Luuk L. Westerhof, MSc
What interest me as a therapist is topics such as trauma, addiction, child development, human potential, stress, health, and the relationship of the individual to the communal, familial, and social environment. I am looking for the unity of things and how the unity of everything shows up in health and illness. The Buddha once said, “One holds the many and many holds the one. There is no many without the one and no one without the many.”
My personal life history can be a bit misleading because there is so much drama to it that people, when they think of trauma, they think such things must happen for us to call something trauma. Where I think trauma is much more subtle than that.
Clyde Hertzman, a seminal known researcher on child development, said that it’s not the big things, but the daily misfortunes that affect children that have overall impact.
So, with that in mind, my trauma is somewhat dramatic because it happened from the day I was born. Being born as an asthmatic infant separated from my mother’s care immediately after birth something that disrupted necessary attachment and robbed me of the neurological first and foremost needs, safety, and attachment. The separation from my biological caretakers has undermined my ability to attach properly in infancy and life overall. Too, the ability to feel safe in this world has been compromised. I have suffered many emotional consequences due to the traumatic separation from my primary caretakers.
The separation has had a huge impact on the formation of my personality and my emotional state and determining many aspects of my behavior and emotional life later. Yet, I must emphasize that you don’t need the drama like mine for people to be hurt.
The experiences in childhood shape our development and adult behavior. And my understanding is that those experiences has taught me a lot about how trauma affects children, and their development. One of the pivotal questions regarding being traumatized in childhood is, how do children adapt and get through these experiences? How does it affect them as they grow up into adults?
Life affects human development. Whatever happens in life will influence human development and whether those things are good, whether those things are harmful. All that will have an effect because we’re creatures of the environment and we’re born with certain biological and psychological needs.
We can’t separate the two -the biological and the psychological- because the emotional needs that are not met has direct and definable and defined physiological effect on the brain and on the body, and this begins in already in utero, the preverbal stage.
So already the stresses on a pregnant woman will have an impact on the physiological stress reactivity of the infant. Recent studies show that stress on the mother in pregnancy shows documentable effects on the infant’s stress responsivity and way up into adulthood.
The more stressed a woman is, to more inflammation that might translate in the child’s body, and successively the more stress regulation mechanisms of the brain might be disturbed. Too, metabolism becomes affected due to chronic stress. Chronic stress -from mother to child- goes on to childhood infancy and causes a combination of physical effects. Trauma translated through stress shows in disruptive visceral sensations.
Looking at how the human brain develops, the most important and pivotal determinant determining influence on the actual development of the brain is the quality of the emotional relationship between the child and the parenting caregiving environment. The child’s neurology is primarily shaped within the realm of the parental relationship.
In an article from Harvard Center on the Developing Child published in the Journal of Pediatrics in 2012 says,
“The architecture of the brain is constructed to an ongoing process that begins before birth, continues into adulthood, and establishes either a sturdy or a fragile foundation for all the health, learning, and behavior that follow.”
Thus, it is not some aspects of health, learning, and behavior, but all the consecutively health, learning and behavior that follow. In a second sentence in the same article,
“The interactions of genes and experiences literally shapes the circuitry of the developing brain and is critically influenced by the mutual responsiveness of adult-child relationships, particularly in the early childhood years.”
Under the circumstances of my infant years when both my father and mother were absent, they could not provide me with those playful, relaxed, stress-free interactions that I -my neurology and body- required for my healthy development. In the absence of those much-needed loving and caring cues, my lung condition worsened dramatically.
Today a lot of parents are stressed in such a way that they can’t be responsive to their children’s needs. This lacking ability of responsiveness has nothing to do with the parents not loving their child but tells a story about that too much stress disables and disconnects a parent -people overall- from their ability to respond sufficiently to the needs of the child and their own. Stressed parents are often too, depressed. They don’t feel that they succeed “good enough” in their parental tasks and become discouraged. The feeling of not being “good-enough” can contribute to the re-experience of trauma. Trauma than becomes a distraction worsening the biopsychosocial condition of the parent rendering the parent in a state of powerlessness.
Children are at their core resilient and highly adaptive. In highly stressful environments that adaptability can be a remarkable skill and sensitivity later in life, yet it comes with a price. The question is how adaptation happens and how some and some not end up with these exceptional skills?
