"Real" Trauma

    Sometimes, when I talk to my therapist about things like going to church, some details about my Evangelical upbringing, or the Baptist school I went to during childhood, she'll listen and then she'll say something like, "That was traumatic for you." Or, "X is hard when there is trauma related it." In my earlier days in therapy, I always felt weird when she'd mention trauma related to those areas of my life. I was even quick to dismiss it to myself and occasionally to her as "not real trauma" because the things I was dealing with didn't meet the definition of trauma that I had in my head because they weren't really "serious" or "big" enough. 

    When we think of trauma, we typically think of "big", objectively terrible events like war, natural disaster, car accidents, being the victim of a violent crime, living in a domestic violence situation, or witnessing the sudden death of someone. If any person lived through any of the things I just listed, they would be reasonably expected to have trauma as a result, meaning the event would have mental health-related consequences, like anxiety, panic attacks, depression, or another clinically diagnosed mental health condition.

    But...what about the events that aren't objectively terrible that still cause a person trauma? This kind of "smaller" more subjective trauma is often dismissed as "not real trauma". People tend to say, "Oh, this isn't a traumatic event for me, so it can't be a traumatic event for you either." 

    That's not actually how trauma works, though. According to the American Psychological Association's Dictionary of Psychology, trauma is defined as, "any disturbing experience that results in significant fear, helplessness, dissociation, confusion, or other disruptive feelings severe enough to have a long-lasting effect on a person's attitudes, behavior, or other aspects of functioning." That definition points out the part of trauma that most people miss. The "any disturbing experience" part of the definition highlights the subjective piece of trauma.

    Trauma isn't caused by the event itself, really. Trauma is caused by the person's experience and perception of an event. Different people experience and perceive events completely differently because different people bring different feelings, thoughts, and associations to the event that color how they experience and perceive it. Trauma, like mental health treatment, isn't a one-size fits all kind of thing. An event that causes trauma for one person might be a normal day for someone else. Many events can cause significant fear, helplessness, and other disruptive feelings for someone depending on how any individual perceives that event.

    An example that comes to mind for me when I think about how subjective trauma actually is, is my own experience with going to Tuesday chapel in college as a person with religiously-based OCD that involves blasphemous intrusive thoughts. Since I went to a Baptist college, chapel was a requirement. Every Tuesday that I had to go into church, I was absolutely sure that, before the service was over, I was going to be struck dead in my pew because of my intrusive thoughts. Can you imagine the fear and the helplessness I felt going to church, sure I was going to die each time but being forced to go for a school credit requirement? Some days I would actually dissociate, only to snap back into reality as I was walking to my first class. For everyone else, chapel was just an average Tuesday while I perceived it and experienced it as the event that would immediately lead to my death. (Thank God for my therapist, y'all, because I'm not in that place anymore.) Just because everyone else didn't experience Tuesday chapel as a traumatic event like I did doesn't mean that the resulting trauma I had to work through with my therapist was any less real than someone else's trauma after a car accident or some other objectively terrible event. 

    I'll end with this: The trauma that results from a traumatic event isn't caused by the event itself. The trauma is caused by the way an individual perceives and experiences the event. Sure, some events are objectively terrible, and anyone that went through any one of those objectively terrible events would be expected to have trauma as a result. However, "smaller", more personal events can cause trauma as well because the trauma depends on how the person feels and thinks about a thing they have experienced. So, just because something wasn't traumatic for you, or just because the thing wasn't an objectively traumatic event, doesn't mean it wasn't a traumatic event for someone else. 

Finally More Than a Punchline

     Last week, I was watching an episode of this new comedy show, Call Me Kat. (It was season 2, episode 2, if you're curious, and it airs on Fox and streams on Hulu.) In this particular episode, one of the main characters named Randi, played by Kyla Pratt, tells her current love interest that she got her tattoo during a time when she was really struggling with depression.

    As soon as "Randi" brought up her mental health, I felt myself bracing for an inappropriate joke about mental illness. I'd seen this sort of thing too many times in comedy shows and movies. I expected "Carter", the love interest, to make an awkward and insensitive joke to "lighten the mood", or I expected "Randi" to make a self-deprecating joke, to beat "Carter" to the punch.  But...the joke never happened. 

