Phil Mollon Ph.D. DCEP
Brief comments on trauma – and the contribution of psychoanalytic energy psychotherapy.
Phil Mollon PhD.
All traumas – experiences that overwhelm a person's coping capacities – are difficult to recover from, but some are worse than others. Some traumas smash the soul. These are those malign experiences in which a person's humanity has been systematically destroyed by a sadistic other, or group of others. Such events are of a different category than those that do not involve human malevolence – such as an experience of a car spinning out of control, for example.
Trauma shatters our illusion of safety, causing an influx of existential dread [Mollon 2002a]. Thus the effect of a trauma is not only to leave a legacy of fear in relation to situations closely associated with the traumatic event, but also to render the person generally fearful and in full awareness of ordinary human vulnerability. Where the person has been subject to systematic torture, whether by a state, a gang, or a family, he or she is in addition exposed to human malevolence.
When we are shocked and frightened, it is natural for us to want to turn to other human beings for comfort. In some circumstances it is those same human beings who are the agents of our trauma. This is both terrifying and mentally indigestible. Human beings seem mostly to manage to hold on to a sense of the existence of goodness in others until this is shattered by an encounter with intense badness.
For a child, the exposure to malevolence from a caregiver is probably an intolerable perception – an awareness that is therefore blocked. This is the central thesis of the book Betrayal Trauma by Jennifer Freyd . It was also a core theme in the work of the Scottish psychoanalyst Ronald Fairbairn , who worked with abused children. He coined the term, the 'moral defence', referring to the child's tendency to blame the self, to assume that the self is bad, rather than perceive the neglect or malevolence of the caregiver. Such blaming the self also provides some illusion of control – 'it was my fault because I am so bad' – in contrast with the true perception of helplessness.
A woman known to have been extensively sexually abused by her father, from an early age, objected to my use of the word 'abuse' when I interviewed her. She sternly rephrased my enquiry by replying “The first time I allowed my father to touch me sexually was when I was age 4”. In this way she shifted the locus of control from her father to herself.
It follows that a major hidden injury for those who have suffered interpersonal trauma is to the sense of trust – trust in others and trust in the self. Any attempt to bypass this issue and to persuade the traumatised person to trust are likely to compound the problem. Paradoxically, for those who have suffered interpersonal trauma, trusting others is felt to be the most dangerous and foolish position – and, thus, if such a person begins to trust, he or she will feel even more frightened and vulnerable [Mollon 1996]. At core, the belief may be that it is not safe to trust anyone – that the best stance is to assume that no-one can be trusted. Nevertheless, the urge to attach, to seek comfort, and to trust remains – and this conflict over reaching out versus remaining armoured within is at the heart of the dilemma of trauma.
Trauma tends to throw our natural direction of energies into reverse. Instead of seeking life, love, and joy, there is a flowing of life energy backwards [Diamond 1985] – an addiction to trauma, a fixation on traumatic memories, and a preoccupation with death. We are sucked into a psychic black hole – a maelstrom of trauma from which it can in some cases prove impossible to emerge.
We become identified with the trauma – fixed in the traumatic perspective. All life then becomes interpreted from the point of view of the trauma. It consumes our being. The traumatised person may also identify with the ones responsible for the trauma. These become internal voices, haunting reminders and continuing perpetrators of the trauma – taunting and disparaging from inside [Mollon 1996]. A woman reported having been subject to a horrifying and prolonged gang rape and torture session many years previously – and described being continually tormented by internal voices mocking her and addressing her with the same abusive words used originally by the gang members.
When we have been subject to prolonged interpersonal trauma, feelings of shame and guilt – and sense of one's fundamental badness and worthlessness – become intensified, a state of toxic shame [Mollon 2002c]. Held naked before the black sun of human malevolence, all sense of personal value becomes burnt away. This is a common, yet insufficiently recognised result of prolonged abusive relationships amongst adults, where there has been a combination of physical and emotional violence – a systematic undermining of self-worth. Although not as damaging as childhood traumatic abuse or severe torture, the malign effect of toxic relationships on self-esteem, self-image, and mental health generally, should not be underestimated. Indeed the term 'toxic relationship syndrome' might often be relevant.
