3 Stages of Identity Formation After a Trauma

This post is an excerpt from the study guide which accompanies the “Post-Traumatic Stress” seminar. This portion is one element from “STEP 3: UNDERSTAND the impact of my suffering.”

To RSVP for this and other Summit counseling seminars visit bradhambrick.com/events.

What do I call myself now? After completing school, I called myself a “graduate.” After getting married, I called myself a “spouse.” After having a child, I called myself a “parent.” After a experiencing a trauma, I call myself what?

Language, in these situations, is important because it carries an identity that comes with expectations. We will look at three types of identity that emerge after a trauma. They are meant to be sequential; which best fits you should change with time, but there is no time line for how long each identity statement is appropriate.

“Abuse feels like an experience that has stamped you and has the final word on your identity. But the truth is God gives you a different identity… Your identity as God’s child is far deeper than the abuse you suffered (p. 4).” David Powlison in Recovering from Child Abuse

The three questions you should be asking yourself as you study this section are: (a) which of these best fit how I relate to my trauma now? (b) did I process the earlier stage of post-trauma identity well? and (c) what would it look like for me to grow into the next stage?

1. Victim

This is a word that carries strong, negative connotations; because we often think of it as part of the phrase “playing the victim,” insinuating that someone is passively remaining in role of victim in order to get more of whatever sympathies or benefits accompany this role.

The fact that some people “play the victim” does not mean it is a defect in your character to be a victim. Victims of a crime should avail themselves to the counter-influences of justice. Victims of a heart-attack should abide by the recovery plan of their doctor.

A wholesome definition of being a victim is, “The recognition of when intense suffering has impaired your ability to engage life as fully as you did prior to the suffering event and willingness to allow others to play roles of care or justice until it is wise, healthy, or legally appropriate for you to do these things for yourself.”

For a time, it is appropriate to use the label “victim” to describe your relationship to your trauma.

  • After an assault someone is the “victim of a crime” and should allow the legal system to seek justice.
  • After a severe injury someone is a “victim of that circumstance” and should be willing to receive additional care as they learn to live self-sufficiently again.
  • After being in a war zone someone is a “victim of what they’ve been exposed to” and it is good for them to allow others to help them process their reactions to those experiences.

2. Survivor

There is a time period between “needing additional help” and life assuming a “new normal.” The trauma still has a significant negative impact on your ability to function or emotionally respond to life as you would prefer. But you have established a level of safety and resilience that allows you to be more independent that you were in the victim phase.

Indicators that you’re entering the survivor phase of relating to your trauma would include:

  • You understand the different kinds of impact that emerge from your trauma experience.
  • Your post-traumatic symptoms do not “seize” you in a way that impairs your life functioning.
  • You can be patient with yourself when experiencing post-traumatic symptoms.
  • You do not live bracing against the possibility of post-traumatic symptoms unless there are strong situational variables that make it wise to prepare for such experiences.
  • The sense of shame you feel when thinking of your trauma is significantly diminished.
  • You manage much less of your life to avoid post-traumatic symptoms than you did in the victim phase.

3. Steward

In this phase, memories of your traumatic experience are able to be managed well enough that they are “available” to help care for other people who are at earlier phases in their journey with trauma. In this phase, trauma has changed from a “weapon” used by Satan against you to a “tool” God can use to allow you to care for others.

II Corinthians 1:3-5 captures this phase of your journey with trauma, “Blessed be the God and Father of our Lord Jesus Christ, the Father of mercies and God of all comfort, who comforts us in all our affliction, so that we may be able to comfort those who are in any affliction, with the comfort with which we ourselves are comforted by God. For as we share abundantly in Christ’s sufferings, so through Christ we share abundantly in comfort too.”

But do not try to rush yourself to this point. You will be best used by God as a steward of your trauma when you have walked your journey in the healthiest way possible. Be as patient with yourself as you would be with someone else with a comparable experience so that as you share your journey, it will be maximally beneficial for them.

Read I Timothy 1:15-17: In this passage, we see the benefits that can emerge with being able to trace the lineage of our identity in relation to the significant parts of our life. This passage looks at sin. In this study, we are studying suffering. Notice that Paul can trace his relationship to sin. He is still the “chief of sinners” (v. 15) but has come to know God’s perfect patience (v. 16) and ultimate victory (v. 17). Similarly, a healthy relationship to trauma will likely include: a recognition of ongoing impact, resting in God’s patience, and trust God’s in-process but assured victory.