    "Randi's" love interest simply asked her if it was any better now. Then "Randi" replied and told him that it was better "most days" and that finding a great therapist and the right medications helped her. And, still, nobody made a joke about it. "Carter" didn't make any unkind remarks, act uncomfortable, or make a joke about her admission that she took anti-depressants or went to therapy. He simply accepted the information and was only concerned with making sure "Randi" knew he cared. I let out the breath I'd been holding. The whole mental health disclosure moment was handled with respect, compassion, and understanding. I had to go back and watch it again. 

    In all the years that I've been old enough to watch comedy TV for a "grown up" audience, I'm not sure I've ever seen a comedy show handle mental illness in this way. I mean, we're probably all familiar with shows like Monk and that infamous episode of Friends in which mental health is treated as a joke. The disclosure of the mental illness or mentioning of the symptom has been, more often than not, treated as the opening of some unkind or awkward joke made at the person's expense or by the actual person in an attempt to be self-deprecating to beat the other person to the punch.

    Call Me Kat could have followed in the same footsteps, but the creators and the writers deliberately chose not to do that. They deliberately chose to make that one scene in the show in a way that was compassionate and understanding and filled with kindness without losing any of the fun and humor throughout the rest of the episode. They chose not to make the joke because, I like to think, the way people think about mental illness is slowly changing. I also think that, if more comedy shows stopped using mental illness as the awkward punchline and started handling it with more openness and compassion like this episode did, it would go a long way toward ending the mental health stigma.

    I'll end with this: For as long as I can remember, the entertainment industry has used mental illness as a joke in comedy movies and shows. Every time someone brings up mental illness in a show or movie, I find myself bracing for the joke, and I'm always still disappointed when the writers go on to make the "easy" joke. It was honestly a breath of fresh air and SUCH a relief when Call Me Kat chose instead to bring up the topic of mental illness and then treat it with the kindness, compassion, and understanding that it deserves. If more shows and movies took the same approach as Call Me Kat, I think it would be a step in the right direction to help end the mental health stigma.

Processing Overloaded...Human Function Disabled

    I'm sure all of us have been in the situation in which a lot of things were happening at once, and generally all the things that were happening should have caused a storm of feelings. Then, for whatever reason, the storm of feelings just didn't happen. We realized that we felt...fine? Then suddenly we're asked to make one small decision, or one small thing goes awry, and that really small thing seems to be the straw that broke the camel's back. Then we're left feeling like we're having some kind of breakdown because of something small like we lost our favorite pen, ripped our favorite shirt, or maybe we couldn't decide what to make for dinner. 

    I recently found myself in that situation. As I mentioned before, I spaced out my therapy appointment for five weeks instead of two. I was dealing with holidays and the emotions the holidays tend to bring up for me. I decided to try going back to church. In addition to all the things that I mentioned before, someone dear to me passed away suddenly. I had also recently found out something that made me feel hopeless. I expected an uptick in my anxiety and to possibly have a panic attack as well as a storm of emotions as I was suddenly buried under all these things, but the anxiety and the rest of the storm didn't happen. Then a few days later, I was trying to choose what I wanted for dinner, and I ended up just crying in the car because that small decision was just TOO MUCH. 

    It felt like my brain was at capacity. It felt like my brain was saying, "Still processing request number one. Please wait until all other requests have processed before submitting another request to the incoming stack. Warning: adding more thoughts and/or decisions at this time may result in a meltdown of the human functions." 

    Since I hadn't taken the time to process all the things that were happening, having to make a decision about dinner felt like the last drop into an overfilled glass that caused everything else to slosh out and make a mess. It wasn't about the dinner itself. It was that I didn't have the mental space left in that moment to do even a simple thing without overloading the processing function. 

    Instead of being able to choose what I wanted to eat, I cried because that was the only option my brain left me with, and the crying turned into an anxiety attack. I cried on the way home, and then I cried for nearly an hour at home until I medicated. I spent the next three days medicated and binge-watching Marvel movies and series while I allowed everything time to process. I cycled through all of my emotions: the anxiety, the sadness, the anger, the grief, the hopelessness, and then I took a nap because all that was exhausting.

