First lesson on trauma and the brain...

I wish to write more about the topic of how bodies are long affected by sexual abuse, but there is so much to understand before you can really grasp the breadth and depth of its effects.

For me, what has helped the most has been The Courage to Heal. The reason is that the authors explain so much about what has, is, and might happen to you.  Instead of being crazy and alone, you are actually normal and in large company.  If nothing else, learning those two things changed my life.  Given that I had had counseling several times before reading the book, I find that immensely, ineffably sad.  

Why did it have to take so many years for me to find this book??

The authors encourage you to not read the book alone and to not feel constrained to read it in a linear fashion, although that is very helpful to do.  Because of this, when I saw a note about trauma and the brain, given how much I have been affected by the physical trauma of the pit bull attack, as well as sexual abuse.  I have PTSD and, as noted in the first post, it is difficult to pin-point an exact cause, but the tipping point, for me, was the pit bull attack, those long, terrifying, agonizing minutes where I was screaming for help and no one came.  This time, I was screaming aloud, and yet ... still ... no one came.  Not when I wanted someone to come.  Not until after.

While it is definitely not my intent to quote entire swaths of Bass and Davis' book, with regard to how trauma affects the brain and this knowledge's help with understanding the effects of sexual abuse, I want to include what I believe are some key points and do not wish to diminish the expertise and eloquence of the authors by summarizing this important knowledge.

We have learned a tremendous amount about the physical and emotional effects of trauma.  Although there are important differences between child sexual abuse and other kinds of trauma, there are also many similarities.  If you have been sexually abused as a child, you have a lot in common with people who have gone through other types of traumatic experiences—an orphan living in a war zone, a shopkeeper held up in a robbery, a driver in a head-on collision, a veteran struggling with memories of war.  In some cases, the trauma is linked to a one-time event; in others, the experience is severe and ongoing.  But in every instance, victims suffer a devastating combination of terror, helplessness, and loss of control.

When people are confronted with a traumatic event, their bodies have an immediate physiological reaction.  Every species has this biologically drive response to dire threats of harm or annihilation.  The instant a threat is perceived, our brain reacts, sending signals to the pituitary and adrenal glands to release a flood of stress hormones.  These hormones—among them, adrenaline, cortisone, and norepinephrine—make you hyperalert, preparing you to either fight or flee.  This fight-or-flight response is extremely useful when survival is at stake:  The heart beats faster, blood pressure rises, breathing speeds up, and the entire body prepare for action, whiles nonessential function—such as hunger, sleepiness, and digestion—shut down.  Once the threatening event passes, normal functions are reactivated and the body returns to normal.  People often become suddenly aware that they are exhausted, hungry, or in physical pain.

A third biological response to danger is the freeze response.  In nature, when fight or flight would be futile, animals instinctively collapse and becomes inert.  They look as if they are "playing dead."  This reflex releases more chemicals—pain-killing endorphins and opioids—that take the animal from a state of extreme energy to complete immobility.  Tense muscles instantly relax and breathing and heartbeat slow to barely perceptible.  If the animal survives, it immediately begins to discharge the built-up chemicals through intense shaking and trembling, heavy breathing, and sweating.  Ultimately animals return to a state of equilibrium and leave the encounter fully recovered, carrying no residual trauma.  (The Courage to Heal, Bass & Davis, pp. 242-243)

I would like to note a few things before continuing with the rest of this first lesson on trauma and the brain.

In reading through the book, I have become increasingly aware of just how careful Bass and Davis are with each and every word.  They are purposeful writers, as I noted in always making the distinction between sexual abuse survivors and sexual abuse victims. One word that I noted above is "annihilation."  This is not a word of extreme. This is reality for so many when faced with sexual abuse.  Sometimes, it is an annihilation of life itself, such as being held in place with a knife or a gun.  But, sometimes, it is an annihilation of hopes, dreams, identity, safety, etc.  Those are real things, too.  In some cultures, virginity means life for females who are not married.  And, in some cultures, even if you are a sexual abuse survivor, you are seen as complicit in adultery, which can carry a death sentence.

For Christians, who have had purity-as-law and purity-as-evidence-of-faith heaped upon them, sexual abuse is an annihilation of faith and/or hope of all that is entangled with purity, with virginity.  I believe, completely, that the place for sex is in marriage.  I believe, completely, that those who sin by having sex outside of marriage, are forgiven just as with any other sin.  And I believe, completely, that the sins of sex outside of marriage and of adultery leave you no less clean, no less pure than any child of Christ, washed clean through the Holy Waters of Baptism.

However.

However, it oft seems that sexual abuse is viewed, in some twisted fashion as the sin of sex outside of marriage.  Sexual abuse is not sexual activity; it is not a willing and free act of sinning against what God has designed with regard to the activity between male and female.  It is not sex.  Yes, a child of sexual abuse is no longer a virgin, by definition of that state, but a child of sexual abuse is not committing sexual sin.

I lost count of how many times I was told by Christians, when I revealed my past, that I was no longer pure.  Some of those times were by males who said they could only date someone they could marry and that person had to be pure.

Yes.  Having only recently discovered the pure doctrine of the Christian Book of Concord, I have long, long struggled not just with the feelings of filth and dirtiness that can come from being violated, but with the feeling and idea that I was spiritually filthy, spiritually dirty.  So, for me, facing the prospect of being sexually abused, especially after I became a Christian, was facing annihilation.

But in every instance, victims suffer a devastating combination of terror, helplessness, and loss of control.

