Hot Desk Extract: Reclaim

I started seeing Anna when she was 33. She was seeking therapy to

support her with the end of a difficult relationship. ‘I think I’m falling

apart,’ she said, tight-lipped. I looked at her carefully; she appeared

composed, but was twisting a tissue in white-knuckled hands. Rings

of old ridged scars ran up her arm, signalling intense difficulties

managing emotion and a history of self-harm as a way of soothing

herself. There was a single fresh, angry scar slicing across her arm.

Anna saw me looking at it.

‘I tried to stop myself, but I just couldn’t feel better. I wanted

to die.’ She started crying, softly at first and then furiously, sobs

wracking her body. Over time, Anna told me her story, and we started

to understand why the end of her relationship was so distressing that

her own life ceased to hold meaning or value in comparison.

She spoke of her distant, withholding mother who was

absorbed in her own pursuits and of being a young child left alone,

desperately alone — even as she begged and pleaded to be loved

and seen. She spoke of her angry father and the rages he would

fly into, where he screamed at Anna and told her that she was

disgusting and that no one would ever love her. She said that she

hears his voice and feels petrified each time she feels a partner

pulling away or rejecting her in any way. She said that she could

not shake her father’s voice from her internal landscape — that it

went away when things were calm, but re-emerged as soon as she

was wounded by a partner or close friend, and the small, shamed

self, who had once felt so hated, reared her head. Anna preferred

to be on her own, often refusing to connect with other people to

avoid rejection, but then feeling deeply alone.

The world of a trauma survivor can be one of some confusion and

fragmentation.

It involves a set of deep defences built to shield oneself from

the knowledge of the trauma and the harms caused. These defences

protect against the trauma, but they also protect against positive

experiences — we cannot build a wall to keep out the sun without

also blocking the light and the view. Anna had intimate knowledge

of this — she hated feeling vulnerable and did her best to keep

people at arm’s length, preferring to have superficial relationships

instead. While this sometimes protected her from rejection, it also

meant that she had very limited social support to draw on, and often

felt isolated and ashamed of being isolated, further strengthening

the internalised, punitive voice of her father. When she did have

relationships, she found it difficult to be reliably close to people; she

yearned to merge with them, but also preferred to keep them at a

firm distance, and she did a number of things that appeared almost

self-sabotaging. She said it felt like there was an empty hole inside

her, and nothing that partners did was ever enough to fill it.

‘I would prefer to leave first; then at least I’m not waiting around

for them to leave,’ she once said.

This push-and-pull dynamic characterised our work together,

often rearing into the therapy room as Anna pulled me closer, and

then rebuilt her walls or abruptly cancelled sessions. Eventually, she

ended therapy by simply disappearing after our last session without

paying her outstanding fee and ignoring my attempts to contact her

to settle this fee, and to rebook sessions.

This was not dissimilar to the self-sabotaging pattern she

demonstrated in her other relationships.

Beyond the defences, the world of a trauma survivor involves a range

of socio-cognitive difficulties: painful thought patterns, overwhelming

feelings, intense anger, and a range of compensatory mechanisms

to help manage or numb these difficult feelings, including patterns

that appear self-defeating, such as deliberate self-harm or substance

use. Some trauma survivors prefer to block out emotion completely,

and often do so successfully for years by using a range of dissociative

mechanisms. However, it is difficult to operate in the world with its

attendant stressors without the guidance of one’s emotions, and trauma

survivors who resort to defensive emotional blocking often notice that

they somatise emotions instead or that the blocking catastrophically

breaks down, usually precipitated by stress. Other survivors have

little emotional control, lashing out when any strong emotion arises,

experiencing helplessness as they are flooded by difficult feelings.

People can punish themselves for not living up to the rigid standards

they hold, and they may punish others for the same sins.

The traumatised world is characterised by a deep sense of shame

and defectiveness and a range of overcompensations for this, or,

paradoxically, complete helpless surrender to that defectiveness.

Lifestyle disorganisation and health difficulties are very common,

underpinned by a range of complex biological mechanisms, as well

as distorted thinking, learned behaviours (e.g., throwing oneself

into work and ignoring bodily needs for rest and exercise), and

compounded behaviour patterns. Overall, the traumatised world

often feels overwhelming. There is little certainty and no apparent

structure; people remain unsafe, relationships are confusing, and

above all, many trauma survivors trust no one, least of all themselves.

_____________________________________________________________

Reclaim is out now. View more information about the book here.