    After I took the time I needed to process and I allowed myself to feel all the things, I felt human again. My emotions no longer felt extreme and out of my control. I felt like I was able to think and make decisions again. It was a rough two weeks, and then because I didn't take the time to check in with myself about how all the stress and emotions were processing, it was an even worse three days.

    I sometimes forget, that after something stressful or emotional happens, just because I feel fine doesn't mean that I'm actually fine. I forget that the emotions and stress are still there, just under the surface of my conscious awareness, and that I still need to allow them their time to come up to my awareness and move along. That is, I forget until my brain says, "We have reached capacity. Disable the Human Function. Activate extreme emotional response. These feelings need to go somewhere, NOW." 

    I'll end with this: When we have a lot of stressful, emotional things going on in our lives, whether we live with a mental health condition or not, it's so important to remember that just because we feel fine at the surface level, that doesn't mean we're completely fine. Even if we feel completely fine, it would be a good idea just to go a little deeper and check in with how we're feeling and processing everything that is happening. If we don't check in, we run the risk of our brain forcing us to take a break to process everything whether or not we have the time or desire to do so. 

Pushing the Limit

    It's hard for any of us to admit that we have any kind of limitation on what we are able to do or to mentally carry, but it seems to be particularly hard when that limitation is related to a mental health condition. Sometimes, the knee-jerk reaction to this "invisible" limitation can be to try to push the limits of what we can do or carry, just to prove to our mental illness that it doesn't have the control. From a different perspective, it can also be SO tempting to push our limits after we've been in therapy for a little bit and we've healed to the point that some things that may have been triggers for symptoms of our mental illness seem less triggering than before. I know, we get excited and think, "X happened, and even though I expected to get anxious/depressed/triggered, I didn't/it wasn't as bad as I expected! So, just how far can I actually push this limit now? Let's find out!" 

    I recently found myself in this situation. In my last appointment, my therapist gave me the option to have another session in five weeks instead of our usual two weeks. She also gave me the option to have the usual bi-weekly appointment in a different time slot. I was feeling brave, so I took the option to have an appointment in five weeks to see if I could push my limit. This would also probably be a good time to mention that the holidays are typically a more anxious time for me, but I was doing so well and feeling so brave, that I decided to push my limit a little bit.

    I also decided during this time that I could go ahead give going to church another try, despite already feeling anxiety about the holidays and a little bit anxious about the longer time between my appointments. I went one week, and I made it to late afternoon before all the issues I mentioned in my last church-related blog post crept back in. This time, instead of taking weeks to recover, it took days, and I felt mostly back to normal. The shortened recovery time made me feel like I had improved slightly, and so I decided to push a little more. So, I went back a second time, hoping I would be fine. By the next day after the second trip, I was a crying, anxious mess, and I had started not to like myself again just like I did before. (It's been a couple of weeks since that last trip, and I'm still anxious and riddled with guilt. I'm slowly improving, but it's been rough.)

    So, not only was I dealing with the usual holiday and pandemic anxiety, I was then also dealing with my religiously-based OCD ramped up to full power like it hadn't been in years...and I had put my therapy appointment out for five weeks instead of two. I had pushed my limit too far in too many directions at once in my eagerness to see just how far I could push it because I noticed some slight improvement. It seemed like a good idea at the time, but looking back, I can see my mistake. I tried to carry too many things at once without taking the time and care I should have to make sure I processed all the things.

    I'm not saying to be overly cautious and to never try pushing your limits. All I'm saying is, push your limits SAFELY because pushing your limits too far too quickly can have unpleasant consequences. Talk to your therapist about whatever limit it is that you want to push. Then, only push one thing at a time. If the first little push goes well, and you're still in a good place with your mental illness, after you discuss it again with your therapist, then you could push back on another limit your mental illness has given you. 

    I'll end with this: I know, when we notice improvements in ourselves in relation to our mental illness, especially after we've pushed back on one of our limits, it's so tempting to keep pushing the limits. We feel better and brave, and we get eager to see just how far we can push our mental health limits. This can lead us to push too many limits too far too quickly, which can land us in a spiral. Always remember, to maintain that mental wellness that has made you feel better and brave, you have to be careful with yourself. Push your limits, one at a time, slowly, with the OK and the help from your therapist. Taking your life back from your mental illness isn't a race, it's a slow and steady journey.