To me, this is important to note.  It is a combination that is truly ineffable.  It is a combination that does not always have an ending.  And it is a combination that, for me, was written into my being in ways I still am only now beginning to recognize.

For example, I learned a while ago that the smell of beer is a trigger for me.  [Talking about triggers must come later.]  After receiving a call from someone who was struggling, I drove over to be with her.  When I pulled into her driveway, she was already walking toward me, so I rolled down my window.  But, as she drew close, I was overcome by terror and an inexplicable—at the time—desire to flee.  The woman was drunk, reeked of beer, and was sloshing the contents of a bottle all over herself and the driveway.  I did flee.

Later, when I learned about triggers, I realized that beer was one of mine.  A regular abuser was almost always drunk when he hurt me.  As an adult, I have avoided the smell of beer and places where beer is consumed without ever realizing why.  Now, I know.  But, when I smelled beer that night, I was overcome with terror, helplessness, and a loss of control.

The most important point, to me, of this passage is two-fold: 1) The responses of your body and mind are normal, expected and 2) How gracious is our Creator who made our bodies and minds to protect us wherever possible.

Oh, how long it has taken (and is still taking) me to grasp that my responses are normal and not something for which to punish myself further.  Understanding what happened—and happens still—has been one of the biggest steps I have ever taken toward healing.  Period.

Shut up.
Be still.
Wait until it is over.

This has been the litany of my life.  For good.  Yes, for good.  It helped me to survive.  Now, when I find myself following that litany, I try to stop and tell myself that I am safe and that I have choices.  And if I fail, if I still find myself in that place, then I work to let that be okay.

I want to finish this first lesson on trauma and the brain with why knowing how trauma affect the brain is especially important with child sexual abuse.

In human beings, dissociation is the mind state that accompanies the freeze response. With the help of pain-killing biochemical that have suddenly been released, we disconnect from what is happening to us. Our capacity to feel—both physically and emotionally—shuts down and we distance ourselves from the pain and terror we would ordinarily experience. Dissociation is an extremely effective survival mechanism, shielding us from the full impact of traumatic events. But the trauma itself is not processed or healed. In most cases, it is stored, not as a usual memory that fades and distorts over time, but as a nonverbal body memory, which is much harder to identify and process through thinking and talking. This is why we are not able to change our reactions to traumatic events just by “thinking them through." (243, emphasis mine)

Thus, my pattern, my litany, my life of Shut Up.  Be still.  Wait until it is over.  Any threat.  Anything that was threatening to me.

When humans freeze or dissociate, we are deluged with the same hormones as animals under attack. Once the danger has passed, we can sometimes use the same natural recovery mechanisms. We can shake, move, cry, yell, and breathe deeply, processes that sometimes help eliminate the chemicals our bodies have produced, just as animals do. And when we have the support of a caring person or community, we can receive comfort, thus meeting our need for understanding and connection.

But when children are sexually abused, they are rarely in a situation with optimum conditions for recovery. Instead, silence, secrecy, and isolation are the norm. Sometimes children are prevented even from crying out. And far often the abuse is a recurring event, without time for recovery before the next assault.

In the weeks and months after a traumatic event, trauma survivors often experience an acute stress reaction that can incorporate an array of troubling symptoms, including nightmares, flashbacks, trouble concentrating, intrusive thoughts, insomnia, an increased startle reflex, panic, depression, numbness, mental confusion, sudden explosions of rage, and alienation. The world no longer feels like a safe place.

For many people, these reactions last a few weeks or months and then gradually subside. But for others, the symptoms persist, eventually developing into post-traumatic stress disorder, or PTSD. Survivors of child sexual abuse—especially incest—are at increased risk because they experienced many of the dynamics that make long-term PTSD more likely: the trauma (or threat of trauma) was repeated and of long duration, they were children when the abuse occurred, they experienced great helplessness and betrayal, they believed the abuse was their fault, and, most significantly, they used dissociation as a way to escape. Although dissociation is an important protection, it is a factor that is correlated with the later development of PTSD.

Post-traumatic symptoms can grow stronger and become more entrenched over time. Or they can go underground and reemerge years, or even decades, later at a time of increased vulnerability—when a life event acts as a stimulus and triggers the post-traumatic reaction. (243-244, emphasis mine)

There is a misnomer with regard to children and sexual abuse.  So often, you hear:  Children are resilient.  This implies—if not outright stated afterwards—that it is okay if children are sexually abused because they will bounce back, will get over it easier because they are children.    To say this, to think this,  to act upon this is an egregious perfidy.  Utterly.  

It. Is. Not. True.

Sexual abuse survivors of all ages and all numbers of instances need careful, considerate, and comprehensive support and assistance to set them on the path to healing.  Some wounds, I believe, may not be fully healed this side of the vale, but there is hope for a start to healing, for a measure of safety, for peace.

There is so much to say about trauma and the brain, about triggers, about instinctive responses, about patterns, about PTSD.  But it is my hope that this is a solid beginning to help you think about the topic. Understanding yourself, your body, your mind is ever so helpful in healing.  Knowing that you are known, even in the things you do not yet see or understand, is powerful.

This is why, when I created the Praying the Psalter blog, with labels (Blogger only allows up to 20 per post) to help others navigate the Psalter in their prayers and begin to see the themes in this collection of prayers that our Triune God gave us in His Living Word, I added a post I had written about how the Psalter showed me, taught me, that I am known by God.  With regard to what I have shared here about responses, Psalms 42 and 77 are the clearest examples of how my Creator understands me, understands Myrtle.  

I am Yours, Lord.  Save me!