POST-TRAUMATIC STRESS
Date: Saturday September 26, 2015
Time: 4:00 to 7:00 pm
Location: The Summit Church, Brier Creek South Venue
Address: 2415-107 Presidential Drive; Durham, NC 27703
Cost: Free
RSVP Here

Guidance for Talking with Others about Your Post-Traumatic Experience

This post is an excerpt from the study guide which accompanies the “Post-Traumatic Stress” seminar. This portion is one element from “STEP 2: ACKNOWLEDGE the specific history and realness of my suffering.”

To RSVP for this and other Summit counseling seminars visit bradhambrick.com/events.

This will be a big step; probably the most challenging thing you’ve done since you decided to start this study. Give yourself the grace that this reality deserves. That grace should take the form of patience.

“True hope never minimizes a problem in order to make it more palatable and easily managed. For the Christian, hope begins by recognizing the utter hopelessness of our condition and the necessity of divine intervention, if we are to experience true joy (p. 105).” Dan Allender in Wounded Heart

Here are several things to keep in mind:

  1. All your information is yours to do with as you please. Do not let the advisements of this study rob you of your voice in the process. If you’re not convinced this is a wise step for you at this time either seek greater clarification or wait.
  2. Sooner is not always better; ready is better. A premature step forward can be a significant step backward. Make sure you’ve established a sense of safety before engaging this step.
  3. Think about the post-disclosure timing. Is there anything coming up in the next few weeks (i.e., holidays, wedding, important business trip, etc…) that mean it would be better not to engage with disrupted emotions?

To whom is it beneficial for me to acknowledge what happened?

The biggest factor in selecting the person with whom you initially discuss you trauma is trust. As you talk about something that will generate many associations of feeling unsafe, being in the presence of someone that you trust is vital. You want the trust that you have for them to begin to transfer a sense of safety into the recollection rather than the memory projecting a sense of mistrust onto this individual. There are three types of trust that are important to consider.

  1. Personal Trust: Are you comfortable in this person’s presence? Do you value their opinion? Can you share struggles and insecurities with them without feeling shame? These are the kind of factors that minimize the emotional magnifier of personal discomfort – you want the presence of this person to reduce your discomfort.
  2. Emotional Trust: Do you have reason to believe this is someone who can handle the weight of hearing about your trauma? Do you feel like you would have to “tame” what you shared to protect this person from your story? These are the kind of factors that minimize the emotional magnifier of guilt – you do not want to feel like you are burdening this person beyond their emotional capacity.

    “Combat veterans will not form a trusting relationship until they are convinced that the therapist can stand to hear the details of the war story. Rape survivors, hostages, political prisoners, battered women, and Holocaust survivors feel a similar mistrust of the therapist’s ability to listen (p. 138).” Judith Hermann in Trauma and Recovery

  3. Experiential Trust: Do you think this person would know how to respond if you started “getting lost in your upset” as you talked about your trauma? Do you think this person understands the experience of trauma well enough to help you process what you’re sharing? These are the kind of factors that minimize the emotional magnifier of uncertainty – you want this person to help reorient you if the process of remembering becomes overwhelming.

Who are the people in your life that best meet these criteria? If you cannot identify someone who meets these criteria, then consider meeting with a professional counselor who has experience in the area of trauma.

In what level of detail do these acknowledgements need to occur?

There is not a “right answer” to this question. There is not a “percentage of the full story” that is optimally beneficial to disclose; as if there was a thermometer or measuring tape by which to determine optimal disclosure.

A better way to frame this question would be, “Am I moving towards not having what I disclose about my experience of trauma and post-traumatic stress determined by fear and shame?” If the answer to this question is “yes,” then you’re moving in a healthy direction. In this sense, you should be thinking about a trajectory; not a point on a scale.

The nature of a given relationship will determine how much is good to disclose.

