I’ve had many first appointments with mental health professionals over the years, so I’ve had some time to learn the standard assessments that psychiatrists and other professionals are taught to give. It’s always very interesting to me how each person interprets this, and I’m always curious to see which symptoms are inquired about and which are ignored. For example, I’ve never been asked any questions related to dissociative symptoms, and the entire psychotic spectrum are sometimes forgotten as well. There are occasionally enquiries about trauma and these tend to be the most insensitive and unhelpful possible. I was once asked by a psychiatrist to rank each of my traumatic experiences in order of most to least traumatic. I explained that this was not possible, that I had more than one incident that was for me a 10/10. This particular doctor seemed quite irritated by this and explained to me that as my “life has been a train wreck” he had no interest in working with me. The feeling at that point was rather mutual. These kind of first appointments invariably left me quite shattered, the effort of talking about traumatic events with no care or concern on the part of the doctor, trying to recall precise factual details and dates and not cry or express unwanted emotion was extremely unhelpful. I had to space out these kind of appointments with weeks or months between as they left me extremely raw and shaken.
Likewise, there has to be a purpose and a gentleness to going over trauma memories. Talking about them does not in and of itself, magically heal anything! Talking about them when you don’t really want to, when the timing and choice are not yours, and in an environment or to a person who does not feel safe and caring may actually only traumatise you further. This is important to keep in mind, as quite a lot of the harm that many traumatised people experience isn’t just due to the actual events, but also to how they are treated after the incident/s or when they seek support.
Talking about what happened can help, but the reason this helps is because of things like – having a chance to express how you felt about things, feeling heard by another person, having someone else help you to reframe the experience (‘you did nothing wrong and have nothing to feel ashamed about’ for example), getting the opportunity to think through and make sense of things that at the time were chaotic and surreal, starting to be able to orient the memories in the past so they feel like they happened rather than are happening to you… Some people with amnesia for traumatic events find that remembering can be a relief in a way, to know what happened and not be wondering. On the other hand, others find that their focus is in the here and now, building a good life, and that process shouldn’t be disrupted to go hash over the very life they’ve just escaped from. Trauma work of any kind is supposed to support and complement the work you are doing in your life and your focus of energy, not interrupt and divert it. Everything has its own time and that time is different for everyone. Talking about memories because you feel you have to, because you’re afraid you won’t get better otherwise, with someone you don’t connect with, in a way that makes you feel more shameful, more hurt, and more alone isn’t going to make anything any better!
One of the most common feelings that many traumatised people have is ambivalence. That doesn’t mean not being sure what you feel, it means feeling more than one contradictory feeling. You may want to talk and not talk, or to remember and not remember, both very strongly. It can be really difficult at times to work out which feeling to follow, which instinct is taking you in the right direction, and which will lead you to an unsafe place. I sympathise! I’ve found that over time with some thinking about it, I can start to unpick what drives each feeling, the wanting to talk may be motivated by fear that I wont make progress, even though I feel really unsafe with the person I’m going to talk to. In that case I’d not share. Or it might be that the wanting not to talk is being driven by old childhood fears that telling secrets will get me into trouble. I can’t give you a way to easily work out which impulse to follow, only to say that if you’re unsure, wait a while, and if need be mentally try on each idea for a little while and see how it feels. If you find your stress going through the roof and all your symptoms increasing – maybe that’s not the way to go. If on the other hand some internal distress settles and you feel less overwhelmed – that sounds like the right path for you at the moment.
If you can’t work it out, perhaps don’t act on either and see if time changes things or things become clearer. If you just feel stuck, perhaps try to act out each impulse in a very small way – if it becomes clear that one road is not helpful you haven’t done anything too wildly disruptive and should be able to ride out the distress, gather yourself, and give the other road a try. This isn’t an all or nothing deal either, it might be that you feel okay talking about x and y but z is completely off limits at the moment. That’s okay – you’re the one responsible for taking care of you. It’s also pretty common for us traumatised folks to do things at the extreme and think of things in polarised way – either I tell all or nothing, either that person is 100% safe or completely unsafe. Most of life and a lot of trauma work is about being able to reclaim a bit of grey and try out small steps instead of swinging wildly from one extreme to another. It’s okay to take these things slowly, and if you try something that doesn’t work, oh well. We’ve all been there. Hang tight and settle and give something else a go.
If you’re in a spot in your life where it feels like digging into memories wouldn’t be helpful, I’d like to recommend considering taking a look at 8 Keys to Safe Trauma Recovery by Babette Rothschild. She has a whole chapter about how it’s entirely up to you whether you feel remembering and talking about the trauma would help, and some ideas on how to talk to a therapist about your feelings and choices, and other things you can do to support yourself instead. If you are in a place where you feel a need to talk about what happened, to feel heard and be able to express how it felt and you’d like to learn more about how this process might happen and how it could help, you might find Facing the Wolf by Theresa S Alexander a useful resource. It details eight sessions of working through painful memories from the perspective of both the therapist and client. (of course, please be aware that this does involve memories of child physical/emotional abuse and neglect) I’d also like to mention that if you do not have a therapist, or do not have a good relationship with one, don’t forget that a friend, helpline, or your own journal can all be places where memory work happens. While therapy can be a wonderful support, a great deal of our healing and hope is also developed in the rest of our lives. Good luck with whatever you decide to do. 🙂