A mountain of shit
This week I went to an incredibly good conference organized by the London charity Body & Soul, on Love and Trauma.
It was a unique combination of talks by leading trauma psychologists – Stephen Porges, Peter Fonagy, Paul Gilbert and others – with performances by artists like Lemn Sissay, Emeli Sande and Emily Lim of the National Theatre.
Somewhere in between was a lecture-boogie by dance psychologist Peter Lovatt, surely the best after-lunch speaker I’ve ever seen.
Lemn Sissay especially was extraordinary, talking about his experience being adopted from Ethiopia into a white, Christian family, who then gave him away into care – apparently because he was doing too well at school. He then survived 14 years in care without a single friend or hug, to become the person he is today, a very successful poet and chancellor of the University of Manchester. All of that, and he was so funny. He has an incredible ability to change range and keep audiences in a slightly edgy place. He embodies the archetype of the foundling, Harry Potter or Moses, the lost child who goes on to great things. He talks about that in this talk.
All the psychologists agreed on the massive emotional and economic costs of childhood trauma, triggered by adverse childhood experiences (ACEs) like physical, verbal or sexual abuse; physical or emotional neglect; having a parent who’s an alcoholic or a victim of domestic violence or in jail or mad; a parent who disappears through divorce, death or abandonment; or experiencing racism, bullying, or a severe illness or accident…All the ways life can be crappy.
Children who have experienced four or more ACEs are three times more likely to smoke, 10 times more likely to be alcoholics, 49 times more likely to attempt suicide, 15 times more likely to commit violence. Between half and three quarters of psychiatric inpatients suffered sexual or physical abuse as children. According to one guestimate, the global cost of childhood trauma to governments is $7 trillion a year.
But it’s the emotional cost that strikes me. It gives me a sense of the karma of suffering building up, through the generations.
36% of people who were abused as children go on to be abused by their partner. 41% of abused partners have a child who witness the violence. 34% of children who witness domestic abuse go on to be abused.
On and on it goes, through the millennia, building up like a mountain of shit, and the shit begets more shit, and the mountain gets higher and higher.
What causes trauma?
Well, that’s easy isn’t it. Shit. Shit causes shit. Poverty and prejudice and violence and injustice.
But also, according to the psychologists at the event, isolation and loneliness and violations of trust.
Trauma, said Peter Fonagy, ‘is a non-shared experience of adversity. Adversity becomes traumatic when it is compounded by a sense that one’s mind is alone.’
Trauma can emerge from a lack of connection.
We learn to emotionally regulate, according to psychologist Stephen Porges, through our interaction with others.
A baby learns emotional expression and emotional regulation by mirroring its mother, and by synchronizing with it.
If a mother ignores her baby or stares at it without responding, it freaks the baby out. Like this:
According to Porges, when something really scares us, our mammalian emotional regulation strategies (hug, articulate our emotions) shut down, and we go back to more basic physiological responses. We freeze, we dissociate, we stop being able to mentalize (imagine others’ mental states). Life feels unreal.
When people are traumatized, we can get stuck in these body responses. Whenever we get triggered, we freeze, we dissociate, we have panic attacks, and we may seek isolation to try and calm down and hide our distress from others.
That can make our trauma worse. ‘Trauma disrupts connectedness and opportunities to co-regulate’, says Porges.
We want nothing more than to be understood, to be seen, to be held, yet we’re also terrified of being seen, being judged, being hurt. So we seek the easier option of isolation. And the isolation slowly kills us .
It was difficult to hear this. I was traumatized as a teenager, through a couple of bad LSD trips.
I was surrounded by opportunities to share the adversity, but I couldn’t. My cultural upbringing made me think it was shameful to be hurt. So I let adversity turn into trauma.
The trauma really harmed my ability to connect, and my ability to be in a relationship. I used various toxic substitutes for genuine relationships, like escaping into books. Books were and are my safe space.
Anyway, we’re all traumatized, aren’t we. Or at least, 67% of us apparently had at least one adverse childhood experience.
What can we do about it?
Some speakers suggested we should aim for the complete eradication of trauma from children’s lives.
That’s a bit like the Mahayana Buddhist ambition: ‘may all beings be liberated from suffering’. Good to aim for, but it’s not going to happen in the immediate future.
