4.  
      1. Engagement in high-risk behaviors
    5.  
      1. Increased use of alcohol and drugs
    6.  
      1. Impulse control problems
    7.  
      1. Social withdrawal, which can lead to isolation
    8.  

“Over time as most people fail the survivor's exacting test of trustworthiness, she tends to withdraw from relationships. The isolation of the survivor thus persists even after she is free.” 
― Judith Lewis Herman
  1. Difficulty maintaining close relationships
  2. Sexual dysfunction
  3. Existential Symptoms
     
    1. Immediate Existential Reactions
       
      1. Intense use of prayer
    2.  
      1. Restoration of faith in the goodness of others (e.g., receiving help from others)
    3.  
      1. Loss of self-efficacy
    4.  
      1. Despair about humanity, particularly if the event was intentional
         
        1.  Negative thoughts about yourself, other people or the world
      2.  

      1. Immediate disruption of life assumptions (e.g., fairness, safety, goodness, predictability of life)
    5.  

 
  1. Delayed Existential Reactions
     
    1. Feeling as though one is permanently damaged
  2.  
    1. Questioning (e.g., “Why me?”)
  3.  
    1. Increased cynicism, disillusionment, about the future, about humankind
       
      1. “Unlike simple stress, trauma changes your view of your life and yourself. It shatters your most basic assumptions about yourself and your world — “Life is good,” “I’m safe,” “People are kind,” “I can trust others,” “The future is likely to be good” — and replaces them with feelings like “The world is dangerous,” “I can’t win,” “I can’t trust other people,” or “There’s no hope.”  ― Mark Goulston MD, Post-Traumatic Stress Disorder For Dummies
    2.  

 
  1. Increased self-confidence (e.g., “If I can survive this, I can survive anything”)
  2. Loss of purpose
  3. Renewed faith
  4. Hopelessness
  5. Reestablishing priorities
  6. Redefining meaning and importance of life
  7. Reworking life’s assumptions to accommodate the trauma (e.g., taking a self-defense class to reestablish a sense of safety)
  8. Effects of Trauma -- Going beyond the surface level, what is more readily observable in self or others suffering from trauma
     
    1. Going into survival mode
       
      1. Necessity of coming out of this alive.  Very primitive, basic responses.  Drive to survive.
         
        1. “We don’t learn things that help us to thrive when we are in survival mode. It’s only when we are in sensual mode that we do.” ― Lebo Grand
      2.  

      1. Many, many people live chronically in 


    1. Increasing fragmentation -- decreasing integration
       
      1. Overwhelming intensity of experience.  
        1. Overwhelming Grief -- episodes 81-83

      1. Integration much more difficult, even impossible in the current conditions
         
        1. We need disconnects -- we need to not know that if A=B and B=C, then A=C, because A=C is too threatening for us
           
          1. Example of little girl with a sexually abusive father -- can't come to the full implications of that without being overwhelmed. 



      1. Loss of a sense of time
         
        1. “When something reminds traumatized people of the past, their right brain reacts as if the traumatic event were happening in the present. But because their left brain is not working very well, they may not be aware that they are re-experiencing and reenacting the past - they are just furious, terrified, enraged, ashamed, or frozen.” 



― Bessel Van Der Kolk
 
  1. Identity issues
     
    1. Who am I?
       
      1. “I felt as though everything inside me had been obliterated.
    2.  

However much I tried, however much I wanted to go back to being who I was before, it was impossible--all that was left was an empty husk of my former self.” 
― Shiori Itō, Black Box
  1. Shame (episodes 37-49)
     
    1. Trauma generates and activates and exacerbates and perpetuates shame.  

    1. Generates Shame
       
      1. “Shame is internalized when one is abandoned. Abandonment is the precise term to describe how one loses one’s authentic self and ceases to exist psychologically.”  ― John Bradshaw, Healing the Shame that Binds You
    2.  
      1. Genesis 3
    3.  

    1. Activates Shame
       
      1. Preexisting, unresolved shame can come up.  
        1. A plausible explanation for why the adverse event happened or is happening.  