Going back to the Harvard Center on the Developing Child, 2012 we’ll find the following quote,
“Growing scientific evidence demonstrates that social and physical environments that threaten human development because of scarcity, stress, or instability can lead to short term physiological and psychological adjustments that are necessary for immediate survival and adaptation. But which may come at a significant cost to long term outcomes in learning, behavior, health, and longevity.”
Reading this quote raises the awareness that adaptations are necessary and help the child endure the immediate stress, even though they become a source of problems later, in most cases. The adaptations in itself do not result in the formation of managing skills, but in steadily working through them through the lifespan that fosters and results in the formation of certain skills.
Tuning out absent-mindedness is an observation; dissociation is an adaptation. When the stress is too much and one can’t change the situation or escape from it, then one dissociates.
Well, that’s not a good thing, but it’s a good thing in the short term because otherwise a child’s brain just couldn’t endure the stress. That same dissociation then can result later in any set of mental health and/or physical conditions.
Given the first years of my life, I got the message that I’m not wanted. Well, that has translated itself in the adaptation of working ridiculously hard to make myself wanted. Neuroceptic -an awareness without the assistance or aid from cognition and mental knowledge- there is that hope that people will affirm me as being a really good therapist. So, I work hard. I’m available to my clients. I work hard to ensure that clients are pleased and confirm my “being-good.” There is nothing wrong with this skill, it has helped me to adapt and survive. Yet this adaptive behavior becomes counterproductive when my desperation to be wanted and validated to justify my existence separates me from my “authentic self.” The disconnection from the authentic self-compromises the immune system thus opening for e.g., autoimmune diseases, certain forms for cancer, and visceral distress like hypertension and constipation.
Being a dedicated therapist or any other professional is a good thing. But if it’s driven by an unconscious need, it’s not a good thing; it makes you depended on sources outside of you for survival, rendering yourself to the mercy of other people. The ability to be connected to the authentic self is located within the confines of safety and is needed to prevent learned helplessness.
Working through those things will help you to broaden your scope of insight and empathy and compassion through working through “the stuff.”. The adaptation itself makes you compassionate.
From early age on, I am aware of the immense pain residing in the world. Too, I know there are people that have felt pain and were hurt yet did not deserve it. This raises the question, why are people hurting people? How could this or that have happened? What made human beings behave the way they did and do? And what makes them today behave the way they do even though they know that they are hurting and thereby re-traumatizing people?
I think that we may consider one thing to be genetic, namely, sensitivity. One of the biggest mistakes e.g., clinicians make us to think and postulate that sensitivity (as in ADHD) is an inherit mental diseases. No research has to this day come up with scientific evidence that sensitivity is genetically. There’s no gene that codes for any mental illness too, no set of genes that code for any mental illness. There’s no set of genes without which you can’t have a mental illness. There are a set of genes which if you have them, you’re more prone to have any number of mental health problems non-specifically.
But with the same genes given good circumstances lead to increased creativity, leadership, spontaneity, aliveness. So, what are the genes for? The genes are for sensitivity. And the more sensitive people are, sincere, meaning the Latin word sincere to feel, the more they feel. That means when bad stuff happens, they feel that more and their adaptations become more rigid. At the same time when good things happen, it has a more positive effect on the sensitive person. So, sensitivity itself is a neutral quality given the right environment, it’s highly beneficial. Given the negative environment, it leads to more pain and more suffering. But it always makes for a more possibility of insight and empathy.
Adaptation itself is multilayered and has a certain wisdom to it. Trauma is not primarily what happens to you but what happens in you because of what has happened to you. To put it in other words, you can be hit by a storm, yet you are not the storm. Biopsychosocial problems start to occur when we move from “experiencing a storm” to become the storm itself. The word trauma comes from the Greek word for wound. With other words, trauma is a wound being inflicted on you through an adverse event.
Now, let’s say you have a three-year-old child throwing a temper tantrum. If you follow (sadly, many do) psychology professor Jordan Peterson’s advice, an angry child should be made to sit by himself and realize that you give the message that his anger is not acceptable. Now, what will a three-year-old do if he continuously gets the message that his anger is not acceptable? What will he do with that anger? They’ll stuff the anger down as far as it can go, thus becoming a container for unresolved aggression. A tantrum is a child’s adaptive ability to make sense and meaning of the world and relationships he lives inn. When not met empathetically the child will depress his anger and sense of being unsafe. Depression thus becomes an adaptive skill and must not be understood as a maladaptive and manipulative behavioral pattern.