  • In a counseling-focused relationship, you would disclose more because you are working to assimilate all of the events of your life into a cohesive whole and not have certain parts (i.e., the traumas) that dominate or recast the other parts.
  • In a relationship with someone as close as a spouse or best friend, disclosure would still be high as their care for you prevents you from believing this is something that you must keep hidden.
  • In casual relationships, disclosure would be relatively low unless sharing parts of your traumatic history allowed you to care for this person in an important way or was needed to explain an uncommon reaction to something.
  • In functional relationships (i.e., business or recreation), disclosure would likely not be warranted. This freedom reminds you that trauma is something you’ve experienced; not who you are.

Again, don’t feel like you have to do all of this now. We are describing a destination, not prescribing present reality. If at this point in your journey you take a wise step in the direction of what’s being described, then you are doing everything that is recommended at this point.

Here are other recommendations regarding how much to disclose when you are first talking to someone new about your experience of trauma or its influences in your life.

  • Decide before hand how much you want to share and only share that much. This helps ensure that the moment of disclosure does not begin to feel “out of control” and, thereby, serve as a trigger event.
  • Have a “thirty second version” of your story that you can share if a situation demands. These statements should acknowledge the reality without shame and without inviting further questions. Having these statements prepared prevents you from having to be creative in a moment when you already feel exposed.

Example after a Public Upset: “I’ve experienced some pretty difficult things that make it more difficult to gauge how to react to some challenges. I’m growing stronger and learning, but I’m sorry that I did not handle that as well as I would have liked.”

Example for an Awkward Direct Question: “Yes, I’ve been through some things that are harder than most people face. When its beneficial for myself or others, I’m open to talking about it, but I don’t believe now is one of those times.”

  • Realize you can always share more, but you can’t share less. In a healthy relationship, it is always appropriate to say, “There is more to what I shared with you about…” This means that you should feel free to end a disclosure when you want and resume it later if you decide that is wise, needed, or beneficial.

When is it beneficial to begin this process; how do I know if I’m ready?

Not until you can embrace this step as something you believe will be beneficial for your recovery. You really do get to be in charge of your own recovery process. The trauma you experienced created enough disruption that you decided to start this study. You may have felt like you had little choice in that.

But it is good for you to study future steps and wait until you become convinced of their benefits before you take action on that step. This is not being “controlling” or fearful. It is exercise your voice and choice in the process of recovery. In trauma recovery, healthy is only healthy when you’re ready.

Here are several indicators that you’re ready to begin an initial disclosure with a highly trusted individual.

  • It is clear to you who would be the best person with whom to have this conversation.
  • You are taking this step because you believe it’s best for you and not because you’re being told you should.
  • You’ve taken the available steps to establish a sense of safety in your life.
  • You have decided how much you want to share at this initial disclosure.

When these criteria are met, beginning an initial disclosure is wise; that doesn’t mean it will be pleasant. You may be relieved to have it over with or it may feel quite disruptive. But there is no pressure to share more until you have regained a sense of stability and safety after this initial disclosure.

What benefits can I expect from this step?

Secrets foster shame. Silence echoes pain. Lies unspoken cannot be refuted. Isolation keeps pain fresh.

Until we allow someone else into our world to speak truth on God’s behalf, our trauma tends to have the last word on our lives. Disclosure is the crack in the door that allows light into darkness.

You may not experience all of these benefits at first. The initial experience of disclosure may be disorienting and frightening. But you can rest in the knowledge that this is the process you’ve set in motion and that, if you patiently continue this journey (taking breaks as needed), then shame can be removed, silence filled with care, lies refuted, and isolation replaced with a community.

Read Joel 2:18-27. What you have learned in this chapter may feel like a news report on all that “the locusts have eaten” (v. 25). Acknowledging the specific history and realness of your suffering can be a painful step. That should not be glossed over or understated. It is real. But take this passage as a promise from God to you. You can be made whole. Your emotions can be restored to health. You can learn what makes for healthy relationships and identify friendships that merit trust. You can be fully known and fully loved. Those things may seem far in light of what you’ve acknowledged in this chapter and your experience of remembering, but they are possible. Allow that to give you the hope necessary to continue on this journey.

POST-TRAUMATIC STRESS
Date: Saturday September 26, 2015
Time: 4:00 to 7:00 pm
Location: The Summit Church, Brier Creek South Venue
Address: 2415-107 Presidential Drive; Durham, NC 27703
Cost: Free
RSVP Here

Tweets of the Week 8.25.15

There is great value in saying something in a memorable, concise manner. Twitter has caused us to make this a near spiritual discipline. For my own growth (as a generally verbose individual… that’s a long way of saying “wordy”) and for the benefit of others, I highlight tweets each week that deliver a big message in a few words.

