LISTS & SYMPTOMS

One of the good things about evidence-based counseling is that they generate a lot of definitions, check-lists, and categories.  Not everyone considers that good and they can be destructive or misleading.  But right now my attention is captured by some of them.  Provisionally.

These are supposed to be the five main signs of damage from Complex Trauma:

1.  Affect dysregulation

2.  Structural dissociation

3.  Somatic disregulation

4.  Impaired self-development

5.  Disorganized attachment patterns

Now I’ll try to translate them to plain English, though maybe not exactly as their originators would see them:

1.  Getting mad or depressed or falling in love or getting high without any awareness of the connection to events and no ability to manage the extremes.  Confusion about what happened and about reactions.  I suppose bipolar disorders might fit here.  Lack of reality checks.

2.  Sectioning off one’s internal personality so that some sides are just not admitted to -- maybe not even consciously known.  I think the explanations and mechanisms of dissociation are the weakest subject in this book and so do others who are writing IN the book!  It’s not the book, it’s the concept.  This is the sexy stuff that gets dragged into schizophrenia (which may be as much or more organic as psychological) and split personalities, which appear to be much exaggerated.  Parting out personality is much more subtle and pretty much universal.

3.  Always miserable: flu symptoms, too fat, anorexic, aching, unable to sleep, a whole series of colds, whatever.  Plus what used to be called psychosomatic but could just as easily be called somatopsychic.  Does substance abuse go here?

4.  Some people don’t live up to their potential.  Maybe they don’t want to.  But maybe it’s a worrying failure to get ahold of things.  I know that feeling.

5.  Falling intensely in love, getting close to someone, then feeling oppressed and running for the exit or demanding “space” or attacking or starting a new relationship.  Choosing impossible people.  Or simply never caring much about anyone.  Even after babyhood it is important to have secure and lasting attachments, but if one didn’t have that original anchor in the proper time to form the ability (infancy), it will be very hard.  I think that’s right.  But in today’s world it kinda gets pushed onto people.  Even ministers in some denominations are moved all the time so they don’t get “too attached.”

These five probs are the usual middle-class complaints that get taken to middle-class counselors.   People sit in comfortable chairs and talk.  But things can get much, much worse.  Though this set of essays doesn’t address the following, Courtois/Ford at least lists them:

•   Economicaly impoverished inner city ethnoracial minority persons.
•   Incarcerated individuals and their children and families.
•   Homeless persons and their families.
•   Sexually and physically revictimized children or adults.
•   Victims of political repression, genocide, “ethnic cleansing,” torture or displacement.
•   Developmentally, intellectually, or psychiatrically challenged individuals.
•   Civilian workers and soldiers harassed and assaulted on the jobs or in the ranks.
•   Emergency responders who are repeatedly exposed to grotesque death and suffering.

Not on the list are child soldiers psychically emptied by committing forced atrocities against their own families.  The list missed reservations, rural economic sumps, and illegal immigrants -- but then there’s no limit to such a list, is there?   

Courtois and Ford do at least realize that the PTSD in the Diagnostic and Statistical Manual of Mental Disorders IV still doesn’t go far enough.  They provide the acronym DESNOS:  Disorders of Extreme Stress Not Otherwise Specified.  I laugh because it’s such an et cetera category, but it probably does the job, which is to simplify and shorten the label.  Also, if you have a label to google, you might actually find something you want.  If you want to know more about the condition the acronym stands for, try this: http://www.traumacenter.org/products/pdf_files/DESNOS.pdf

Desnos also turns out to be the name of a Parisian surrealist poet who died of typhoid in a concentration camp in 1945, just AFTER liberation.  http://en.wikipedia.org/wiki/Robert_Desnos  The Holocaust can definitely give a person DESNOS !!  But Robert Desnos knew the power of the word and act.   

Susan Griffin relates a story that exemplifies Desnos' surrealist spirit:

One day Desnos and others were taken away from their barracks. The prisoners rode on the back of a flatbed truck; they knew the truck was going to the gas chamber; no one spoke. Soon they arrived and the guards ordered them off the truck. When they began to move toward the gas chamber, suddenly Desnos jumped out of line and grabbed the hand of the woman in front of him. He was animated and he began to read her palm. The forecast was good: a long life, many grandchildren, abundant joy. A person nearby offered his palm to Desnos. Here, too, Desnos foresaw a long life filled with happiness and success. The other prisoners came to life, eagerly thrusting their palms toward Desnos and, in each case, he foresaw long and joyous lives.

The guards became visibly disoriented. Minutes before, they were on a routine mission the outcome of which seemed inevitable, but now they became tentative in their movements. Desnos was so effective in creating a new reality that the guards were unable to go through with the executions. They ordered the prisoners back onto the truck and took them back to the barracks. Desnos never was executed. Through the power of imagination, he saved his own life and the lives of others.

This strikes me as being on the boundary between the therapeutic and the spiritual, the liminal place where a leap to vision can change events.  In a few  of these counseling essays there is mention of spiritual factors that help people comfort, protect, and control (they say “modulate”) their trauma.  I haven’t seen this before and it is an important link for “The Bone Chalice.”  A liturgy, for either a single person or a holding community, scripted or extemporaneous, can have enormous power in this way.  

Professional counselors, no more than the general public, have a very limited understanding of how to use these resources.  Most people think that spirituality is a supernatural force that descends on lucky people, esp. those who have an inclination towards New Age captures of unfamiliar cultures.  Some are too eager to accept any magic that comes along and others will scoff and denigrate anything that isn’t concrete and proven.  Both extremes are unhelpful, but it’s tough to get people to the “meta” level where they can see past their own lives.  This specific task is an item on some of these lists of goals.