What can we do now?
Well, we could try to lessen child poverty, for a start.
Here’s a quote from a new book on schizophrenia, The Heartland by Nathan Filer:
The single biggest predictor of psychosis and so-called schizophrenia, according to Professor of Clinical Psychology John Read, is poverty. Living in poverty increase a person’s likely exposure to a whole range of stressors and potentially traumatizing events.
Social discrimination, adversity, and feeling like an outsider also increase trauma – this may be why second-generation immigrants are more likely to experience psychosis (‘some of the highest reported rates of psychosis are among Greenlanders in Denmark’).
If trauma comes from disconnection, we can try to create more connected societies.
That’s hard.
We can put public funding into creating anti-stigma mental health campaigns, and encourage people to speak up when they are suffering.
That can certainly be healthy – my shame and silence at being hurt helped cause my trauma.
But emotional and psychological literacy does not always equal resilience.
There is a risk our society is becoming more and more psychologically literate (able to feel and articulate our suffering, able to self-diagnose ourselves) and less emotionally resilient.
Woody Allen’s protagonists, for example, are psychologically literate without being resilient.
We’re sharing all our shit on social media, but we’re not necessarily dealing with our shit.
There can even be a sort of competitive sharing. How many ACEs do you have?
The constant self-disclosure works in the public marketplace of Twitter, but it doesn’t necessarily lead to genuine connection and relationships if you’re always going on about your trauma.
We can try and protect our children from adversity. Of course we should. But there’s also the risk that we over-protect them and stop them developing proper coping strategies for the unavoidable adversity of life.
We can try to increase access to talking therapies.
We are too quick in western cultures to medicate our emotional problems with booze or drugs.
We know too little about the long-term consequences of anti-psychotics. And too little about the risks of long-term use of anti-depressants, or the risks from withdrawal. (The Royal College of Psychiatrists only admitted anti-depressants have serious long-term withdrawal risks this week).
That’s why I support better public funding for talking therapies. CBT helped me to deal with some of the symptoms of PTSD, like panic attacks.
But Cognitive Behavioural Therapy doesn’t work for everyone. It can be rather rational, instrumental, soulless.
Other types of therapy can also help. Paul Gilbert told us about compassion-focused therapy, for example, which can help people with critical inner voices to develop a more compassionate inner voice.
Stephen Porges told us how the physiology of trauma can be counter-acted through the body.
Through singing, for example, or through poetry (which mimics the sing-song voice that mothers use to soothe us), through slow-breathing or chanting, or physical exercise, or dance and theatre.
We heard from Emily Lim, head of a new programme at the National Theatre called Public Acts, which brings charities and communities together in amazing public performances.
It reminded me how important theatre was in ancient Greece as a vehicle for the catharsis of trauma.
Ever since Freud, talking therapies have aimed for ‘catharsis’. It’s good to remind ourselves that, when Aristotle first used that term, he was talking about theatre and ecstatic dance.
Of course, the easiest way to give a society all these things – connection, therapy, music, group singing, chanting - is through religion and spirituality.
One of the speakers at the event spoke of how trauma made her feel broken and worthless, like a ripped £20 note. She had to realize her inner value.
I knew just what she meant. Trauma deeply damaged my sense of self-worth. And the healing began through a spiritual experience that made me feely deeply loved and OK.
Psychology and psychiatry ignore that spiritual aspect of life, or actively denigrate it.
Nathan Filer, a mental health nurse, wrote a very compassionate book about ‘so-called schizophrenia’ (The Heartland) but when it comes to anything spiritual in psychotic experiences, he shows all the scorn and hostility characteristic of white middle-class psychiatrists ‘There is no ghost in the machine’ he tells us firmly. When he refers to people’s religious beliefs he tuts: ‘People believe in all sorts of nonsense’. How can mental health services be open to people’s experiences if they are so hostile to spiritual / religious experiences and beliefs?
None of the speakers at the Body & Soul event talked about religion or spirituality either. But I liked the organisation’s name – it was given to it by the service-users, apparently.
And I liked that many of the speakers were not embarrassed to talk about love. Love and connection are what heal us from trauma – love for ourselves, love between other humans, love between humans and pets, and sometimes transcendent love from some deep source, possibly in the brain, possibly somewhere Else. Love.