Schrodinger's Trauma: "If everything is traumatic, nothing is traumatic"

How the trauma "debate" mirrors the dynamics of a traumatised mind (and why that matters).

Salutations, I’m Skye. I’m a psychotherapist (diagnosed ADHD) and I write about therapy, therapy culture (yes, they’re different things), neurodiversity, trauma, creativity, addiction, psychology, meaning and relating.

I can barely remember his face. Such is often the way with memories, especially the ugly ones.

I can remember what I was wearing though (jade blazer, houndstooth pumps) and how numb my ass already felt on the chair (unyielding fake leather over gleaming corporate steel). I can remember the shaft of afternoon sun beaming through the window, dust motes sparkling despite the abject soullessness of the consulting room. I can remember the boredom in his voice.

“So just to be clear, you’ve never experienced any trauma?” the psychiatrist drawled as he clackety-clacked at his keyboard.

Excuse me?

I could only think the words, not quite spit them out. I took a deep breath, and let it out slowly. Maybe I’d simply misheard.

I’d just finished answering a range of uncomfortably intrusive questions about my brother’s suicide. Method. Body discovery. Aftermath. How it felt to receive the news. My opinion on why he chose this final, violent act. The extensive, colourful, and floridly shameful extent of what I did afterwards to “cope” with the horror show that now passed for living.

Just to be clear, you’ve never experienced any trauma.

It wasn’t really a question, but I answered it all the same: “Well. I’d say what I spoke about just now was pretty traumatic for me.”

I can’t remember his face. But I can remember that he started to roll his eyes and then caught himself. He smiled quickly, and briefly, and unconvincingly. “Sure. Right. But I’m talking about something really traumatic. Getting gang raped, for example. Has anything like that ever happened to you?”

---

I promise I’m not making this up. At least, not on purpose. As much as I can trust my memory, this recounting includes neither fabrication nor exaggeration. Admittedly, memory isn’t as reliable as most of us would like to believe, and that’s very relevant to the core of what I’m going to attempt to get at here.

“Trauma” is, once again, something of a hot topic. The discourse seems to flare up periodically like a warm bucket of coals — potentially dangerous and stubbornly persistent. Because I have the blessing of a brilliant clinical supervisor (and also because I’ve also read way too much Last Psychiatrist), I know there’s a reliably sane way to observe a debate like this one: don’t get distracted by the words people are saying, don’t get caught up in trying to pick a side, watch the dynamic.

“What is Trauma?” is the Wrong Question.

Roughly, there’s two “positions” in the trauma debate:

(1): trauma explains every mental health issue in the DSM (and therefore, we can and should ditch the DSM). If you have a mental health condition, and claim you’ve never experienced trauma, either you don’t remember what happened or you’re so defended against it you can’t recognise how damaging it was. We are almost all traumatised beings. Bessel van der Kolk and Gabor Mate are both strongly associated with this stance, though both of them are rather more nuanced than their detractors like to pretend they are.¹

(2): the term '“trauma” should be reserved for the most extreme circumstances (essentially, war and gore). Otherwise, we encourage people to tell a victim story about themselves that discourages resilience and agency (the charmless midwit conducting something vaguely resembling a psych assessment in the opening vignette clearly fits into this category).

Both stances include (in my view anyway) a solid measure of truth, and I’ll say more about this in a minute. More importantly, though: these two polarised positions echo almost perfectly the two positions a traumatised mind tends to take in response to what it has lived through:

(1): I am what has happened to me. What happened to me is wound into the core of who I am. It is inescapable. I am beyond hope, redemption and understanding, cut off from the essence of what makes me human, and from any who might shepherd me back into the fold of the living. (i.e. trauma shapes everything).

(2): Nothing has happened to me at all. I have no right to claim suffering, or pain, or dysfunction, no right to cry or rage or grieve. It wasn’t that bad. If I think it is sometimes, when my hands shake or I wake up terrified in the night, I am lying or being dramatic. It doesn’t count. It wasn’t bad enough. (i.e. trauma is for war veterans, only. Maybe).

Some traumatised people tend towards the first position, and some the second. Some unfortunates — many unfortunates — whipsaw between both, forgetting each time they shift position what it felt like to experience the other pole. Trauma is a malaise of extremes. Feeling everything, or feeling nothing, or both. Feeling so much nothing you could die of it. Seeking safety. Seeking danger. Seeking either/or, depending on the day. Fighting and raging. Running and hiding. Numbing out. Digging in your own flesh, trying to get deep enough to feel something.

What’s important to remember is that neither is entirely true. What’s most important to remember is that neither is particularly relevant.

Because the salient bit about trauma isn’t about what happened, or how bad it was, or what to label it, or how to measure it.² It’s not even about what you tell yourself about what happened to you (though that gets closer).

The relevant question is this, and only this:

What are you doing with your suffering?

I’m a trauma therapist, for the record. I don’t claim to be brilliant, but I have proven myself at least well enough to receive government funding (and believe me, official departments where I live are not exactly profligate where it comes to mental health money). In addition to seeing my own private clients, I’m also commissioned to assess and diagnose people who are seeking psychotherapy following a traumatic event. The vast majority of my practice involves working with trauma — usually sexual trauma, but also plenty of significant early life ruptures, exposure to horrific tragedy, the whole spectrum of small-t to Big-T trauma.

Nobody has yet walked into my office and told me they’re there because of “trauma”. They don’t lead with “I found my neighbour’s body”, or “My stepdad abused me”, or “My mom was a drug addict.” What happened isn’t the point. It’s not what brings people to therapy. Rather, people lead with what they’re doing with their suffering. Things like:

• “I can’t control my emotions. Sometimes I get so angry, and I say the most terrible things, and then I can’t stop crying. Other times I can’t feel anything at all, and that’s almost worse.”

• “I can’t stop hurting myself and I don’t understand why. Last time, I went into a sort of trance, and cut myself so badly I needed stitches. I’m really scared.”

• “I don’t want to be alive anymore. I don’t think I want to kill myself, but I just don’t want to exist. Everything is hard. There is no joy.”

• “I watch horrifically violent porn. I feel disgusting and I hate it, but I can’t stop.”

• “I want to be in a good relationship, but the second I meet someone who treats me with kindness I feel absolutely repulsed by them.”

• “I feel like there’s something missing in me, or something dead at the core. I don’t feel like a person. I don’t feel real.”

The “trauma debate”, if you can call it that, is curiously irrelevant for all the sound and fury currently raging around it. Whether X horrible thing should “count” as a traumatic event, or whether people can really claim to be “traumatised” by things in their earliest years of life despite lack of memory isn’t as important as you’d think.³ Trauma treatment doesn’t begin with the event, it begins with the impact. From the impact, we work to understand likely causation. From there, we make a treatment plan.

Now. To further elaborate on what I mentioned earlier, each position in the argument contains a kernel of important truth and an equal measure of something dangerous.