Fall always reminds me of the work I do with clients in therapy. They come to me as trees full of leaves. Heavy and weighed down. They are all searching for a way to release some of this long carried weight. Letting those leaves they have carried for so long fall away.
For a good portion of their lives they have carried these leaves representing the baggage of their past everywhere they go. Into every decision, response, relationship the leaves go with them. The weight is heavy and at times overwhelming but they cannot seem to rid themselves of these ever clinging traumas.
When clients come to therapy, they talk about how these leaves cling to them and nourish the fears, anger, sadness, and negative thoughts that grow and blossom each day. The leaves continue to feed their ever growing tree of trauma. They have become used to the weight. They are accustomed to how they look when the leaves are full and on display for all to see. They are comfortable with how it envelopes them mind and body.
But it is so heavy. It is so hard to carry on with daily life when weighed down by depression, anxiety, anger, judgment, and fear. Every action, every decision becomes just that much harder. There seems to be no escape no matter how much they may want to let their leaves go. The negative thoughts keep the leaves bound to them.
As they work through these traumas and begin to acknowledge them for what they are and where they started, the leaves start to drop off. At first, maybe it is just one small leaf. The process moves slowly. The leaves start to lose energy, change, and have less power to hold on to them. The leaves become less nourished and start to wither.
As more work is done and more understanding is gained, the leaves lose their vibrancy and turn darker and become less noticeable. They have far less power over responses and actions. The thoughts become quieter and less invasive. They start to realize they no longer need this heavy covering of weight. And they start to fall off slowly, slowly.
The traumas fall away becoming only remnants of their former selves. Yes, they were there and happened, but their power over them is lost. They can be let go. They are no longer needed. They no longer need to fear them.
The leaves drop off becoming dead, crunchy and returning to the soil in which they were made to be reborn in spring as new life. Traumas falling away being absorbed back into the universe and becoming the catalyst of change for them. The leaves they regrow as they change are lighter, beautiful, and nourishing to new life. To their new life.
This is hard work. Shedding old life to birth new. It requires great energy and constant attention. It requires releasing that which is no longer needed in favor of that which renews.
This is how I see therapy, good therapy in which the client is invested in change and willing to do the work required. The falling away of all that has weighed them down body, mind and spirit and the investment in growing that which is uplifting, empowering, and transforming.
Earlier this week, I read an article that broke my heart. In one of the high schools in the state where I live, they reported that seven students have lost their lives to suicide since May of 2020. Seven lives that are no longer with us. And this is just one high school that has reported numbers. I feel that there are probably quite a few more.
This is not an article to blame Covid for yet another thing. It is very likely that most of those who have taken their lives since Covid began were struggling well before that with depression, anxiety, trauma or some other mental health issues. It is unlikely that Covid was the only reason for their feeling they had reached the end of their ability to go on. Although, there may be some for which that is true. It is impossible to know.
What I do know from data I have seen reported all over the country is that the impact of Covid has pushed many with mental health issues over the edge. For some, it is quite possibly the last straw. And I am not talking about the illness of Covid as much as the surrounding fear, isolation, increased depression, lack of normalcy and chaotic changes.
Covid especially for school age individuals has caused periods of isolation, sometimes long periods of isolation from friends and a normal routine. It has caused a huge increase of fear and possible loss of loved ones. It has increased depression through these things. The constant changes of what is going on with Covid, with schools, with jobs, with family and friends results in a large amount of increased anxiety. And the feeling that this may never end adding to the already present thoughts of nothing ever changing for the better.
When taken together, the many things that surround Covid may be considered as the last straw. The situation that has pushed people over the edge. The thing that has increased suicidal thoughts and ideation. Again, it is not the only thing and these thoughts and ideation did not start in 2020 for most, but they were likely increased.
The other thing I have noticed is that while much attention is being paid to Covid and illness and health care and vaccines, much less attention is being paid to mental health issues. While schools are focused on masking, vaccines, quarantining, and mitigation of illness, they are far less focused on addressing the mental health of their student population nor have they been throughout this crisis.
