Getting to the root of dealing with trauma

What lessons do you gain when you are sitting across from the world’s greatest living psychotherapist, described by many practitioners as the “modern Freud”? Straight to the deep end: What is “trauma” that leaves an imprint on us and those around us? Thus began our conversation with Dr Bessel van der Kolk, the leading neuroscientist in the difficult field of understanding and treating psychological trauma.

A few days before his visit to Greece (September 14-15) for a two-day masterclass on trauma and innovative treatment protocols, the guest of the Trauma2Therapy Institute, Dr Bessel van der Kolk, granted an exclusive interview to Kathimerini. In his work “The Body Keeps the Score,” he condensed 40 years of experience in the medical examination of trauma, analyzing hundreds of stories of people who found healing to their “nightmares.” In his book, the 80-year-old “guru” posits as a key challenge that people must become masters of themselves. This is what he sets out as an introduction to those in the auditorium of the American College of Greece (Pierce) in the coming days. 

In today’s rapidly developing world, trauma is presented as an epidemic rather than a declining phenomenon. On this basis, I would like to delve into what trauma is and how it can be diagnosed.

Well, I do not think there is any more of an epidemic of trauma than there has been many times in history before. It is just that people recognize it as such. And trauma is having an experience where you are completely bereft and unable to do anything to change what is going on. It is an event or series of events that overwhelms your mental capacity to cope. For example, you had these forest fires in Greece. Yes, these are disastrous, but they are not necessarily trauma because people are able to do something. They are able to react, train to put out fires, and train others to do the same. And so it is a very bad situation to happen, but it is not necessarily trauma. A trauma may happen with the refugees who see their kids drown and who are completely helpless to do anything about their future. Therefore, at the core of the trauma is very much a sense of physical helplessness.

How can trauma be diagnosed?

What happens when people get traumatized is that their system gets stuck in a state of helplessness, fear, rage and terror. So, the whole system changes and it is no longer quite here; however, the system continues to react as if the past is still happening to them.

How does trauma connect with disorders like post-traumatic stress disorder (PTSD), depression and anxiety?

This is a question that introduces us to the chaotic psychiatric diagnostic system, which is completely unscientific. Psychiatric disorders are just ways of more or less approaching extremely complex mental phenomena.

In your book “The Body Keeps the Score,” you highlight the impact of childhood trauma on adult well-being. How do early experiences like bullying shape long-term mental and physical health?

Even when you become an adult, the basic orientation of your creaturehood, of you as a creature starts reacting to traumatic situations as if you are helpless and threatened over and over again. Even though they live in safe environments they keep reacting to ordinary events as if their life is in danger.

In recent times, there has been a noticeable rise in the incidence of domestic violence and femicide. What factors, in your analysis, contribute to the erosion of familial cohesion and violence?

No, that is not true at all. Greece is a great example of a place where there always has been domestic violence. Check among your friends and ask who among them has witnessed domestic violence in their home. I am sure a lot of them have been subjected to forms of violence. While your grandparents have also witnessed domestic violence. Except today, we actually dare to talk about it. If you know the story of Agamemnon, who was born in your country, then you realize that there was a little trauma in Greece in 500 BC, which is beautifully described by Homer. And all these people killing their children or their neighbors created quite unpleasant experiences. The fall of Atreus was a great example of a traumatized family. Another example is Oedipus, who had to live the rest of his life with the bad experiences that happened to him and traumatized him.

‘What you need is social structures of justice; unfortunately, that is oftentimes missing when you live in a theocratic society, such as Greece’

What are the factors that contribute to the erosion of family cohesion?

So you have all kinds of questions that do not quite fit in with how I would see things. Is there an erosion of family values, or is there a revolt against the patriarchy? It is not black or white. You know, if you look at your own culture, there has been always a struggle with internal violence and violence against women and violence against children. It is not some recent phenomenon. Except now we talk about it.

What strategies can be used to avert the ensuing trauma?

If you are in a domestic, violent situation call the police. Hopefully, the police will not traumatize you, but sometimes they do. So, what you need is social structures of justice; unfortunately, that is oftentimes missing when you live in a theocratic society, such as Greece. Society in Greece for a long time determined what you were allowed to say, and what you were not allowed to, or psychiatrists were telling you what you were allowed to say, and what not. Therefore, it depends very much on the culture and if it is able to recognize that somebody is getting brutalized.

There is evidence that the digitization of our lives and the constant use of social media is leading to shadow trauma. What is your approach to this phenomenon?

I am not sure if that is true. We have no evidence at all about what the digitization of our world does to our mental processes. It has certain advantages and it has some disadvantages. But I would not say it is a trauma. It is like changing who we are as human beings and we will see where it goes.

What strategies or interventions have shown promise in helping children or patients in general recover from trauma?

At first, people recover from trauma by feeling safe. And feeling safe means that you feel physically safe and that you know that you are not going to get punished for what you say or be extruded. And so, first of all, a very important part of dealing with trauma is to be able to tell the truth. For example, in many cases of domestic trauma, child abuse, and spousal abuse, people are not allowed to say what happens. And oftentimes, institutions like the church help people to cover up the stories. So first of all, you need to acknowledge the reality and for people not to get punished for telling the truth. That is the number one issue and number two is that your body needs to be helped to be safe. And that can sometimes be very complicated.

How can society better address and support individuals who have experienced complex or developmental trauma?

What I see happening in America is that people are slowly becoming aware of the reality of trauma. Thus, school teachers ideally become aware that some of the misbehavior of their kids is rooted in traumatic events, meaning kids who have been victims or witnesses of violence at home. So, many teachers are now realizing that these kids are agitated or shut down in the classroom because they are preoccupied with events that have happened to them in their homes.

Unfortunately, it is quite natural in our societies to further punish people who are agitated because of their trauma, and people oftentimes see it as, “Oh, you are misbehaving, so let me punish you a little bit more.” And so, recognizing that certain forms of agitation or collapse in human beings derive from their organisms, which are stuck in a state of terror, fear and rage. And then the question becomes, “How do you calm that down?” 

Traditionally, the way people have calmed us down has been through the use of voices and faces, by talking to each other, making face contact with each other, listening to what people have to say, and creating situations in which people feel safe. Oftentimes, music plays a very important role in helping people feel people are safe. In Greece, for example, dancing together can be extremely soothing. Being able to engage in rhythmical movements with other people can be a very nice way of re-establishing a sense of cohesion with other people. Conclusively, the biggest issue and most important is recognizing the physical symptoms of trauma and creating a sense of safety. Then you can move forward to the healing procedure. 

What should we expect to hear in your lecture and which therapeutic methods will be discussed?

I will talk about how to recognize trauma, about the different effects of different traumas on brain development, and how the age at which the trauma occurs has a big impact on who you become or your identity. Then I will talk about the “eye movement desensitization and reprocessing (EMDR)” method and I will extend to psychedelics. Furthermore, I will talk about yoga and theater and I will delve into the method of neurofeedback and all these different ways that can help people.

I read that you studied ancient Greek at school. How did ancient Greek philosophy and intellectualism influence your later career?

Well, that is hard to say because I am part of the Western canon. I am one of the tens of thousands of people who, in the course of history, studied the classics. It is part of my culture, and I hope it is part of your culture too. What I remember is the following verse from the preamble of the Odyssey: “Tell me, O Muse, of the man of many devices, who wandered full many ways after he had sacked the sacred citadel of Troy.”