    1. Deep sense of not being loved, not being lovable -- often denied, because it's so painful.
  2.  
“...one of the hardest things to admit is that we weren’t loved when we needed it most. It’s a terrible feeling, the pain of not being loved.” She was right. I had been groping for the right words to express that murky feeling of betrayal inside, the horrible hollow ache, and to hear Ruth say it—“the pain of not being loved”—I saw how it pervaded my entire consciousness and was at once the story of my past, present, and future.” ― Alex Michaelides
 
  1. Decreased capacity for relationships
     
    1. Decreasing vulnerability within the self or with others
  2.  
    1. Out of touch with so much of ourselves.  

    1. Lack of Trust
       
      1. “The words "I love you," used to be enough for me. They used to mean the world to me, today they don't mean shit. Oh you love me? Really? Why? How? When did it start? Why? Give me reasons, show me behaviors that PROVE you love me, or get the fuck out of my way. I am not interested in diamonds and platitudes, I want to know that I GENUINELY matter to you, because I don't have time to waste on pretty lies that are ugly beneath the surface.” 


― Devon J Hall
 
  1. Desperation
     
    1. Can lead to suicidal impulses.  Episodes 76-80. 

  2. Spiritual Effects
     
    1. God image issues -- episodes 23-29.  

    1. Unconscious and conscious
  3.  
    1. Problem of evil.  

  4. What didn't happen
     
    1. Attunement  - Daniel Brown and David Elliott
       
      1. Feeling safe and protected afterward
    2.  
      1.  Feeling seen, heard, known, and understood -- someone else making sense of the adverse experience
         
        1. “Trauma is personal. It does not disappear if it is not validated. When it is ignored or invalidated the silent screams continue internally heard only by the one held captive. When someone enters the pain and hears the screams healing can begin.” 



― Danielle Bernock, 
  1. “To survive trauma one must be able to tell a story about it.” 
― Natasha Trethewey, Memorial Drive: A Daughter's Memoir
  1.  
  2. Feeling comforted, soothed, calmed, reassured
     
    1. “Feeling listened to and understood changes our physiology. Being able to articulate a complex feeling and having our feelings recognised lights up our Limbic brain, and creates an ‘ah-ha’ moment. In contrast, being met by silence and incomprehension kills the spirit.” ― Bessel van der Kolk
  3.  
 
  1. Feeling cherished, treasured, loved, delighted in
  2. Feeling that someone had my best interests in mind.  
  3. Experiential Exercise -- No-Go Zones. 
    1. Not therapy
    2. Pencil or pen and paper -- some way to record -- could be your phone.  
    3. Safety issues
       
      1. Zone of tolerance
    4.  
      1. If this doesn't suit you, don't do it.  

      1. Can stop at any time.
    5.  
      1. Take what is helpful to you.
    6.  
      1. No driving, can stop the recording until you're in a good place for it.  

      1. Asking that no part of you overwhelm you.  

    7. Not going to open up any traumatic place.  We are focused on delineating where those places are within you.  
    8. Going to the lowest place within us.  
    9. Really slowing it down
    10. Notice what is going on inside you right now. 
      1. Can you be curious
      2. Can you have a big open heart
      3. Can you accept what you find if it's not overwhelming
      4. Can you be receptive to new ways of understanding yourself.  
    11. Notice the reactions
       
      1. Body Sensations
    12.  
      1. Emotions
    13.  
      1. Visual Images
    14.  
      1. Memories
    15.  
      1. Inner voice
    16.  
      1. Thoughts or Beliefs or Assumptions
    17.  
      1. Impulses
    18.  
      1. Desires
    19.  
      1. Fantasies
    20.  
    21. Any concerns about this so far?  Is it OK?  If not discontinue.  Not the time.  If it's OK, then continue.  
    22. Word list -- noticing the reactions to 30 words -- write down any words that you notice reactions to and the reactions if you wish -- body sensations, especially, but also the rest of the list.  Again, we're not trying to explore any areas of trauma, but if you parts are willing, to understand a bit more about your internal world, your inner experience.  
      1. School
      2. Love
      3. Body
      4. Not being seen or heard
      5. Playground
      6. Loneliness
      7. Arguing
      8. Sickness
      9. Alcohol, Drugs
      10. Fear
      11. Safety
      12. Chaos
      13. Sex
      14. Escape
      15. Mom
      16. Help
      17. Shame
      18. Protection
      19. Pain
      20. Distress
      21. Trust
      22. Dad
      23. Wound
      24. Abandonment
      25. Abuse
      26. Sadness
      27. Nothing
      28. Guilt
      29. Anger
      30. Survival
      31. Any other words or images or thoughts or anything else in your experience.  
    23. Gratitude.  
 