To express the anger is to threaten adaptively their relationship with the people that they rely on. So, there comes a wisdom with that adaptation -tuning-out. There is wisdom in these adaptive manifestations.
Maybe a contradiction yet plausible, disease can be embraced as a teacher. Through the years a lot of people have told me that they wouldn’t switch their disease for non-disease because of what they’ve learned. I don’t promote that way of learning but telling you what people have told me. From an educational perspective, trauma than contains a lot of wisdom and learning and that wisdom comes in multiple ways.
There is wisdom in adaptations – the de-pathologizing of what people attempt to ward off and what they are going through. E.g., when we think about addiction, we are inclined to think that everything about the addiction is wrong. But what if there is something right about the addiction? What if addiction is an adaptive feature aiding a person in obtaining temporary pain relieve? The issue is not to propagate a certain model but to consider the wisdom in the addiction, i.e., what is right about it? What does it do for a person that is so meaningful and helpful that it overrides all the negative consequences for himself and the environment.
If we really want to understand traumatized and addictive people, we need to let go our hold on certain models as being the only right explanation and solution to e.g., the opioid crisis. The medical model has addiction as a disease largely inherited, which is genetic absurdity. There are no genes that code for addiction. Nor are there genes that if you don’t have them, you can’t get addicted.
Addiction is more an adaptive feature aiding a person to obtain temporary pain relieve. This does not mean that a person can’t have certain sensitivities, which has to do with certain genetic predispositions. A predisposition is different from a predetermination, they are not identical. To really understand what’s going on in addiction, let’s look at what an addiction is.
Addiction can be defined as a complex, psychophysiological process–manifested in any behavior that a person finds temporary pleasure or relief in and therefore craves. Yet suffering the negative consequences because of the alienation of self, family, friends and so on, yet has trouble giving up the addiction despite all the negative consequences. Addiction then as an adaptive feature is short term oriented and focused on temporary relief, pleasure, craving. The long-term consequences e.g., harm and alienation are mostly beyond cognitive awareness; pain relief is the main objective simultaneously fostering the inability to give up the addiction.
Taken into consideration the definition of addiction we know that addictions could be to substances, prescription drugs, alcohol, sex and other illicit substances and stimulants. Too, addiction can be sports, training, shopping and so on. The issue with addiction is not the activity itself but what internal relationship does a person have with the addiction. What does connect a person to the addiction? What purpose does the addiction serve? What do you like about your addiction? Addictions are adaptive features aiding a person to distract and dissociate even though it’s just temporarily. Temporary pain relief overrides the awareness of long-term consequences. Addiction provides for a temporary mental holiday, a temporary get-away from the noises in my head. Even though many addictions have been criminalized in our society, for the addict addiction is not the primary problem. It’s not a disease rather it’s an attempt to reduce emotional pain and solve problems. The question must not be why the addiction but rather why the pain?
So, the question on addiction is not why the addiction, but rather why the pain? Now, if I look at why the pain, I’d have to look at your life and my life and everybody’s life. Something has happened down the line that create that mental noise. And we live in a culture, that delivers and instigates a lot of mental noise. But again, it still has to do with child development. And that mental noise is not an automatic attribute of a human being.
So, rather than seeing the addiction as the primary problem, we can look at the issue of mental noise as a primary problem and what maybe can be done to quiet it in ways that don’t have negative consequences. Then addiction transferred from the disease model as a response to a human experience model. Which means that treating it requires a consideration of the human experience and the trauma, the traumatic imprint that human experience carries. The neglect of the human condition has left me critical about the mainstream medical approach to trauma and addiction.
What I advocate is that we start talking about the way we think and talk about trauma and addiction and where we should head with all of this. Most chronic illness, whether physical, so-called, or mental so-called, is rooted in trauma. Addiction follows trauma. The British psychologist, Richard Bentall, writes that the evidence regarding psychosis, for example, to childhood adversity is stronger or is about as strong, at least as the evidence linking cigarettes and lung cancer or lung disease. So, it’s not like we lack the evidence.
All mental problems is a response, in my view, an adaptive response to childhood adversity and trauma. Most chronic illnesses are adaptive responses, to put it more simply, the body keeps the score and will in many cases shut down – a physiological response when the Body Says No. A Harvard study shows that women with post-traumatic stress disorder, severe post-traumatic stress disorder doubled the risk of ovarian cancer. Animal studies show that stress and trauma increased the risk of ovarian cancer, and that there is a connection between emotions and malignancies. This information has been coming in for decades and decades and decades. So, whether you’re talking about autoimmune disease or talking about malignancy, that is a huge traumatic imprint every time.
