Why Addressing Trauma Has to Be the First Step
By Christina Mallie, Founding ED of Colors of Connection
Trauma fundamentally changes our understanding of the world. In my own experience with trauma, the emotions I felt were deeply terrifying and disorienting. I didn’t have the words to identify, let alone express what I felt, so it wasn’t possible to share my experience with my friends, my family, or anyone close to me. I remember the only way that I felt connected to what I was experiencing was when I was painting alone in my room or in art classes. I developed a consistent “style.” Near the completion of whatever subject I was painting — a portrait, figures, or landscape — I would add a jagged red line that cut through the image. It always felt right to do that, in retrospect perhaps because it represented how my life had been disrupted by something painful. Those years of my life were like living in another reality. I felt largely unable to connect to the more “normal” dramas and experiences of those around me. I was disconnected, depressed, and rarely at ease.
As debilitating as trauma is, it is also very common. At some point in life, 7 out of every 10 people will have a traumatic experience. Even though trauma is pervasive, there is not a lot of space for it — culturally, socially, economically, politically. We often avoid it, minimize it, hide it, or treat it as inappropriate, all things that throw up barriers to healing.
We would fare better if we made the effort to understand how trauma impacts us, and the systems that contribute to it. Traumatic experiences are not equally distributed; deep social inequalities mean that some groups of people will know it more. In places of endemic conflict and poverty, and for groups who are marginalized — including women, black, indigenous, and people of color, and non-binary people — trauma will be higher. These groups have a greater need for resources and effective approaches to treat mental health. The World Health Organization found that 1 in 5 individuals living in conflict have a mental health disorder. And yet 75% of individuals with mental health conditions in low and medium income countries do not receive any treatment.
Post traumatic stress disorder (PTSD) first made it in the Diagnostic and Statistical Manual of Mental Disorders (DSM) 40 years ago. Since then, our understanding of how traumatic experiences shape the brain has radically improved, along with a suite of tools for how to treat trauma. Pharmacology has developed medications that help millions manage mental health, and therapies such as Eye-Movement Desensitization and Reprocessing (EMDR) have opened up new fields of treatment for PTSD.
But while the field of psychology continues to evolve, innovations in treatment have lagged far behind. There is much more ground to be covered in the areas of the research and practice outside of talk therapies and mainstream drugs. We need effective, affordable, culturally relevant solutions that consider the whole person.
Bessel Van der Kolk, a psychiatrist and researcher speaks to this deficit in his NYT bestselling book the Body Keeps the Score. Advances in biopsychology have enabled researchers to get not only a more complete picture of how trauma impacts us, but why alternative therapeutic approaches such as the arts, yoga, and meditation are needed to treat PTSD. Through neuro imaging studies of patients with PTSD, neuroscientists have been able to see that during a traumatic experience the left side of the brain, the place where we create narratives and use executive functioning goes dormant during a traumatic event, and the right side of the brain — where we store memories of our physical experience such as touch, smell, taste, and images — remains active. Thus we intimately collect the sensory details of the trauma while our rational brain goes off-line.
These brain scans reveal the biological workings of traumatic experience — and explain behavior, such as why PTSD patients have trouble expressing their traumatic experience with a coherent narrative. The fact that brain scans of people experiencing PTSD are similar to those who have experienced a stroke and lost speech capabilities is telling of how psychological experiences of trauma have real physical impacts. Trauma literally disables our ability to process what is happening to us.
New biopsychology research is showing us that trauma treatments need to include approaches outside of left-brain focused therapies (talk therapy) that have been undervalued or overlooked. Art has a special connection to the part of us where trauma lives. Music, dance, drawing, painting sculpture, theater — these art forms tap into our senses. When people experiencing trauma or PTSD make art, they have a way to express their emotions and make sense of their traumatic experiences. They find an outlet for expressing themselves that surpasses language.
Years later, after having time to heal, I can see that when I turned to painting, and found the red line so important, I was making sense of my trauma.
Traumas are not only painful, they are dangerous because they can stymie our growth and development. They become the center of our identities, how we find meaning, and we get stuck there until we can make sense of what we have experienced. Art offers a path out, allowing us to process and confront our trauma in a way that can be manageable, while at the same time cultivating the vision and creativity so essential to growth in life. When traumatized, we lose the capacity to imagine. Part of the healing process is to resuscitate it. Van der Kolk says, “Imagination gives us the opportunity to envision new possibilities — it is an essential launchpad for making our hopes come true. It fires our creativity, relieves our boredom, alleviates our pain, enhances our pleasure, and enriches our most intimate relationships.”
There is minuscule support for trauma-healing and alternative approaches. This is especially true in communities where the likelihood of trauma is high. A 2019 review of the past decade of international funding for mental health (not even considering alternative approaches) made up only .3% of all development assistance for health. We know that emotional health is central to every effort and ignoring this truth undermines other work. Expecting a better future without laying the foundations for traumatic recovery is a disservice, and an ineffective way to use our resources. It’s time to do better.