My school age clients report that during the many months of remote learning, no one called or checked in from the school on their mental health. They were only concerned with academics. No one asked if they were depressed or anxious. No one asked them about suicidal thoughts or plans except for me. Imagine how many more school aged children were out there not going to counseling with no one to ask them these questions.
Of course, it is not only school age children who had an increase in suicide through this crisis. Many people did of all ages. Mental health was never high on the priority list of any organization or government entity and it still is not sadly.
When you talk to people about how they are handling Covid, why not ask them how they are feeling. Ask them how this has all affected them emotionally. Ask them how they are coping with the things they have to go through with this crisis. Ask them if they need help.
If you or someone you know is struggling with suicidal thoughts or intent, please seek help or help them to find help. Reach out for counseling services. Call the National Suicide Hotline at 1-800-273-8255 or text the Crisis Text Line at 741741 both available 24/7. Find out resources in your community and have them handy for referral to those in need. Check in on the mental health of those around you, it could be just what someone needs to keep going.
As a clinical counselor, I would estimate that 95% of the clients I see have experienced some kind of trauma in their lives. And that 100% of those clients would like their trauma to be “fixed”.
Trauma cannot be fixed. It can only be lived with, better.
As soon as I tell clients that there is no way to “fix” or get rid of or not be affected ever again by their trauma, they generally make one of two decisions.
They get upset and decide that I am a terrible therapist and that surely there must be one out there who can “fix” them or that therapy is bogus and they are never trying it again and they do not come back to see me again OR they decide they are willing to try to live better with their trauma.
You can remove trauma or at least obliterate it from memory. One way to do that is to have a lobotomy. Another way to do it is to undergo ECT (electroconvulsive therapy) or shock therapy. Hypnosis can make you “think” you have removed trauma, but it only replaces it with another thought or reaction.
Otherwise, trauma remains part of who we are, forever. It can control our thoughts. It can control our actions and reactions. It can control our lives.
If we allow it to do so.
Or we can gain control over our trauma and learn to live BETTER with it.
Step one, acknowledging and confronting all of our traumas. Knowing them. Being able to name them, talk about them, and recognize how they started. We must truly understand what our traumas are in order to learn to better live with them.
Step two, we must learn and accept how these traumas now control our lives. What emotions do they make us feel, what beliefs have they created in our minds, how do they affect our relationships with others, how do they affect our relationship with ourselves? Recognizing that how we live with trauma is how we live our entire lives. Every aspect of our lives.
Step three, we must work to change negative beliefs, emotions, choices, actions, and reactions. We must work to replace these with positive. We must work to confront these with the truth instead of the trauma-informed lies. We must consistently, constantly with every single one apply repetition and reinforcement to live better with our trauma.
It is exhausting work.
And this is the point where those who have chosen to stay at work to live better with their trauma start to reconsider. In the world of quick fixes, instant gratification, change at blinding speed, the work required to change our trauma-informed life can seem overwhelming. And many will give up at this point feeling that it is too hard and that living the way they have always lived is easier.
But it is not easier, it is just comfortable, familiar.
Those that stay after this point come to understand that by doing this work they can live better with their trauma — despite their trauma. As survivors.
Living better means having positive beliefs about yourself. Living better means having more positive emotions than negative in relation to your trauma and your life.
Living better means making more positive choices because you want to make them not because your trauma-informed lies direct you to make them. Living better means having positive actions and reactions based on what you truly want for yourself not what your trauma-informed lies tell you that you deserve.
Trauma cannot be fixed. As a therapist, I do not have a magic wand. What has happened to all of us happened, it cannot be erased.
It can be lived with — BETTER — with work, with understanding, with love for yourself.
Trauma creates change you don’t choose. Healing creates change you do choose. ~ Michele Rosenthal
In the years that I have been a clinical counselor, I have come to believe based on observations of the clients I have seen and people that I know personally, that well over 90% of the American population has had some sort of trauma in their lives.
