Our thoughts on what is Post Traumatic Stress Disorder (PTSD) and the controversy over whether its diagnostic criteria cover what people call ‘trauma’.
“A bad thing happened – I didn’t want it to happen – nobody could stop it happening”
Survivor of American school shooting.
This is for me a very clear definition of trauma – something bad happens, we have no control over it and it changes us. The wounding is both the event itself and our response to it. Trauma comes from the Greek meaning a ‘piercing of the skin’; in physical medicine, it means a wound to tissue. Freud was the first person to use trauma as a metaphor for how the mind can also be pierced. Other psychotherapists define ways in which the psyche or self can also endure a traumatic wound. There are other simpler definitions – a loss of heart, self, trust or connection.
I believe in a compassionate and inclusive view of trauma as a part of the human experience. It heals through love, creativity and connection.
But before that, let’s start with the standard psychological model. The following is useful to know but remember that a psychiatrist diagnoses someone, not a counsellor or psychotherapist.
In the first month after a trauma, you can be diagnosed with Acute Stress Disorder if you have 9 named symptoms. Psychiatrists call ASD a normal set of responses to an abnormal event.
Many people recover from traumatic events with the right kind of support in this timescale.
This means someone trained in specific trauma therapy, not a general counsellor (that comes later). However, if you are still suffering from the ways set out in the DSM V manual after a month, you can be diagnosed with Post Traumatic Stress Disorder (PTSD).
What if there isn’t a diagnosis but it is still ‘traumatic’?
The diagnostic criteria for Post Traumatic Stress Disorder (PTSD) are very specific. Indeed, there is controversy over whether this covers what a lot of people working in the field would call ‘trauma’.
For example, would these narrow definitions include people who had been subject to ongoing abuse or neglect at the hands of their parents? Bessel van der Kolk is one of a number of specialists who would like this kind of complex relational trauma to be formally recognised by the medical profession; his book ‘The Body Keeps the Score’ makes a powerful argument in favour of relational trauma.
Working with complex relational trauma (repeated actual or threatened abuse from a carer) is an area where sandplay and other creative arts can really help both adults and children.
Why does a traumatic event affect some of us more than others?
Why do only some people who witness trauma go on to develop PTSD? What is it about them? Is there something missing in them, in comparison to those who feel the shock and move on with their lives? Many clinicians believe that a lack of proper maternal care makes us vulnerable to traumas later in life. Also, we don’t recover as well as people with a better attachment history. Often clients will come to counselling because of a later trauma only for the work to be all about their earliest parenting issues.
“Trauma is more often an absence than a presence. The idea here is that the absence of an emotionally receptive mother is a trauma for the infant and that this is the sort of disaster that may be passed from generation to generation. These traumas follow an individual line but then there are the massive social traumas like wars, epidemics, massacres and economic collapses that have devastating effects on the human spirit. Mothers caught in these social disasters are focused a hundred per cent for themselves and their babies. When survival is achieved it is often at the cost of the infant’s emotional wellbeing.”
Neville Symington Becoming a Person (2007, Karnac).
Working creatively allows all our traumas – especially the wounded child’s – to see, hold and integrate them in a playful and non-threatening way. It’s a gentle, loving way of being with really being present with someone in their pain. Our weekend course will introduce you to using sandplay, art, music and movement with trauma models to help build that connection. Your heart will do the rest.
Introduction to Working Creatively with Trauma™ weekend
Saturday and Sunday 6/7th March 2021 from 10 am to 4 pm online via Zoom Meetings
Certificate in Working Creatively with Trauma™
Starts 6th February 2021 from 10 am to 4 pm online viz Zoom Meetings
The cost of this trauma therapy training course is £1620 in total if paid before the first weekend. £1800 paid in instalments. We need £250 from the above amount as a non-refundable deposit at the time of booking. GO HERE TO BOOK or for more details email email@example.com or call 07932 694779.