PTSD – A Way Out A mindful way to heal

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Excerpt: From Bessel A. van der Kolk, MD

“The Body Keeps the Score”

“When trauma emanates from within the family, children experience a crisis of loyalty and organize their behavior to survive within their families. Being prevented from articulating what they observe and experience, traumatized children will organize their behavior around keeping the secret, deal with their helplessness with compliance or defiance, and acclimate in any way they can to entrapment in abusive or neglectful situations.

Being left to their own devices leaves chronically traumatized children with deficits in emotional self-regulation. This results in problems with self-definition as reflected by a lack of a continuous sense of self, poorly modulated affect and impulse control, including aggression against self and others, and uncertainty about the reliability and predictability of others, expressed as distrust, suspiciousness, and problems with intimacy, resulting in social isolation.

Chronically traumatized children tend to suffer from distinct alterations in states of consciousness, including amnesia, hypermnesia, dissociation, depersonalization and derealization, flashbacks and nightmares of specific events, school problems, difficulties in attention regulation, disorientation in time and space, and sensorimotor developmental disorders. The children often are literally are “out of touch” with their feelings, and often have no language to describe internal states.

When a child lacks a sense of predictability, he or she may experience difficulty developing of object constancy and inner representations of their own inner world or their surroundings. As a result, they lack a good sense of cause and effect and of their own contributions to what happens to them.

Without internal maps to guide them, they act, instead of plan, and show their wishes in their behaviors, rather than discussing what they want. Unable to appreciate clearly who they or others are, they have problems enlisting other people as allies on their behalf. Other people are sources of terror or pleasure but are rarely fellow human beings with their own sets of needs and desires.

These children also have difficulty appreciating novelty. Without a map to compare and contrast, anything new is potentially threatening. What is familiar tends to be experienced as safer, even if it is a predictable source of terror.

Traumatized children rarely discuss their fears and traumas spontaneously. They also have little insight into the relationship between what they do, what they feel, and what has happened to them. They tend to communicate the nature of their traumatic past by repeating it in the form of interpersonal en- actments, both in their play and in their fantasy lives.

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