Some trauma is fairly self explanatory and easy to recognize such as physical or sexual abuse. Some trauma is not so easily defined, such as verbal or emotional abuse. But they can all inflict traumatic memories and negative beliefs on those who receive them.
When I start seeing clients I will often times give them an assessment to briefly assess their traumas. It doesn’t cover everything, but it gives a good idea of a starting place for therapy.
This assessment is called the ACES test or Adverse Childhood Experiences. This assessment does not assess stressors outside the household such as violence, poverty, isolation, etc.). Something I feel that was left off of the ACES is death or loss of loved ones. This can be a huge trauma for children. It does not take into account any protective factors and it does not differentiate meaning not all people with high ACES scores will have a poor outcome and not all people who have zero ACES will have a positive outcome. It is an indication of greater risk of a poorer outcome and trauma responses.
The following is the ACES assessment:
Prior to your 18th birthday:
Did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt? No___If Yes, enter 1 __
Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured? No___If Yes, enter 1 __
Did an adult or person at least 5 years older than you ever… Touch or fondle you or have you touch their body in a sexual way? or Attempt or actually have oral, anal, or vaginal intercourse with you? No___If Yes, enter 1 __
Did you often or very often feel that … No one in your family loved you or thought you were important or special? or Your family didn’t look out for each other, feel close to each other, or support each other? No___If Yes, enter 1 __
Did you often or very often feel that … You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it? No___If Yes, enter 1 __
Were your parents ever separated or divorced? No___If Yes, enter 1 __
Was your mother or stepmother: Often or very often pushed, grabbed, slapped, or had something thrown at her? or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? or Ever repeatedly hit over at least a few minutes or threatened with a gun or knife? No___If Yes, enter 1 __
Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs? No___If Yes, enter 1 __
Was a household member depressed or mentally ill, or did a household member attempt suicide? No___If Yes, enter 1 __
Did a household member go to prison? No___If Yes, enter 1 __
Now add up your “Yes” answers: _ This is your ACE Score. A higher score in multiple studies has shown links to increased negative mental and physical outcomes as well as increased negative social outcomes. The website Got Your ACE Score? has multiple links to studies and many charts that lay out the possible effects of a higher ACES score.
Resilience on the other hand may help those with higher ACES scores combat negative outcomes. A secure early childhood is helpful for future living but not always absolutely necessary if one has a higher resilience. Again, this is very individual dependent and definitely not true for everyone.
1. I believe that my mother loved me when I was little.
Definitely true Probably true Not sure Probably Not True Definitely Not True
2. I believe that my father loved me when I was little.Definitely true Probably true Not sure Probably Not True Definitely Not True
3. When I was little, other people helped my mother and father take care of me and they seemed to love me.Definitely true Probably true Not sure Probably Not True Definitely Not True
4. I’ve heard that when I was an infant someone in my family enjoyed playing with me, and I enjoyed it, too.Definitely true Probably true Not sure Probably Not True Definitely Not True
5. When I was a child, there were relatives in my family who made me feel better if I was sad or worried.Definitely true Probably true Not sure Probably Not True Definitely Not True
6. When I was a child, neighbors or my friends’ parents seemed to like me.Definitely true Probably true Not sure Probably Not True Definitely Not True
7. When I was a child, teachers, coaches, youth leaders or ministers were there to help me.Definitely true Probably true Not sure Probably Not True Definitely Not True
8. Someone in my family cared about how I was doing in school.Definitely true Probably true Not sure Probably Not True Definitely Not True
9. My family, neighbors and friends talked often about making our lives better.Definitely true Probably true Not sure Probably Not True Definitely Not True
10. We had rules in our house and were expected to keep them.Definitely true Probably true Not sure Probably Not True Definitely Not True
11. When I felt really bad, I could almost always find someone I trusted to talk to.Definitely true Probably true Not sure Probably Not True Definitely Not True
12. As a youth, people noticed that I was capable and could get things done.Definitely true Probably true Not sure Probably Not True Definitely Not True
13. I was independent and a go-getter.Definitely true Probably true Not sure Probably Not True Definitely Not True
14. I believed that life is what you make it.Definitely true Probably true Not sure Probably Not True Definitely Not True
How many of these 14 protective factors did I have as a child and youth? (How many of the 14 were circled “Definitely True” or “Probably True”?) _______Of these circled, how many are still true for me? _______
Many people have had at least one trauma in their lives and many more have had traumas that are not listed on this assessment. As stated, this is just an early assessment that can offer a lot of information about how someone has experienced trauma and if they also had any resilient factors in their lives.
