A structure of healing

For all of the sadness that is coming up in future posts, it is going to be on the path of healing.

I want to pull one more thing each out of Chu and Herman.

Rebuilding Shattered Lives: The Responsible Treatment of Complex Post-traumautic Stress Disorders by James A. Chu, 1998.

Mind you, since this 23 years later, there could easily be better models, but Dr. Chu did put forth what he called the SAFER model in the book, elements that were helpful for progress.

• development of Skills for Self-care and Symptom control
• Acknowledgement (but not extensive exploration) of traumatic antecedents
• Functioning
• appropriate Expressions of affect
• maintaining collaborative and supportive Relationships

Clearly it is a retronym, trying to force a word that makes sense, and not particularly memorably. It still contains helpful information. 

For many of the patients suffering from PTSD, they felt like they had no control. Finding ways that they could detect and mitigate symptoms would be a victory. Being able to know that their trauma was valid (and there) was necessary to sit with before diving into it. Knowing that pain and making it through routines anyway, being able to express feelings without losing control, building relationships that offered support -- especially in contrast to previous damaging relationships -- these were steps that could be managed. 

They prepared the ground for deeper work, and if they were not in place they were an indicator that bringing out more details (that extensive exploration) of the trauma was probably not a good idea.

This is the earliest use I have seen of "self-care" (without having researched). You may notice that in many ways these work as ways of the patients being kinder to themselves, which is often not the first instinct of someone with Complex PTSD.

Trauma and Recovery: The aftermath of violence – from domestic abuse to political terror, Judith Herman, 1992.

This quote from the beginning of Chapter 8 struck me:

“Recovery unfolds in three stages. The central task of the first stage is the establishment of safety. The central task of the second stage is remembrance and mourning. The central task of the third stage is reconnection with ordinary life.”

For the record, Dr. Chu referenced Dr. Herman frequently; it is not impossible that SAFER was a way of getting through that first stage.

It may seem like cruelty, but it is completely logical that you don't heal from a situation while you are still in it. There may be insights and tools acquired that will be helpful, but overall healing is impaired while the injuries are still being inflicted.

We may be more resistant to the logic of needing time to mourn. We have moved past the bad times, so it is only fair that now is the time to be happy. 

No matter how sad you might have felt during the trauma, it is unlikely that you were able to adequately grieve it, and that grieving is necessary. 

I do think part of that remembrance is also about gaining perspective. Denial can still be remarkably powerful, but once we are safe, denial should be one of the things that it is safe to let go of.

Obviously, there is some simplification there. 

I remember getting irritated as a youth when people would say that you can't love others until you love yourself. I was quite sure that I loved others; it was less certain that I loved myself. (And it kind of sounded like if I had a hard time loving myself it was one more thing to feel guilty about.)

In retrospect, I did have some love for myself, but when that increased I was able to love others better. 

Humans are better understood along spectra than binaries, it appears.

Maybe you are partially safe, but there is a danger you still tolerate, and maybe for very good reasons. Our lives are rarely that simple.

For me, I suspect that I have not mourned adequately. There have been hints all along, but lately there are frequent moments when there are tears just at the border, but they don't quite let loose.

There are tips on the internet for ways to lean into the crying, but that doesn't seem like the right answer at this time  They will come when the time is right. 

If I am lucky, the time might even be convenient, but I'm not counting on that one.