Overeating, Undereating, Substance Abuse and Trauma. You Hold the Key.

It can seem to be such a small amount of time compared to one's life, but so strong in the devastation it leaves. Memories of events too terrible to live through even once, indelibly imprinted in memory. Sights, sounds, smells, touches, feelings; senses storing memories to reappear in nightmares, in discussions, unbidden and undesired, or reacted to without an awareness of why.Feeling unsure of what's going on, lonely, alone and afraid.

Post Traumatic Stress Disorder, PTSD, the collection of symptoms often left in the wake of trauma is not pathology, in this therapist's opinion, but an understandable response to horrific experiences. People re-experience the trauma either in nightmares or when a trigger in their environment is similar to something that occurred and raises feelings, sometimes without being aware of why. For example, a person raped by a bearded stranger might pass someone with a beard and have an anxiety attack, wondering where their anxiety came from.

Hypervigilance, being on high alert, scanning the environment for danger is another symptom as is something called psychic numbing, being out of touch with feelings. Dissociation can also occur. Dissociation is a feeling of being separate from oneself perhaps even watching as if the trauma is happening to someone else. Avoidance, making changes to avoid situations, discussions or other behaviors that would lead to anxiety is another.

Many people entering treatment that have been through trauma have co-existing conditions. Alcohol or substance abuse, overeating, Anorexia Nervosa, Buleimia or other eating disorders, self-injurious behaviors such as excessive piercing or tattoos (not done for aesthetics but for the experience), carving or cutting are some of the behaviors we often see together with PTSD. It is sad and unfair that someone does these things to themselves while the perpetrator goes on living their life without the pain and struggle.

Sexual abuse, rape, physical or other types of abuse, domestic violence, victims of other types of crime and others affected by trauma can carry things left by the perpetrator. Effects of the trauma make some feel as if they are damaged, are incomplete, that something is wrong with them.

Eating Disorders, both overeating and under-eating, can be seen as a way to control the uncontrollable. Both often are used to self-medicate and at times to keep oneself at a distance. If we overeat we can insulate ourselves emotionally and perhaps keep people at a distance.

There are a lot more to eating disorders than this. Treatment, not only by a licensed therapist, but by one who knows eating disorders that addresses the issues, is needed. A future post will focus on treatment of trauma as therapist's treatment ranges widely from inadequate and avoidant to highly skilled.

Victims are victims. They did not cause it to occur, though self-blame is frequently present. The perpetrator made a choice, caused it to occur. Anger that should be towards the perpetrator sometimes gets directed at oneself. Not fair. That person should have the feeling of shame, not the victim. Though it may feel otherwise, the perpetrator has something wrong with them, not the victim. The victim has the effects of what had occurred to them.

There is a way out. We don't have to overeat and feel bad afterwards. We don't have to starve, binge or purge or do other behaviors to get the pain out. Meeting with someone, a therapist, who works frequently with trauma and knows what they're doing can be like getting a key to let yourself out of a prison that has been familiar for a long time. You can do it, one step at a time.

There are times when we need others. As a therapist who specializes in trauma I am ineffective in working with myself. I cannot be inside a problem, and be outside looking at it from another perspective. If I am lost somewhere unfamiliar I can't give myself directions, I don't know them. I can't know all the answers, I just need to know where to get them. It's not about skill or intelligence, but about being human.

If you are stuck, know that there is help. If you have been a victim of trauma, know that PTSD is an understandable reaction to trauma, and that there is a way out. Know that you are okay, and that any anger needs to be at the perp, not you. Take care of yourself and know that you have the key.