And one because it’s funny…

 

Post-Traumatic Stress Symptom Chart

This post is an excerpt from the study guide which accompanies the “Post-Traumatic Stress” seminar. This portion is one element from “STEP 2: ACKNOWLEDGE the specific history and realness of my suffering.”

To RSVP for this and other Summit counseling seminars visit bradhambrick.com/events.

Remember to move through this material slowly. Do not over-saturate yourself with information that can serve as triggers for post-traumatic responses. Your goal should be to ensure that you’ve maintained a sense of safety and stability after each section of material (not just after each chapter to step) that you study.

To help you move slowly we have included a “PTSD Daily Symptom Chart.” (Note: This is referencing the trauma evaluation in a previous post.). This is intended to do two things:

  1. Initially, to help you become more familiar with the types of post-traumatic response you are experiencing.
  2. Ongoing throughout your journey, to help you identify when symptoms are increasing and you need to take a break.

With time you will begin to use this tool to measure progress – a decrease in the symptoms of post-traumatic stress. For the time being, you are advised to be content using this tool to orient yourself to the experience of post-traumatic stress – gaining self-awareness of how your present reactions (i.e., thoughts and emotions) are tied to your past trauma. The greater your understanding of these connections the less “out of control” you will feel.

This tool can also be an effective way to communicate about the challenges you are facing with others. Having consistent language and being able to articulate the rise, fall, and triggers for each experience should decrease the awkwardness you feel in trying to describe what is commonly called “the invisible injury” (a name many war veterans give to their experience of PTSD).

In later steps in this material, the information you gather about the frequency, duration, intensity, and correlation with life events will be valuable in identifying goals to counter the impact of your suffering. In this sense, you are combatting PTSD in two ways with this tool:

  1. Demystifying the experience of PTSD which should lessen the shame and secondary fear (that is the fear created by the misunderstood post-traumatic experiences), and
  2. Equipping yourself with the information needed to strategically begin re-engaging with more of life and relationships when that becomes the wise next step in your recovery.

POST-TRAUMATIC STRESS
Date: Saturday September 26, 2015
Time: 4:00 to 7:00 pm
Location: The Summit Church, Brier Creek South Venue
Address: 2415-107 Presidential Drive; Durham, NC 27703
Cost: Free
RSVP Here

5 Ways to Establish an Environment of Safety in Which to Address PTSD

This post is an excerpt from the study guide which accompanies the “Post-Traumatic Stress” seminar. This portion is one element from “STEP 1: PREPARE yourself physically, emotionally, and spiritually to face your suffering..”

To RSVP for this and other Summit counseling seminars visit bradhambrick.com/events.

It is difficult to break the silence of trauma. It can feel like opening Pandora’s box to let someone else in to what you’ve been experiencing. There is the fear of, “Can I turn the memories off once I start to think about what happened?” This is why we don’t start with memory work.

We start by establishing some rhythms and routines to life that allow you to return to a sense of safety even if later parts of this seminar take you through some hard times. Remember, take a break from this study whenever you need to in order to re-establish the sense of safety.

1. “Home Base”

Beginning and ending your day in a place that feels safe is an important life rhythm to establish. Creating the expectation that you will “book end” whatever stress you face during the day with safety does a great deal to establish an over-arching sense of safety to your life.

  • Wake up in time to have an unrushed start to your day.
  • Arrange your home so that your most frequently used items are easy to find.
  • Avoid movies or forms of entertainment with high violence or drama content.
  • Play music that you find soothing and reveal your personal taste.
  • Use ear plugs or white noise machines if outside noises are disturbing.
  • Have an evening “wind down” routine that prepares you to sleep.

2. Body Management

Your body is also a type of “home” for your mind. Caring for your body well places your mind in the best context to face the challenges of post-traumatic stress. The actions listed below both (a) increase your body’s ability to withstand stress and (b) demonstrate your ability to impact important factors related to your stress.

