Thursday, April 26, 2012

Thursday's Therapy - How Do We Best Cope With Severe Loss and Trauma (Part Three) ~with Dr. Mary Baures

Thursday's Therapy 
How Do We Best Cope 
Severe Loss and Trauma
(Part Three)

By Dr. Mary Baures, Co-Producer and Author of Undaunted Spirits

Continued from last Thursday, the following are the next three Coping Behaviors and Attitudes that Dr. Baures says Help Us Come Back from Profound Loss:

4. Denial

Denial helps us pace ourselves through the process of adjusting to catastrophic loss. Without denial many of the survivors would not have been able to live through their traumatic experiences. 
If Arn Chorn-Pond had given vent to his anger and feelings of injustice he might have lost control and killed. He coped by denying his rage and humiliation.

In recovery from trauma, denial or a sense of unreality or numbness, a feeling of dread combined with a feeling of being afraid to know, can alternate with emotional overload (Horowitz, 1983). This cycle is aimed at restoring the self and accepting new realities. 

Ronnie Janoff-Bulman (1985) similarly argues that adjusting to a new reality is a gradual process. Denial provides us with stability and coherence while we rebuild our basic ideas about life and incorporate them into our internal world. Before we have the resources to accept radical change, denial divides it into manageable doses.

Although he lost both his legs in Vietnam, Max Cleland could not accept that he would never walk again. Through an extraordinary effort, he did what doctors said could not be done: he learned to walk on artificial legs, although they caused him intense pain. He saw the pain as a further test of his endurance. His dream of walking kept him moving hopefully into the future where he rekindled an interest in politics; winning an election eventually gave him the self-esteem he needed to face the reality that he would never walk again.

When people are frightened by overwhelming feelings which disturb a fragile equilibrium, denial is a scramble to ward off panic. Panic is an extreme form of anxiety which comes from not knowing the world one is in (Rollo May, 1969). Trauma destroys our sense of security in the world, but in adjusting to the experience, denial allows us to let in only as much pain as we can tolerate at one time.

5. Hopeful Visions of the Future

The people whose story this film tells forged hopeful images of the future which served as a holding environment, gave them a model to strive for in their imagination, and, as they attempted to make their dreams a reality, gave them a respite from their present difficulties.

Max Cleland began to come back from a severe depression when he decided not to dwell on all the doors which his disability closed for him. Such a focus, he realized, kept him from seeing the doors which it might open for him.

Robert Lifton (1988), however, makes the point that survivors must look backward as well as forward in time, in order to assemble images and feelings that assert, however tenuously, the continuity of life.

6. Developing Skills

Survivors of trauma need to learn to accept those things which they cannot change; more importantly, they need to learn how to work a change where they can. 

To that end, survivors have to, and frequently do, acquire skills having to do with both work and relationships.

Before the trauma, many survivors had skills that seemed appropriate to their gender. Women were more skillful at intimacy and connecting to other people; men were more independent and aware of their agency. 

In dealing with the crisis, the men became more skillful at intimacy or communication, the women realized their own agency more fully and became more independent.

Prior to an accident which left her paralyzed from the chest down, Nackey Loeb lacked confidence. With her husband, she attended meetings at their newspaper, but she would always just sit in a corner and knit. 

The intense struggle of learning to function gave her a kind of self-assurance that she had never known before. 

After William Loeb died, the newspaper needed her and she was able to go in and use the skills she acquired in her own survival. 

Just as women seemed to gain confidence during their crises, men learned how to love and connect in new ways. 

Author Andre Dubus, who spent much of his life protecting those weaker than himself, had to reexamine his concepts of manhood after he became disabled. Before, masculinity was associated with physical strength, but after his body was badly damaged he developed new relationships with his children and learned how to take support from them.


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