The brain of the traumatised person is altered by the overwhelming events – flooding with cortisol and other stress hormones can cause real physical alterations, especially if prolonged – resulting in sensitisation, such that stress responses are released ever more easily [van der Kolk et al.1996]. The amygdala fires relentlessly, generating fear, whilst hippocampal functioning is impaired, disrupting the normal coherence of perceptual and cognitive experience. The body too continues to resonate to the impact of the original trauma – generating the same physiological arousal, particularly to any cues associated with thetrauma.
Trauma consumes the mind, the brain, and the body. Attempting to address the mind alone, as in traditional talking therapy, without taking account of what has happened to the brain and the body, is both futile and frustrating. This point is often emphasised by the Harvard psychiatric neuroscientist and trauma specialist Bessel van der Kolk, who advocates a variety of body-based approaches, including EMDR and 'energy psychology' methods.
In aiming to help the traumatised person, attention to building trust and a sense of safety in the therapeutic relationship is crucial – but often not sufficient. In addition, the traumatic memories themselves, along with associated beliefs and patterns of (now dysfunctional) safety-seeking behaviour need to be addressed and resolved. Unfortunately (and despite the ubiquitous hype about cognitive behaviour therapy) talking therapies are not able to do this very well. Often a traumatised person will feel much worse if asked to talk about their trauma. Repeatedly talking about it just makes the situation worse, stirring up affect and the physiology of stress whilst providing no relief or resolution. The traumatic memories need to be addressed, but approaching them too directly may have catastrophic results – a therapeutic process of 'exposure' or 'flooding' may be successful, but it can be a disaster.
Traumatic memories function like internal phobias. Just as a phobic person will avoid external situations that trigger their anxiety, and this avoidance will generalise over time, a similar process occurs in relation to internal foci of anxiety. The internal cognitive avoidance of traumatic memories steadily generalises, and more and more mental resources are consumed in the effort to avoid – mental and behavioural life become increasingly narrowed over time. This is the sad but common 'natural history' of trauma. Fortunately, there are effective non-verbal methods, adjunctive to talking, which can often help considerably.[see cautionary footnote regarding memory].
Part of the therapeutic task is to address and process the traumatic memories, without the person being left even more traumatised and destabilised as a result. The first effective treatment for trauma was Eye Movement Desensitisation and Reprocessing – developed by clinical psychologist Dr. Francine Shapiro in the late 1980s. Not in any way based on a theory, but deriving from empirical observation, EMDR makes use of eye movements, alternating sounds in each ear, or taps on the body, to provide bilateral body-brain stimulation whilst the person focuses on a traumatic memory. Typically distress initially rises as the traumatic memory is accessed, before eventually subsiding. The bilateral processing is continued until the memory can be considered calmly without distress. This method works well. Despite various controversies over its mode of action, and whether it differs fundamentally from ordinary exposure therapies, those who learn to use it with skill are almost always persuaded, by experience that it is superior to more simple cognitive and behavioural methods [Mollon 2005]. The drawback is that where the trauma has been prolonged, very severe, repeated, or links to extensive childhood trauma, EMDR can be hazardous. The body-tapping variant of EMDR seems gentler than the eye movement version.