“Establishing safety begins by focusing on control of the body and gradually moves outward towards control of the environment. Issues of bodily integrity include attention to basic health needs, regulation of bodily functions such as sleep, eating, and exercise, management of posttraumatic symptoms, and control of self-destructive behaviors. Environmental issues include the establishment of a safe living situation, financial security, mobility, and a plan for self-protection that encompasses the full range of the patient’s daily life. Because no one can establish a safe environment alone, the task of developing an adequate safety plan always includes a component of social support (p. 160).” Judith Hermann in Trauma and Recovery

A. Sleep – There are two ways in which sleep is an important part of good self-care. First, sleep is one of the primary ways that we maintain a rhythm to life. It is hard for life to have any sense of routine if we do not have a regular sleep pattern. Second, sleep is one of the primary ways that the brain replenishes itself. Sleep does for the brain what exercise does for the body. When we do not get sufficient sleep, emotional regulation of any kind becomes increasingly difficult.

    • Play soft music to help prevent your mind from drift-thinking while trying to sleep.
    • Reduce the level of caffeine and sugar in your diet, especially after the noon hour.
    • Avoid daytime naps so that your sleep is in concentrated blocks; the physiological benefits of sleep are less when we break our sleep into smaller units.
    • Establish a bed time routine to help habituate your body towards sleep.
    • Try muscle relaxation exercises or a warm bath before going to bed.
    • Establish a deep slow breathing pattern that simulates sleep breathing.
    • Talk with a medical professional about the possibility of a sleep aid.

B. Diet – Hunger creates a sense of unrest that the body interprets as danger. Over or under eating reveals that we are surrendering control of a fundamental part of our life to trauma. A healthy diet can be a “declaration of independence” that we make three times a day that the effects of trauma will not regulate our lives.

    • If you’ve lost your appetite, eat several small meals throughout the day instead of three big ones.
    • Take a multi-vitamin.
    • Consider a Vitamin C booster for your immune system; stress causes the body to pull energy reserves from the immune system.
    • Avoid excessive sweets or caffeine. These will impact blood sugar levels and impact your sleep cycle; both of which makes emotional regulation more difficult.

C. Exercise – Trauma can leave us prone to both depression and anxiety. Exercise, particularly cardiovascular exercise, is good for countering both. Exercise cleanses the body of free radicals generated by depression-anxiety, boosts energy levels, improves sleep, and facilitates a more pro-active attitude towards life.

What are ways that you can introduce three to five occurrences of cardio vascular exercise into your week?

D. Relaxation Breaks – Consider moments of relaxation or recreation as “oasis points” in your day. When you intentionally plant these breaks into your day, you are preventing the impact of trauma from cascading across your day. You are building small damns that break the tide of trauma’s influence.

What are some types of relaxation or recreation you can begin at set intervals in your day?

3. Community

There are two realities about the role of community after trauma: one good, the other bad.

“Experiencing authentic Christian community is one of the most important ways shame-based lies about oneself can be challenged (p. 90).” Steven R. Tracy in Mending the Soul

“You will want someone who allows you to be honest about your struggles that makes you feel safe at the same time. If you are not careful and you begin to process memories with someone who is not skilled enough, it could make things worse (p. 18).” Tim Lane in PTSD

This material is designed to facilitate helpful relationship with other people who can play a vital role in your recovery process. While a counseling professional can be a great asset on this journey, someone does not have to have advanced degrees to be a good friend in hard times.

  • Make a list of the people you believe would be safe to engage with about your post-traumatic journey.
  • Make a list of the people you believe might not be safe to engage with about your post-traumatic journey.
  • Use these criteria to help you decide who to place on each list.
    • A safe person listens well even when they do not know what to say.
    • A safe person is willing to learn about the experience of trauma to be more understanding.
    • A safe person realizes they cannot rescue you from post-traumatic experiences.
    • A safe person does not take the fear or anger of your trauma personally.
    • A safe person directs you to safe, honoring choices even when you’re upset.
    • A safe person can discern when you’re “just upset” and when you’re “a danger to yourself.”
    • A safe person is willing to involve others (i.e., calling 911) if you’re in a danger to yourself or others.

4. Medication

Post-traumatic stress is caused by life events not brain chemistry. But medication can still be an effective tool in minimizing some of the acute experiences of stress (i.e., panic attacks or flashbacks) and mitigating some of the pervasive experience of anxiety (i.e., hypervigilance) that is common after a trauma. Talking with a physician can be a wise step of ensuring that the stress related to processing trauma is not unduly disruptive to your life.