Trauma, unprocessed, continues to affect us on a daily basis whether we know it or not. It affects how we think, feel, and respond in every situation of our lives because it has instilled beliefs in us about ourselves that are almost always negative. It affects how we live, love, and work. Trauma doesn’t go away because we think we ignore it. It doesn’t go away because we get older and more distance from it. We carry it around in our brains because the brain records everything and then it flings it out at us again and again.
If you have unprocessed trauma, I highly encourage you to find a counselor to talk about it and process through it. Doing so could make all the difference in your life.
I often have clients ask me the question, will I always be affected by my past traumas? The answer is yes and no.
The answer is yes because there are only a few ways to completely remove memories from the brain that I am aware of. Lobotomy. ECT (electroconvulsive therapy) possibly. And the controversial memory manipulation therapies that have been used to change memories or even implant new, false memories.
There is also research that has been done in the past and that is being done now on the drug propranolol (used to manage high blood pressure) and controlling the emotional response in trauma survivors. It does not erase memories. It changes, sometimes dramatically, the brain and body’s response to painful or scary memories. However, taking this drug every day if you do not have high blood pressure is not generally recommended. Some people do already use it for panic attack inducing situations taken before participating in those situations so that it allows them to get through them without panic.
None of these removal processes sound particularly good, which leads to the memory of trauma will always be present in the brain. However, how that memory affects us can be changed.
The answer is no in that traumatic memories can be acknowledged and confronted. They can be understood and accepted. They can be processed and minimized in their effects. Several therapies can be utilized to help trauma survivors live better. EMDR is used to reprocess the brain’s response to traumatic memories. Hypnosis has also been used to retrain the brain. CBT is used to change how people think about themselves and their experiences. And other therapies that reduce emotional response to traumatic memories are also used.
As I tell my clients, it is not the memory or the experience that continues to affect them throughout their lives, it is their emotional response to those things that drive their behaviors, choices, thoughts, beliefs, etc. The memories make them FEEL fear, sadness, anger, worthlessness, doubt, and more that then translates in a response in the brain that moves through the body and becomes manifested in actions, thoughts, beliefs.
The hardest thing for my clients to hear is that I cannot eliminate their trauma memories. That we must find a way through them. To find a way to live better with them. It is at this point that clients either decide they are willing to try to do that or they are not and they stop seeing me and keep searching for a way to remove the memories.
I wish I had a magic wand and could make all the horrible things that have happened to people disappear. But I do not. But you can find a way to live better even with the memories.
It is hard work. It is not comfortable. It is a daily process of choosing to live differently. But it is possible.
Trauma creates change you don’t choose. Healing creates change you do choose. ~ Michele Rosenthal
The more time I spend working in the trauma-focused world of counseling, the more I realize codependency is far more widespread than previously thought. Especially traumas that are experienced in childhood, which makes sense as that is where everything is set for future behaviors, beliefs, and choices.
Codependency most often stems from a childhood that contains either physical/sexual abuse, witnessed domestic abuse, addiction in parents, lack of parents, neglect, parents with mental illness, emotional abuse or any combination of these. Codependency also occurs if the child has no parents especially mothers in their lives.
The child will develop beliefs about themselves and an absolute need to try and contain, control, or cover up the situations they find themselves in. All while desperately wanting to maintain the relationship so their parent will love them or at the very least acknowledge them in some way.