For people who cannot tolerate EMDR, or for those who prefer a gentler approach, the various body-focused methods of 'energy psychology' are ideal. These involve having the person stimulate 'energy sensitive' areas of the body, such as acupressure points and chakras, whilst thinking of the trauma. For some reason these methods do not seem to require such vivid accessing of the trauma as does EMDR. Just a partial contact with the trauma, like dipping a psychic filament into the toxic memory, seems sufficient to bring about rapid desensitisation. Growing out of the early work of chiropractor George Goodheart and psychiatrist John Diamond in the 1960s-70s, the first clear version of what later came to be called 'energy psychology' methods was Thought Field Therapy, as developed by clinical psychologist Roger Callahan in the early 80s [Callahan 2001]. Callahan found that anxiety and trauma are patterned into the body's energy system – this is the 'thought field'. By addressing the body at the same time as the psyche, in rather particular and skilful ways, he found it was possible to eliminate the distress rather rapidly. Initially developed as a treatment for phobias, TFT was later found to be very effective for trauma – and has been used extensively in the wake of military and societal trauma and natural disasters [Callahan & Callahan 2000]. During the 1990s a number of others began teaching, adapting and researching Callahan's methods. In 1995, a simplified version of TFT, called Emotional Freedom Techniques [EFT] was launched through a website. A California acupuncturist, Tapas Fleming, developed a very elegant and easy method involving holding meridian points and chakras on the head, whilst working through a short series of meditative thoughts. This has been found very effective and has been used successfully to treat military trauma. Asha Clinton, a Jungian psychotherapist and anthropologist, developed a deep and thorough approach combining psychotherapy and energy psychology – originally called Seemorg Matrix, but now renamed Advanced Integrative Therapy. My own approach, called Psychoanalytic Energy Psychotherapy, combines aspects of many energy psychology modalities with the perspectives from psychoanalysis and also cognitive therapy [Mollon 2008]. By 1998, the Association for Comprehensive Energy Psychology [ACEP] had been formed by a group of well-credentialled clinical psychologists, psychiatrists, and social workers in the USA , to provide a professional base for supporting research, dissemination of clinical findings, and the development of a code of ethics. It now has an excellent certification programme for those interested in a broad grounding in energy psychology.
In working with the traumatised, we need to draw upon all the knowledge, skills, and relevant techniques available, (including neurobiology and psycho-endocrinology). No single approach has all the answers – but I am certain that the incorporation of energy psychology provides a huge leap forward in the therapeutic possibilities for people who have been traumatised.
Callahan, R.J. 2001. Tapping the Healer Within. Chicago. Contemporary Books.
Callhahan, R.J. & Callahan, J. 2000. Stop the Nightmares of Trauma. Thought Field Therapy: the Power Therapy for the 21st Century. Chapel Hill. Professional Press.
Diamond, J. 1985. Life Energy. St Paul. MN. Paragon House.
Fairbairn. R.D. 1952. Psychoanalytic Studies of the Personality. London. Routledge.
Freyd, J. 1996. Betrayal Trauma. The Logic of Forgetting Childhood Abuse. Cambridge, MA. HarvardUniversity Press.
Mollon, P. 1996. Multiple Selves, Multiple Voices. Working with Trauma, Violation, and Dissociation. Chichester. Wiley.
Mollon, P. 2001. Shame and Jealousy. The Hidden Turmoils. London. Karnac.
Mollon, P. 2002a. Cracking the shell of illusion: a brief theory of trauma and dread. Chapter 1 in Mollon, P. Remembering Trauma. Second Edition. London. Whurr.
Mollon, P. 2002b. Remembering Trauma. A Psychotherapist's Guide to Memory and Illusion. London. Whurr.
Mollon, P. 2005. EMDR and the Energy Therapies. Psychoanalytic Perspectives. London. Karnac.
Mollon, P. 2008. Psychoanalytic Energy Psychotherapy. London. Karnac.
Van der Kolk. B. A. McFarlane, A., & Weisath, L. [Eds.] Traumatic Stress. The Effects of Overwhelming Experience on Mind, Body, and Society. New York. Guildford.
Psychoanalytic Energy Psychotherapy: www.philmollon.co.uk
Association for Comprehensive Energy Psychology: www.energypsych.org
Emotional Freedom Techniques: www.emofree.com
Tapas Acupressure Technique: www.tatlife.com
Seemorg Matrix/AIT: www.seemorg.com
Bessel Van der Kolk.:www.traumacenter.org
Dr. John Diamond:www.drjohndiamond.com
A relevant note of caution is worth emphasising. After extensive scientific and professional debates during the 1990s, it is now generally recognised amongst well-educated clinicians that memories of childhood events can be misleading, that memory is not an objective recording analogous to a video film, remembering is a process of 'reconstruction', and that any attempts to enhance or 'recover' memory from childhood run the risk of merely enhancing confabulation. [Mollon 2002b]