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Randy Sutton is a 33-year law enforcement veteran, a trainer, and the national spokesman for The American Council on Public Safety. He served 10 years with the Princeton (N.J.) Police Department and 23 years with the Las Vegas Metropolitan Police Department, retiring at the rank of lieutenant. He is an author who has published multiple books on law enforcement.

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Patrol

PTSD: Breaking the Silence

If you've experienced trauma, talking about what you're feeling and why can be the first step toward healing.

April 10, 2015  |  by Bessel van der Kolk

Bessel van der Kolk's book, The Body Keeps The Score: Brain, Mind and Body in the Healing of Trauma, is a New York Times bestseller.
 Bessel van der Kolk's book, The Body Keeps The Score: Brain, Mind and Body in the Healing of Trauma, is a New York Times bestseller.

Below is an excerpt from "The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma" by Bessel van der Kolk, M.D. Reprinted by arrangement with Viking, a member of Penguin Group (USA) LLC, A Penguin Random House Company. Copyright © Bessel van der Kolk, M.D. 2014.

Activists in the early campaign for AIDS awareness created a powerful slogan: "Silence = Death." Silence about trauma also leads to death—the death of the soul. Silence reinforces the godforsaken isolation of trauma. Being able to say aloud to another human being, "I was raped" or "I was battered by my husband" or "My parents called it discipline, but it was abuse" or "I'm not making it since I got back from Iraq," is a sign that healing can begin.

We may think we can control our grief, our terror, or our shame by remaining silent, but naming offers the possibility of a different kind of control. When Adam was put in charge of the animal kingdom in the Book of Genesis, his first act was to give a name to every living creature.

If you've been hurt, you need to acknowledge and name what happened to you. I know that from personal experience: As long as I had no place where I could let myself know what it was like when my father locked me in the cellar of our house for various 3-year-old offenses, I was chronically preoccupied with being exiled and abandoned. Only when I could talk about how that little boy felt, only when I could forgive him for having been as scared and submissive as he was, did I start to enjoy the pleasure of my own company.

Feeling listened to and understood changes our physiology; being able to articulate a complex feeling, and having our feelings recognized, lights up our limbic brain and creates an "aha moment." In contrast, being met by silence and incomprehension kills the spirit. Or, as John Bowlby so memorably put it: "What cannot be spoken to the [m]other cannot be told to the self."

If you hide from yourself the fact that an uncle molested you when you were young, you are vulnerable to react to triggers like an animal in a thunderstorm: with a full-body response to the hormones that signal "danger." Without language and context, your awareness may be limited to: "I'm scared." Yet, determined to stay in control, you are likely to avoid anybody or anything that reminds you even vaguely of your trauma. You may also alternate between being inhibited and being uptight or reactive and explosive—all without knowing why.

As long as you keep secrets and suppress information, you are fundamentally at war with yourself. Hiding your core feelings takes an enormous amount of energy, it saps your motivation to pursue worthwhile goals, and it leaves you feeling bored and shut down. Meanwhile, stress hormones keep flooding your body, leading to headaches, muscle aches, problems with your bowels or sexual functions—and irrational behaviors that may embarrass you and hurt the people around you. Only after you identify the source of these responses can you start using your feelings as signals of problems that require your urgent attention.

Ignoring inner reality also eats away at your sense of self, identity, and purpose. Clinical psychologist Edna Foa and her colleagues developed the Posttraumatic Cognitions Inventory to assess how patients think about themselves. Symptoms of PTSD often include statements like "I feel dead inside," "I will never be able to feel normal emotions again," "I have permanently changed for the worse," "I feel like an object, not like a person," "I have no future," and "I feel like I don't know myself anymore."

The critical issue is allowing yourself to know what you know. That takes an enormous amount of courage. In What It Is Like to Go to War, Vietnam veteran Karl Marlantes grapples with his memories of belonging to a brilliantly effective Marine combat unit and confronts the terrible split he discovered inside himself:

"For years I was unaware of the need to heal that split, and there was no one, after I returned, to point this out to me. . . . Why did I assume there was only one person inside me? . . . There's a part of me that just loves maiming, killing, and torturing. This part of me isn't all of me. I have other elements that indeed are just the opposite, of which I am proud. So am I a killer? No, but part of me is. Am I a torturer? No, but part of me is. Do I feel horror and sadness when I read in the newspapers of an abused child? Yes. But am I fascinated?"

Marlantes tells us that his road to recovery required learning to tell the truth, even if that truth was brutally painful:

"Death, destruction, and sorrow need to be constantly justified in the absence of some overarching meaning for the suffering. Lack of this overarching meaning encourages making things up, lying, to fill the gap in meaning. I'd never been able to tell anyone what was going on inside. So I forced these images back, away, for years. I began to reintegrate that split-off part of my experience only after I actually began to imagine that kid as a kid, my kid perhaps. Then, out came this overwhelming sadness—and healing. Integrating the feelings of sadness, rage, or all of the above with the action should be standard operating procedure for all soldiers who have killed face-to-face. It requires no sophisticated psychological training. Just form groups under a fellow squad or platoon member who has had a few days of group leadership training and encourage people to talk."

Getting perspective on your terror and sharing it with others can reestablish the feeling that you are a member of the human race. After the Vietnam veterans I treated joined a therapy group where they could share the atrocities they had witnessed and committed, they reported beginning to open their hearts to their girlfriends.

Bessel van der Kolk, MD is a leader and pioneer in the research of traumatic stress. He has been working with trauma survivors for more than three decades. Dr. van der Kolk is the founder and medical director of the Trauma Center in Boston, Mass., director of the National Child Traumatic Stress Network (NCTSN), and professor of psychiatry at Boston University Medical School. His new book, The Body Keeps The Score: Brain, Mind and Body in the Healing of Trauma, is a New York Times bestseller.


Comments (2)

Displaying 1 - 2 of 2

Dr. Hatim Kanaaneh @ 4/11/2015 10:16 AM

The Book made the NYT bestseller list for the simple reason that it is both redouble and informative. But above all it is innovative and packed with revolutionary concepts that challenge the accepted standard precepts of the profession. Its only shortcoming is that it based on the authors record of achievements in the USA and not his worldwide expertise.

David mull @ 4/14/2015 3:39 AM

Been there

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