What is Trauma?: When the Bear Follows You Home
I was recently camping in the Jemez Mountains outside of Albuquerque, New Mexico with my partner, Lindsey, and my foster dog, Micah. We had settled into our campsite, sitting by the fire as the flames danced hypnotically before us, hissing and crackling, launching sparks high towards the tree tops and darkness above us where a black moonless sky sparkled with stars that are never seen by city-dwellers. We were eagerly awaiting a dutch-oven full of lasagna while the sweet and spicy smelling arrabbiata tomato sauce audibly boiled in the large black iron pot that sat supported and covered by glowing charcoal briquettes next to the fire.
It was then, nestled comfortably in our reclining lawn chairs, that we heard it coming from the darkness of the field that lay between us and the road where we parked our car: deep, bellowing groans and pants; sounds that we both immediately and instinctively knew were of non-human origin. Earlier in the day we had passed a campsite that had been closed due to the activity of a certain animal. So when my partner, Lindsey, uttered the name for what was lurking in the darkness and for the reason that both of our stomachs had dropped to our feet, I knew she was right..."Demian", she said, "that's a bear".
When it really hit me that what was out there was in fact a bear, I had a series of internal reactions (some of which I noticed in the moment and some in retrospect): I felt very faint and dizzy, my heart rate became noticeably stronger and faster, my breathing became more shallow, time felt subjectively slower and I felt highly attuned to my sense of sight and sound. If someone had been measuring the process in my body, they would have seen a spike in adrenaline and cortisol, among other things. And then there were the thoughts...or should I say the thought, which literally was, "we might die right now". For several moments, maybe several minutes, my body was reacting and my mind was perceiving that there was a potentially life-ending danger.
At the risk of being anticlimactic, I will only say that we scared the bear away and came out of the situation with no harm to ourselves or the bear, who most certainly was foraging for food in his home in which we were intruding. It's also worth stating that although the rangers and other campers whom we told about the bear appeared to shrug their shoulders at the smallness of the situation, Lindsey, Micah and I have never encountered an apex predator outside of a zoo. We were caught off guard, inexperienced in this sort of matter and nowhere near the safety of our vehicle. We had only ourselves, our wits and a tent, which we felt most assuredly was nothing but a tortilla to a hungry bear for which we would have been the beans...
The feelings that I describe above are not trauma. In fact, those emotions, sensations, bodily chemical reactions and even the thought that I may die, are a very healthy, very necessary response to a perceived threat. Without them, we cannot survive. In a less intense context, consider what life would be like if you didn't feel fear, even in subtle ways like when you do what your mom told you to do your entire childhood and "look both ways before you cross the street, honey". Life would likely be very short, right? Feeling fear and our ability to perceive dangers in our environment have kept us as a species (and a rather physically fragile one at that) alive for hundreds of thousands of years. Did you know that our brain is a kind of "biological buffet" where certain parts of it have been selected based on different needs over time? One of the oldest parts of the brain, the limbic system, is where emotions like fear reside, and basic survival instincts in general. Anxiety and fear serve a huge purpose...they keep us alive!
So if me seeing a bear, feeling all of the emotional and bodily sensations described and having the thought "we might die" is terrifying but healthy and not trauma, what is trauma? Let me answer with another scenario: Let's say that months after the camping trip, I am at work and have decided to pop down to buy myself a coffee at the cafe on the 1st floor. I am taking the stairs which are dimly lit and I hear something scrape on one of the darkened lower stairwells. That scraping sound may simply be another person exiting the stairwell but I do not know that and unconsciously, the sound reminds me of the low, muffled panting and growling sound that has been residing in the back of my mind ever since the trip, and then it happens: I feel dizzyingly faint and like all the contents of my stomach have just disappeared and left in their place complete emptiness. Then, I notice that my heart begins to pound as though it were going to burst out of my chest. Accordingly, my breathing becomes shallow and at this point I know for sure: I am afraid for my life again! I run back up to the stairwell door for my floor but it's locked. Maybe I finally do faint or maybe I curl up into the corner and put my head beneath my arms and in between my legs...There I wait...It seems like forever until someone opens the door and I am able to get back into my office where I know I am safe.
This is an example of a trauma-reaction. I may logically know that there are no bears stalking me amidst the professional offices, quaint eateries and coffee shops of the high rises in downtown Albuquerque. But, there is a part of my mind and of my body that have been fear-conditioned to associate any remote sound, sight or smell in the environment or even any emotion or sensation in my body with that moment in the woods where I felt and thought that myself and my loved ones may perish that very night. It may even be the case that I experience these symptoms and not even know that they are related to my night in the mountains. A very important role that our primitive, survival system plays in our lives is creating memories so that we might avoid danger (remember a time that you burned yourself? Your mind now associates pain with that hot surface so that you don't burn yourself again) but with trauma, that healthy fear and valuable memory-system begin to over-apply themselves, even when there is no actual danger in the environment. More philosophically, it could be said that a part of me remains trapped back in time, perpetually stuck in the darkness, mired in that moment of fear, overwhelm and chaos.
Where a person that has not experienced trauma may experience a sight, sound, smell, emotion or sensation in the body and know that it is not a threat, a person with trauma may consciously or unconsciously become wrought with anxiety, sadness, anger or guilt.
This may be why those who have never experienced trauma do not understand when someone they care about gets triggered from their trauma and goes into a deep state of anxiety, sadness, anger, shame or guilt at what appears to be a harmless situation like a loud noise or a certain smell. In the trauma example above I mentioned the feelings in my body like my heart and my breathing; these too have become as much a potential trigger for my trauma-reaction as was hearing the low, muffled sound in the stairwell. I want to also make the point that the human experience is subtle, complex, emotionally-based and that humans are biologically, from the ground up, made to be social beings that are defined by the people in their lives and by their relationships with those people. So, when someone has trauma from a relationship with their spouse, their parents or childhood, or has sexual trauma, their triggers for trauma-reactions can be things like emotions, sensations in their bodies, being touched on specific body parts or certain words and vocal tones. You can see that even subtle behaviors by a loved one or even feelings in a person's own body can then begin to relentlessly stalk and terrorize the person with trauma, day in and day out.
Trauma expresses itself within us in so many ways: substance-use issues, patterns of painful relationships, depression and isolation, anxiety and panic attacks, an inability to trust and feel close to others, guilt and self-recrimination, chronic back, shoulder and neck pain...and sometimes, suicide or other attempts to hurt ourselves. Trauma is likely the root cause for soldiers returning home who engage in substance misuse or even attempt to kill themselves. As a public health issue, undiagnosed trauma costs societies billions of dollars per year in medical, legal and occupational settings. The trauma-informed care movement is relatively new to the medical field. And I can't convey how lacking society in general is at understanding trauma and how not to worsen the symptoms of people with trauma. Consider veterans that feel intense anxiety around the 4th of July or the many times I have been working with a client that was forced to discuss her traumatic event with the police or a family member and then went into a full blown traumatic reaction.
What's the bottom line? Never assume you know what someone has been through and recognize that every one of us has or own way of processing pain and fear. Trauma is not a choice but through awareness, courage and perseverance it can become manageable and even help us grow. Please remember that behind every smiling face and every tear that is shed lies an invisible story rich with meaning that yearns to be heard. Some of us just need someone to listen a little more gently, a little more attentively and a little more patiently.