It’s a mixed bag. Transforming the Living Legacy of Trauma: A Workbook for Survivors and Therapists has some profound insights – and also some frustrating perspectives that aren’t consistent with other works and without research cited. It makes it difficult to know which things are true, and which are not.
Thirty Years Ago
“Thirty years ago, it was thought that traumatic experiences could be healed when the secrets were finally revealed and the story of what happened was told to a safe, validating witness. However, contrary to what we believed then, that process often made the traumatic effects worse instead of better.” It’s my first highlight from the book – and it’s wrong. While I understand the intent – and there are aspects of truth to it – it’s not consistent with what we know about trauma today.
First, the truth is that forcing people to relive a trauma, particularly in ways that don’t feel safe (or safe enough), absolutely does do more harm than good. It tends to reinforce the trauma and make it worse. It’s one of the big reasons why, I believe, CISM doesn’t work. (See Opening Up for more on CISD/CISM.)
However, the work of James Pennebaker and others shows that the process of organizing the trauma in our minds (through writing the story) has a healing effect. (See Opening Up.) Peter Levine in Trauma and Memory speaks of the processing that converts implicit to explicit memories and essentially how this is a storytelling process.
This is at the heart of my concerns with the book. Some of the statements have a kernel of truth to them, but they don’t have the clarity necessary for someone to discern what is good and what is bad.
For instance, another challenging statement is, “Doctors, nurses, and EMTs all rely on adrenaline to do their jobs well, as do most peak performers.” It directly contradicts the work of Anders Ericsson and Robert Pool in Peak and is inconsistent with the high-performance state of flow. (See Flow and Finding Flow.) Steven Kotler in The Rise of Superman acknowledges the desire for adrenaline but also is careful to explain that too much is a problem.
Similarly, comments like, “Restricting food intake puts the body into a neurochemical state called ketosis, creating a numbing effect but also a boost of increased energy,” show an ignorance of medical information. Ketosis is the reduction of carbohydrates, not food. It causes the body to derive energy by burning fat – which is why most people indicate a loss of energy as they transition into ketosis. There’s no evidence of “numbing” in the sense it appears to be used here. Numbness and tingling is a side effect of the transition, as there is lower blood sugar and lower blood pressure (generally).
Fisher acknowledges that MacLean’s triune brain model is mostly considered out of date by scientists but continues to use it for its utility. I take no issue with that, because it’s a simple model that helps the reader conceptualize three parts of our brain. It’s useful as a way of understanding our neocortex is often being used to dampen (or amplify) the responses from the more primitive structures of our brain.
However, a bit more concerning is the insistence on using a left-right hemisphere model of describing the brain beyond what is still supported by science – without identifying that it’s a simplification. There’s hemispheric structure to the brain and the corpus callosum does connect the two sides; however, we’ve learned that various parts of the brain operate in concert to achieve what we believe is a single thing.
For instance, generally people believe that speech comes from Broca’s area. Broca’s area seems to handle syntactic structure, but Wernicke’s area is more focused on meaning. Damage to either area impairs the ability to speak. Wernicke’s area occurs in both hemispheres of the brain with slightly different uses. Many of the tasks that we take for granted happen in multiple areas of the brain.
Understanding the Process
Fisher explains that her mentor, Judith Herman (who wrote Trauma and Recovery), insisted that what trauma victims needed was education about trauma, including its ramifications and manifestations. I’d expand this to say that they need to know what to expect. By knowing what to expect in the processing of trauma, they don’t have to be afraid of it. They don’t need to be concerned that their trauma will leave a lifelong limitation. While Herman reportedly wanted patients to make intelligent choices, I believe it’s more than that. It’s about being able to be calm and feel relatively safe through the process. When you know what to expect, it’s safer.
Trauma as Being Forced
Fisher proposes a different definition for trauma, which is, “trauma is the experience of being forced to do what others want.” Certainly, it can be traumatic to do what others want. In the context of Herman’s work in domestic abuse, this can be true. However, as a broader statement, it doesn’t define trauma. At a broader level, the kind of trauma being discussed here impacts the person personally – causing physical injury or at least a constriction of freedom. It also forces us to confront our belief that we’re in control of ourselves. (See Who Am I? and The Righteous Mind for more.)
Shame and Self-Blame
“But remember that shame and self-blame shut down the prefrontal cortex and diminish the capacity to learn.” Yes, but that’s not the primary mechanism. The primary mechanism is fear. The spinning neurochemicals cause memory to encode differently – and generally in ways that’s harder to recall consciously. (See The End of Memory and Trauma and Memory for more about memory encoding and recall.) Of course, Brene Brown has made a career of studying shame, and it’s certainly a noxious self-concept. (See Daring Greatly.) Self-blame, which Brown might call “guilt,” can be instructive when we move from the blame to the behavior change that will prevent the outcomes in the future.
Buddhists speak of the story of two darts. The first dart is the pain. The second dart is our, often maladaptive, reactions. That’s one of the reasons that Buddhists and other contemplative (meditative) practices encourage acknowledging thoughts and then letting them go or getting curious about them. Rather than being self-punitive for failing to meditate “properly,” we can either release the thought or follow it – if it doesn’t lead to rumination.
Sometimes, the experience we find ourselves in is binding – and sometimes less so. A person can make belittling comments to their spouse, but unless the spouse accepts these comments (at any level), they’ll have no effect. It is as if the first dart missed its intended target. (See my review of Rising Strong (Part 2) for more about catching the darts in mid-air.)
Conversely, someone who is concerned about their ability to support themselves financially may accept abuse from their spouse, because they feel as if they have no other options. Not only does the first dart hit, but they launch the second dart at themselves by amplifying the impact. They take it to heart that no one else would love them and they’d be nothing without their spouse. (See Terror, Love, and Brainwashing for more.)
More than the Trauma
Ultimately, recovery comes in the form of reestablishing ownership of our mind and body – that is, the belief that we’re in control of ourselves. Fisher incorrectly quotes van der Kolk from The Body Keeps the Score but with a similar meaning. Van der Kolk’s words are, “The challenge of recovery is to reestablish ownership of your body and your mind—of yourself.”
Practically, this recovery means accepting that you’re more than the trauma and even the outcomes of the trauma, including loneliness and suicidality. (For loneliness, see the book Loneliness. For suicidality, see Loving Someone with Suicidal Thoughts.)
In the end, I can’t recommend reading Transforming the Living Legacy of Trauma – unless you’re willing to carefully challenge what you’re reading with the hope of sharpening your understanding.