The Riggs Blog

Exploring Trauma with Riggs Clinical Staff Member, E. Virginia Demos, EdD – Part 1

Austen Riggs Center Staff Psychologist E. Virginia Demos, EdDIn this six-part series exploring trauma, we will present excerpts from a longer interview with E. Virginia Demos, EdD, a member of the clinical staff at the Austen Riggs Center and an authority on trauma. At the end of the series, we will make the interview, in its entirety, available in our Resource Center

How do people suffering from trauma present themselves to a clinician —or how would a family spot it?

Of course, here we are speaking about people we’ll assume have had actual trauma. We need to be mindful of the problem of false memories—even those that can be implanted by clinicians. But, in general, how a family would spot it depends on where they are in the process of knowing what happened to them. If the trauma is buried somewhere, they can appear quite disconnected from themselves. They might disavow their desires or wishes, and think they don’t deserve what they want, or can’t get it. Some people with trauma hate themselves, but they don’t know why. Trauma is so inexplicable that children come to believe the abuse happened because they were bad in some way. You see, the child needs the parent, other trusted adults, or older siblings and needs to believe that such people can take care of them. So, as a child, it’s more horrifying to believe the older sibs or adults are bad or incompetent than to believe that you’re bad. The child, in order to try to make sense of what has happened, tries to figure out why they were so bad; often their anger at what has happened, or their increased neediness for caretaking is proof enough of their own badness. This deep sense of badness or inadequacy often makes it difficult for them to get close to other people, because that person might discover this “badness.” Thus they often come with histories of avoiding intimacy, or walling themselves off from others.

If the trauma is closer to the surface, they may be struggling with dissociative moments, during which they lose time, or have recurring flashbacks that leave them feeling confused and frightened. Or they may be hypersensitive to sounds or other stimuli. These sensations can leave them feeling that they don’t have control over their lives or their minds. They may have sleep disturbances.  They may fear they’re going crazy. They may have substance abuse problems, and/or eating disorders. They may present as borderline, by which I mean highly volatile. There’s a very high correlation between the diagnosis of borderline and a history of abuse. They can come with a variety of somatic complaints, as well. Often they don’t know exactly what the trouble is. And when they do know, they have become overwhelmed by the terror and lack of control over their minds and their lives. Usually, over the years, they’ve developed a variety of coping strategies. But they come to us because those strategies have broken down and their lives are no longer manageable. 

People with trauma can also be extraordinarily accomplished. We saw a patient who had a history of physical abuse from a close relative.  She was a very bright young woman and drove herself academically. She got into a very good, Ivy League college and began pushing herself and pushing herself, until she fell apart. She was taking extra courses, and was running faster and faster. But she had this underlying despair, and felt the only alternative was to die. Often people who get to us have tried to kill themselves because of this deep sense that something is terribly wrong with them but they can’t quite let themselves know what it is. 

Of course, there is the problem that some of these symptoms can occur when there is no history of trauma, so it would be over-reaching to assume that these kinds of clinical symptoms always mean there was trauma. Not everyone with trouble with intimacy, for example, or with feelings they are bad, has experienced trauma.

Do some people experience horrible events, and come out unscathed? - Part 2

Can you say more about what’s it like on the inside for people with trauma? What do they feel like and think like? And how does that manifest?  - Part 3

It sounds like one of the hallmarks of trauma is its obscurity —its hidden-ness. How do you work with that as a clinician? - Part 4

What does it look like as people start to recover [from trauma]? - Part 5

 

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