The only difference between people who go on to live relatively healthy lives following severe trauma and those who don't is how they cope with the trauma afterwards, and their ability to make sense of what happened.
Dr. Cara Gardenswartz: I work with patients with all types of trauma histories -- adults who, as children, were raped by their father, abandoned by their parents, were physically abused, lived with alcoholic parents, lost family in the Holocaust, and so on. The treatment is intense and long. Often, patients will need therapy two to three times per week for years in order to experience and face their memories and emotions -- with the goal of working through their traumatic histories. But they will always remain, on some level, scarred by their trauma.
Common symptoms of trauma include: re-experiencing the traumatic event with intrusive memories, flashbacks, nightmares, anxiety, inability to remember the details of what happened, difficulty sleeping, anger, hypervigilance (on constant alert), and becoming easily startled. They may also experience guilt, shame, self-blame, depression, and suicidal thoughts.
For people who experience trauma, the ability to trust others and feel safe is shattered. The only difference between people who go on to live relatively healthy lives following severe trauma and those who don't is how they cope with the trauma afterwards, and their ability to make sense of what happened.
Jaycee Lee Dugard, who was kidnapped at age 11 and has just emerged 18 years later (at 29), was kept in isolation from the world while mothering two children (by rape), and has suffered trauma beyond anything we can imagine. In this hideous situation, there are five victims: Jaycee, her children, her mother, and her stepdad. Out of all the victims, it is possible that Jaycee's children, IF they were treated respectably, have experienced the least symptoms, since they haven't known any other life experience but the one they were raised in. However, re-entering the world, in and of itself, will be unknown, disorienting, and alarming.
So how can this family be treated?
It will be very difficult. There are so many levels of trauma. That being said, the goal in therapy for the adults will be to help them have less fear about their memories. By talking about the trauma (both the initial event and the aftermath), they can become less afraid of their memories. Their feelings may become less overwhelming over time. Many clients with severe anxiety require medication to help them feel less sad and worried. They may also benefit from group therapy, in which they could talk about their trauma with others who have had similar experiences. None, of course, will likely be as severe as Jaycee's. However, sharing their stories can help them cope with their symptoms and memories, and hopefully allow them to trust others again. Family therapy will also be critical: between Jaycee and her parents, and between Jaycee and her children.
It will be tremendously complex to talk about the painful situations they experienced. Feelings that emerge in therapy will be scary. For Jaycee and her parents, they will be encouraged in treatment to recall and process the emotions and sensations they felt during the original event and the years following, rather than avoiding the trauma and any reminder of it. Treatment will offer them an outlet for emotions they have been bottling up, and will hopefully help them restore their sense of control and reduce the powerful hold the memory of the trauma has had on their lives.
As for Jaycee's children, they will need to be slowly reoriented to a new, intimidating, and scary world (their previous life will likely feel less daunting). A tremendous amount of individual and family therapy will be necessary for them to grapple with the fact that their "old" world was illegitimate. They will also need to adjust to school, community, culture, and socialization that occurs in the world. They will need to be monitored daily and have a place to talk about their feelings -- with their mom and in therapy. They will also have to mourn the loss of their father, and come to grips with the fact that he was an immoral criminal.
|Dr. Cara Gardenswartz is a licensed clinical psychologist who provides therapy to individuals and couples and runs psychotherapy groups. Her expertise include relationships, depression, anxiety, life transitions, trauma and addiction. She has over 16 years of education, training, and experience in her field. She received her BA from the University of Pennsylvania and went on to earn her Master's and Doctorate in Psychology at the UCLA. She lives in Los Angeles with her husband and son.|