  1. Future Directions -- where we will be zeroing in
     
    1. This episode was bringing to you the conventional secular understandings of trauma.  But there are two area in the secular conceptualizations of trauma that really warrant much deeper exploration.  

    1. Physiological or bodily response to trauma -- that's the next episode, episode 89
       
      1. Not just about memories -- not just about psychology
         
        1. Trauma involves the whole person.
           
          1. Trauma victims cannot recover until they become familiar with and befriend the sensations in their bodies. Being frightened means that you live in a body that is always on guard. Angry people live in angry bodies. The bodies of child-abuse victims are tense and defensive until they find a way to relax and feel safe. In order to change, people need to become aware of their sensations and the way that their bodies interact with the world around them. Physical self-awareness is the first step in releasing the tyranny of the past. Bessel Van der Kolk  




    1. So much happens in our bodies with trauma -- and so much of that is beyond our capacity to control by sheer willpower in the moment.  
      1. “PTSD is a whole-body tragedy, an integral human event of enormous proportions with massive repercussions.” 

― Susan Pease Banitt
  1. The Body Keeps the Score -- by Bessel Van der Kolk
  2. Polyvagal theory -- Steven Porges.  Recovery
  3. “We cannot outrun our past trauma. We can’t bury it and think that we will be fine. We cannot skip the essential stage of processing, accepting, and doing the hard, yet necessary trauma recovery work. There’s a body-mind connection. Trauma can manifest itself into chronic physical pain, cancer, inflammation, auto-immune conditions, depression, anxiety, PTSD, Complex PTSD, addictions, and ongoing medical conditions.” 
― Dana Arcuri
  1.   Common treatment modalities -- EMDR and other ways of treating trauma
  2. Then we will get into an Internal Family Systems approach to trauma -- episode 90
  3. Then we will bring all this groundwork on trauma together to address the spiritual dimensions of trauma
     
    1. Really neglected area
  4.  
    1. So important.  How trauma impacts the spiritual life.  

 
  1. You are a listener to this podcast, and in that sense, you are with me.  I am also with you!  Remember, can call me on my cell any Tuesday or Thursday from 4:30 PM to 5:30 PM for our regular conversation hours.  I've set that time aside for you.  317.567.9594.  (repeat) or email me at crisis@soulsandhearts.com. 
  2. Time is running out -- opportunity available only until January 15.
     
    1. The Resilient Catholics Community at Soulsandhearts.com/rcc.  So much information there and videos.  

    1. How did you respond to that experiential exercise?  What did you learn?  Was that interesting to you?  Can you see the potential for doing more of that kind of work?
  3.  
    1. I want to invite you to the Resilient Catholics Community
  4.  
    1. The Why of the RCC --  It's all about loving with your whole heart -- all of your being.  Getting over all the natural level issues that hold you back from tolerating being loved and from loving God and others.  It's all about your human formation, informed by Internal Family Systems and grounded in our Catholic Faith.  

    1. If you really are into this podcast, if these ways of conceptualizing the human person and integration and human formation and resilience are appealing to you, then the Resilient Catholics community, the RCC may be for you.  

    1. What of the RCC
       
      1. $99 nonrefundable registration fee gets you The Initial Measures Kit -- which generates a 5 page report, all about your parts
    2.  
      1. Weekly premium Inner Connections podcast, just for RCC community members --Lots of experiential exercises.  

      1. A complete course for working on your human formation 44 weekly sessions over the course of a year for $99 per month subscription
    3.  
      1. Check it out -- discernment Process
    4.  

    1. The When of the RCC
       
      1. We open twice per year, next time will be in June 2022, --we've extended the enrollment as far as we can, until January 15.  We are open now.  Soulsandhearts.com/rcc to register. 

      1. Call me with questions!    317.567.9594.  (repeat) or email me at crisis@soulsandhearts.com. 

      1. So sign up Soulsandhearts.com/rcc. Waitlist if you get this after January 15.  


 
 

What is Interior Integration for Catholics?

In the Interior Integration for Catholics podcast, together, we seek fundamental transformation in our lives through human formation, via Internal Family Systems approaches grounded in a Catholic worldview. Join us as we sail through uncharted waters, seizing the opportunities for psychological and spiritual growth and increasing resilience in the natural and spiritual realms. With a clear takeaway message and one action in each weekly episode, you can move from dreading what is happening to you to rising above it. Join us on Mondays for new episodes. You can also check out the Resilient Catholics Community which grew up around this podcast at soulsandhearts.com/rcc.