My recent conversations with a decommissioned special operations soldier with a history of multiple tours of duty have changed me. He’s a bear of a man with a heart that alternates between that of a lion and a lamb. He’s a man who has witnessed more than I can ever imagine or imagine forgetting. That man has shifted my views on the nature of trauma and challenged long-standing assumptions about how it might be treated.
Strangely enough, my views on trauma crystalized as I watched a teacup fill to its brim and then fill beyond it. The cup was visibly over-filled but did not spill over. The bonds between the molecules of tea created attractive forces that allowed them to resist the force of gravity above and beyond the secure walls of the teacup. Those forces are not infinite. Limits to the surface tension of the tea would have produced a spill-over had I continued to add tea to the cup beyond its inherent tipping point. When not supported by the solid walls of a cup, the dynamic forces of surface tension are even more apparent. Soap bubbles shimmer in the sun, reflecting and refracting its light. Even as they bob on a gentle breeze, the soap film bubble is actively flowing unconstrained by a solid container, thickening its width toward its base even as the upper bubble’s walls grow ever thinner. The inevitable popping of the bubble occurs at the moment the surface tension forces that had sustained its globular shape are exceeded.
As I watched the tea above the cup's brim and thought about bubbles and summers, I recalled my conversation with the soldier. He had reminded me over and again how combat changes you. It changes you through what you are required to do, what is done to you, what you gain and what you lose, the moments when you feel numbed like a dead man walking and the moments when you feel incomparably alive and aware. Mostly what I remember is that he said that it is a mistake to view trauma as separate from life itself. He views it as inevitable and even essential to life. More than that, he said that viewing trauma and PTS through the lens of damage and disorder unintentionally contributes to perpetuation of disability, infirmity, dysfunction and even contributes to suicide. He contrasted how deer accept, adjust and move on from a wolf attack that claims a member of the herd with how a trauma can become a life-stunting event for certain people. He spoke of how he watched the forces of life and death play out in nature. She is violent, unpredictable. In the face of force people remain impotent to stunt the irresistible power of life to forge new paths to survival, to thriving and to flourishing. Those forces are clearly contained in nature. But, as part of the world of nature, they are contained in us, too.
It would be easy to dismiss his comments as testosterone-fueled machismo except that as a man at home in the Rockies and Sawtooth Mountains, he’s devoted his time to creating an organization that takes traumatized vets out into the wilderness and exposes them to “positive pressures” as he calls them. He stretches these men far beyond their zones of comfort and tolerance, and returns them to their lives more whole and alive than when they first arrived. I’ve listened to the transformational testimonials of vets who have come through his and similar programs. And, those conversations are reshaping me just as the programs reshape others.
What elements appear to operate in the programmatic reshaping of these vets lives after exposure to such high intensity experience, and what are the implications for our work with trauma survivors? That question takes me back to the teacup and the soap bubbles. The forces I saw at play with tea and soap film lacked the one element the vets and the rest of humanity share: the capacity for self-organization through acquired experience. In other words, the capacity to learn, and through our learning to become more resilient. No matter how many times a soap bubble is formed and launched into the air, the same process will occur resulting in the popping of the bubble when the bubbles walls are too thin for surface tension to keep it intact. No learning. No evolution. No growth. Not so with people, and even more critically, not so with survivors of trauma.
At a molecular level, learning involves changes at neuronal synapses residing within widely distributed neural networks. Increases in calcium atom proliferation at those synaptic junctions produces synaptic “hardening” of the newly learned experience. In effect, we know we’ve learned something when subsequent reactivation of the neural network is likely to produce the same learned response. When asked, “What is 2 + 2?”, the learned response is rapid and essentially automatic. This is also known as habit formation, which is good when adding numbers but something we certainly don’t want to support when it comes to the perpetuation of traumatic symptom expression patterns.
Translating these varied observations and evolving awarenesses into applied practice leads me to offer the following conclusions about what we have to keep in mind when treating people with trauma.
Experience becomes traumatic only when it exceeds the capacity of the person’s self-container to contain the novel experience. Like the teacup, certain experiences exceed the “surface tension” of one’s acquired and innate coping reserves, resulting in overflow, flooding and symptom generation.
While therapeutic re-processing of the experience can assist in reframing it, the point is that the flooding event(s) is/are now inescapably part of the whole of the person’s lived experiences. The only question is whether they will be integrated into the new self-container effectively and successfully, and how to bring that integration about.
The process of integration relies upon top-down (i.e., cortical -> subcortical) cognitive processes that involve new meaning and purpose making ventures. The experience has to “make sense” in terms of the individual’s overall life. In essence, their life has to be perceived as “bigger than” the particular overflow experience(s). Top-down processes activate the brain’s inhibitory circuits. Inhibitory patterns allow for a precious pause to occur before a reflexive reaction does. In those moments involving a mindful and expanded self-awareness, healthier choices can emerge from among a wide range of possible reactions.
Effective and lasting integration of overflow experiences also involves core bottom-up (subcortical -> cortical) processes that alter unconsciously maintained, emotionally-embodied and over-learned self-system response patterns. Those self-system responses are linked to self-survival networks that are part of the deep brain’s FEAR system (see Panksepp and Bevin, 2012) and thus require powerful pressures to overcome the “neurobiological organism’s” neural firing habits.
Accessing the neural rewiring potential of the brain in the service of trauma resolution requires selective “positive pressures” that re-arouse the person in both bottom-up and top-down ways. Bending steel is much easier under high heat conditions. The key is for the “heat” to be controlled and channeled, as are the frightening and challenging out-in-nature experiences that the vets are exposed to in the western mountains. In essence, it takes new meaning-filled, FEAR system-activating experiences to produce the critical neurobiological temperatures at which the spillover experience can now be safely contained and integrated within an expanded self-container. At that point, there is no longer a spillover but a transformational “spell-over” the result of which is new found meaning, purpose and the capacity to re-engage life with renewed vigor and energy.
- David Alter, PhD, LP, ABPP