The child will spend every waking moment trying to make sure the parent is okay or in their minds “happy.” If people are happy they won’t take their unhappiness out on them. They also spend their lives being small adults caring for parents who cannot care for themselves. Cooking, cleaning, providing alcohol or drugs, doing what the parent wants no matter what it is to keep them happy, taking care of siblings.
Always, always, seeking love from the parent, approval, even just being noticed is enough to keep the child repeating the cycle.
Through this behavior, the child develops a very low self-image believing they are not worthy of love. They develop poor boundaries and in many cases no boundaries. There is a constant need to save others or make others happy. They never consider what they need or want. There is a constant need for perfection so that they might be lovable. And an absolute need for control over anything that they can control because life with their parent is always chaos.
All of these things become set inside the child between birth and age 7. After this, these beliefs, behaviors, and choices become solid in the psyche and they are then seen as “normal” and they are not questioned. They are just repeated and repeated throughout their lives in every single relationship they have.
They seek out relationships with those who need saving. They never consider what they want or need or how they feel. Every relationship is the one they had with their parent or the one they didn’t have with their parent because the parent wasn’t there. They control their children’s lives because they couldn’t control their parents. They never say no in relationships because they need the other person’s approval for their own self worth.
Codependency can be extremely hard to change because by the time someone seeks out help it has been their norm for years and years. They have no concept of self-love or self-care. Boundaries are a foreign concept. Being alone is an all consuming fear. Children will always want their parent to love them no matter what the parent has done even when they are no longer children – it is genetic.
Learning to say no is one of the most important things codependent people can do to begin to set boundaries with others. Understanding the difference between saving people and supporting them without enabling their behaviors. Self-care and self-love are absolutely necessary to breaking the chains of codependency. Knowing that they have worth in themselves and do not need others to provide it for them.
Counseling can help codependent people see things more objectively and offer ways to start to change. The biggest thing that keeps people from letting go of codependent behaviors is fear. Counseling can help process through this fear and open the road to moving forward. Reaching out for help can be the first step to change.
For many trauma survivors, the illusion of control provides a way to feel control so that they balance out feeling out of control when memories, flashbacks, and emotions of their past traumas surface. If they can control as much as possible about their daily lives it can appear to them that they are no longer out of control as a result of their traumas. The more control they have the better able they are to avoid the distress that comes with facing their traumas as described in this study Perceived Control and Avoidance in Posttraumatic Stress.
Many times a trauma survivor will seek out anything they think they can control in order to avoid the distress of their trauma history. The illusion of control is defined as “The illusion of control is the tendency for people to overestimate their ability to control events; for example, it occurs when someone feels a sense of control over outcomes that they demonstrably do not influence.” Many times people with trauma history will feel they can control everything around them and even convince themselves that the control they think they have is real.
If they can hold on to this belief that they are in control, then they do not have to confront the loss of control they feel when they relive their traumas. Even if they believe they control one thing, it is better than feeling as if they control nothing. This control can take many forms and some of them can be very destructive.
Self-harm is a classic trauma control. If someone is cutting, they are in control of the release of their pain. If someone is controlling their family members lives and choices, they are in control of trying to make their life different from what it was during their traumas. If someone is enforcing their control of themselves with drugs and alcohol, they diminish the emotions of their trauma.
The other side of control is avoidance. If someone can feel as if they are in control they can avoid confronting their traumas and the emotions that go with them. The very ways that they exercise control can be avoidance. For many trauma survivors, avoidance is automatic. They would do anything to not have to experience the emotions that come with remembering and talking about their traumas.
The illusion of control can seem very real, but it is false no matter how one might try to convince themselves otherwise. The illusion of control can seem to be real for a long time, years even, but there are points where it is evident that it is not and there will come a time it will not hold in the face of the emotions of trauma. These times usually come when their are anniversary dates involved with traumas, when flashbacks and memories occur, when someone engages in therapy, or when nightmares surface.
The illusion of control is only a covering, like a blanket of snow that remains for a while but eventually starts to melt, have holes, and disappear completely.