The average medical student never hears or learns anything about childhood trauma, at least until recently, it’s changing a little bit. The average student does not get a single lecture on trauma. You should get a whole year long course on trauma. They don’t get a single lecture. Except physical trauma, like, you know, broken bones and so on.
Western medicine has the unfortunate tendency to separate the mind from the body, the emotions from the physiology, which scientifically is non tenable. In real life, it doesn’t exist. Let me induce any emotion in you and see if it doesn’t have a physiological correlate in your body right away. Whether you’re happy, relaxed, or terrified or angry. All emotions have physiological imprints. They all involve your nervous system, your cardiovascular system, your gut, your immune system, your hormonal apparatus, it’s all one system. Western medicine does not take that unity into account. Either in its understanding of the etiology of illness, the causation of illness and certainly when it comes to the treatment of it.
In the wake of Western medicine separating the individual from the environment, addiction is seen as an individual problem. The truth is, It’s not. It’s a multigenerational family and social problem. The fraying of the social net has resulted in massive dislocation, massive despair, and massive increases in addiction. You can’t separate the individual from the environment.
Nobody develops PTSD on their own. That happens in collaboration and interaction with an environment. And there are forms for cancer that can manifest itself in the individual female body as a manifestation of a social process. Too bad, that this is not sufficiently understood.
Another sad thing with Western medicine is constituted in their denial that the body and psyche own healing capacity. This denial is the very “red-carpet” rolled out as an invitation to the “cure” industry. With the cure industry comes symptom suppression, for example, chronic mental health conditions and chronic autoimmune conditions. All we do is we suppress symptoms. But that the psyche or the Soma, the soul or the body is an innate healing capacity that can be encouraged and invited and supported, that’s not considered in Western medical training or the Western medical ideology. Many sources contribute to the plethora of biopsychosocial problems that people encounter. Problems that are social and economic and political. Yet, adequate treatment lays in an integrated holistic approach.
Now, people are born with certain needs, e.g., safety, security, and attachment. And given that our biggest need is that mutually responsive relationship with a nurturing environment, deprived of that, who doesn’t get wounded? And in our society, very few people really get that optimal, nurturing, interactive, responsive environment because their parents are too stressed. Because the community is no longer there to support the parents, as it was throughout our evolution. Because parents are themselves traumatized.
Because society creates a lot of strain and puts a lot of burden on people. So, there are very few people who are not wounded in this culture. If you understand the meaning of the word trauma as coming from wound, then yes, there are very few who are not traumatized to some degree or another. Now, there are, of course, ranges and a whole spectrum of trauma, but hardly anybody escapes it completely. Now, when I talk about Western medicine, I acknowledge its significant achievements. So, my objective is not to be critical. I’m just making a critique. I’m saying, here’s how it is. Here’s what medicine can do and here’s what it can’t do and why it cannot do it.
Pivotal for people is to know the truth about issues such as trauma, mental and physical health so they can respond more adequately to whatever is perceived as a tread to mental health and equilibrium. People need at least the possibility to see the truth. Jesus said, You shall know the truth and the truth shall set you free. He did not say, the truth shall set you free! Truth and reality are synonymous and I’m optimistic about the human capacity to receive and to grow with reality. And this despite all kinds of social forces against it. In a society that largely denies human reality and not only denies it, but it also assaults it.
In the diary of Anne Frank, a few months before she was taken to Bergen-Belsen to die, she wrote basically that no matter what people say, that people are good at heart. She was one of these sensitive souls. So, in the middle of the greatest crime, arguably, that human beings have ever committed against one another. She said, ‘I believe that people are basically good at heart. I believe that when goodness doesn’t show up is because it’s being squelched. Whether you’re talking about Donald Trump or a Hitler of Stalin or to a lesser degree, any number of political leaders we’re dealing with degrees of suppression of pain, which results in lack of empathy, in the extreme cases, tremendous cruelty, like monstrous creatures like Stalin or Hitler.
A healing experience comes together with empathy. What people need today is not foremost a medicalization of their trauma, rather empathetic support from family, friends and professionals and the restoration of safety and attachment. When people suffer at the hand of trauma, the question never must be, “what is wrong with you but, what wrong has involuntarily invaded your life?” Addiction is not about what is wrong with it but what is right about it for the addict, what does it do …?