Disclaimer: Names and details have been modified for confidentiality. The article below is brought to you with the full consent of the patient.
An impressive number of people have contacted me over the past few years in my capacity as a psychologist asking me to help them through a sticky situation. Some have come through the Counseling Center at the American Cathedral, others via a French public health network and others via their general practitioner or psychiatrist.
The patients I am referring to have had one thing in common: a work or personal dilemma with legal overtones.
Vanessa arrived for her therapy session huffing and puffing, plopped down into her armchair across from mine, and blurted out, “Am I going crazy or what? I am so tired.” She grabbed for a couple of pages in her purse and began reading her manifesto: “A cry for justice!” which she wanted published on Youtube.
I already knew, from her first session at the free drop-in clinic held at the Counseling Center at the American Cathedral, that she is not crazy. She is well-oriented, busy and functions both at work and in her closest relationships with her partner and children.
Yet she is overwhelmed and not everyone can understand her. Had she been in a car crash or a bank robbery, others would consider her a victim of trauma and would instantly comprehend and feel sorry for her. Everyone acknowledges the overpowering experience of unmistakable “big T” trauma like life-threatening events, natural disasters, sudden out-of-the-ordinary experiences which entail violence or physical injury.
The ordinary human response to danger is a complex ensemble of reactions of the body and the mind. Threat kicks off the sympathetic nervous system into arousal. Attention is focused on the immediate danger, perception of other needs is diminished and the emotions of fear and anger are intense. The person is ready to face the danger, to fight or to flee for survival. (SEE Judith Herman’s work, TRAUMA AND RECOVERY)
Vanessa’s situation, as traumatizing as it is, is ongoing and not so clear-cut. We could call this “small t” trauma. She is facing an ordinary, extremely unpleasant battle of everyday life. Water damage in her building made her apartment uninhabitable. She had to move out and find a lawyer, who indeed charged regularly and worked on her case irregularly. Vanessa had to change lawyers and move into public housing. It has been many years and she is still waiting for justice to be pronounced.
Gradually she is getting exhausted and depressed. Her body and mind are ready to fight, however the danger is not imminent. Instead she is continuously exposed to chronic and recurrent reminders of insecurity in her life.
From studies in the psychology of trauma, we know the basic goals we need to help Vanessa reach. In her psychotherapy sessions, our aim is for her to use, both inside and outside the office, these basic tools to rebuild her strength.
Some first stage objectives include:
- attain a minimum feeling of personal security in her relationship with the therapist
- find some calm and physical rest to reverse the physiological signs of threat
- assess the current situation rationally
- select specific actions she can successfully take now
- rebuild her sense of self-esteem
- reinforce her usual effective personal coping skills
- use her broad social, personal and medical resources
EMDR
Our work together aims to reverse her sense of helplessness, so that she can surpass the ordinary human response to danger.
How familiar are you with “small t” trauma and the best ways to overcome the danger?
Debra Berg, Bilingual Psychologist in Paris