5. Expectations

What are your expectations about what this journey will be like? It can be helpful to articulate those now, so that you do not grow unnecessarily frustrated with yourself along the way. Here are some realistic expectations for yourself on this journey.

  • You will have good days and bad days.
  • The early stages of this process are the most difficult and may involve the recurrence of remitted symptoms.
  • You will need to take a break several times during the course of this journey.
  • You will wish the entire process could just move a little faster.
  • You won’t notice growth until you’re startled by how much you’ve grown.
  • You will frequently wonder if it’s “worth it.”
  • You may never know “why” the trauma happened (i.e., “God’s purpose behind it all”).
  • You will learn that, by God’s grace, you’re stronger than you ever imagined.
  • You will learn to cherish the fact that you don’t always have to be strong to be safe in God’s care.
  • You can expect that life will be better and your trauma won’t get “the last word” on your life.

Here are some indicators that you need to take a break from this study.

  •  Your sleep pattern is disrupted for more than three days in a row.
  • The frequency of symptoms like nightmares and flashbacks increase in frequency.
  • You sense yourself pulling away from your safe relationships and enjoyable activities.
  • You begin to experience persistent physical symptoms like irritable bowel.
  • You begin to feel hopeless and consider suicide.

Any of these are indicators that you are pushing yourself too far, too fast in the recovery process.

POST-TRAUMATIC STRESS
Date: Saturday September 26, 2015
Time: 4:00 to 7:00 pm
Location: The Summit Church, Brier Creek South Venue
Address: 2415-107 Presidential Drive; Durham, NC 27703
Cost: Free
RSVP Here

Post-Traumatic Stress Evaluation

This post is an excerpt from the study guide which accompanies the “Post-Traumatic Stress” seminar. This portion is one element from “STEP 2: ACKNOWLEDGE the specific history and realness of my suffering.”

To RSVP for this and other Summit counseling seminars visit bradhambrick.com/events.

This evaluation seeks to help you assess the presence and severity of the following experiences commonly associated with trauma.

  • Symptoms of Hyper-arousal
    • Hyper-vigilance
    • Agitation
  • Symptoms of Intrusion
    • Trigger Events
    • Flashbacks
    • Sleep Disturbances
  • Symptoms of Constriction
    • Avoidance and Isolation
    • Numbing
    • Dissociation
  • Other Common Symptoms
    • Shame
    • Fragmentation

For a self-scoring, on-line version of this evaluation click here: Post-Traumatic Stress Evaluation (On-Line)

For a printable PDF version of this evaluation click here: PTSD Assessment (PDF)

 

POST-TRAUMATIC STRESS
Date: Saturday September 26, 2015
Time: 4:00 to 7:00 pm
Location: The Summit Church, Brier Creek South Venue
Address: 2415-107 Presidential Drive; Durham, NC 27703
Cost: Free
RSVP Here

Tweets of the Week 8.18.15

There is great value in saying something in a memorable, concise manner. Twitter has caused us to make this a near spiritual discipline. For my own growth (as a generally verbose individual… that’s a long way of saying “wordy”) and for the benefit of others, I highlight tweets each week that deliver a big message in a few words.

Who Should Attend the Upcoming Seminar on Post-Traumatic Stress?

 

Seminar:
POST-TRAUMATIC STRESS
Date: Saturday September 26, 2015
Time: 4:00 to 7:00 pm
Location: The Summit Church, Brier Creek South Venue
Address: 2415-107 Presidential Drive; Durham, NC 27703
Cost: Free
RSVP Here

My Favorite Posts on Personality

The “My Favorite Posts” series on my blog is how I catalog posts I’ve written to help my readers find the material that is the best-fit for their interest or need. I hope this series creates a more user-friendly experience for my readers and allows this site to become a trusted resource hub for the church.

Tweets of the Week 8.12.15

There is great value in saying something in a memorable, concise manner. Twitter has caused us to make this a near spiritual discipline. For my own growth (as a generally verbose individual… that’s a long way of saying “wordy”) and for the benefit of others, I highlight tweets each week that deliver a big message in a few words.