Signs and Symptoms of Unresolved Trauma

 

Signs and Symptoms of Unresolved Trauma

Even when memories of the trauma are hidden from a person's awareness, there are signs that will become noticeable in his or her daily life. Below are some of the most common signs that someone is suffering from unresolved trauma:

1. Anxiety or panic attacks that occur in what would be considered normal situations
2. A feeling of shame; an innate feeling that they are bad, worthless, or without importance
3. Suffering from chronic or ongoing depression
4. Practicing avoidance of people, places, or things that may be related to the traumatic event; this also can include an avoidance of unpleasant emotions
5. Flashbacks, nightmares, and body memories regarding the traumatic event
6. Addiction and eating disorders in an attempt to escape or numb negative emotions
7. Sleeping issues including trouble going to sleep or staying asleep
8. Suffering from feelings of detachment, or feeling "dead inside" (This is perhaps the most devastating of the signs, because it creates a feeling of loneliness and isolation.)
9. Dissociation as a real disconnect in situations and conversations
10. Hypervigilance (a constant feeling of being on guard)
11. Suicidal thought or actions
12. Uncontrollable anger; acting on it
13. Self-harm, cutting, and mutilation
14. Not being able to tolerate conflicts as they once would have
15. Unexplained or irrational fears of people, places, or things

As stated above, this is by no means an exhautive list.  It is not a matter of having all of these signs and symptoms.  Having unresolved trauma is not necessarily black and white but can one can be on a "spectrum" of trauma.  

Trauma needs to be unresolved in order for someone to have a healthier, enjoyable life.  Otherwise, it will haunt one's life and make interpersonal relationships difficult.

Self-Esteem-What is High and What is Low Self-Esteem 1

A book was written in 1994 called The Six Pillars of Self-Esteem." I chose to read it because I have found that high self-esteem and low self-esteem figure prominently in the counseling work that I do. I find that there are a couple of books that are extremely important for my clients to become acquainted with, such as Codependent No More and Boundaries, and have. referred clients to them, and I will be referring people to this book. I found it to be quite important for me personally and for those with whom I work. I thought it appropriate to include some of the ideas proposed by its author, Nathaniel Branden, on this professional blog. There were so many important concepts as I began to read it.  My posting is some of his profound ideas.

• "Self-esteem is defined as confidence in our ability to think, confidence is our ability to cope with the basic challenges of life, and confidence in our right to be successful and happy. [It is the feeling] of being worthy, deserving, entitled to assert our needs and wants, achieve our values, and enjoy the fruits of our efforts."
• "To trust one's mind and to know that one is worthy of happiness is the essence of self-esteem."
• "It is directly affected by how we act...There is a continuous feedback loop between our actions in the world and our self-esteem. [Thus,] the level of our self-esteem influences how we act, and how we act influences the level of our self-esteem."
• 'If I trust my mind and judgment, I am more likely to operate as a thinking being. Exercising my ability to think, bringing appropriate awareness to my activities, my life works better."
• "With high self-esteem, I am more likely to persist in the face of difficulties. With low self-esteem, I am more likely to give up or go through the motions of trying without really giving my best."
• "If i respect myself and require that others deal with me respectfully, I send out signals and behave in ways that increase the likelihood that others will respond approriately...If I lack self-respect and consequently accept discourtesy, abuse, or exploitation from others as natural, I unconsciously transmit this, and some people will treat me at my self-estimate. When this happens, and I submit to it, my self-respect deteriorates still more."
• "Healthy self-esteem correlates with rationality, realism, intuitiveness, creativity, independence, flexibility, ability to manage change, willingness to admit (and correct) mistakes, benevolence, and cooperativeness.  Poor self-esteem correlates with irrationality, blindness to reality, rigidity, fear of the new and unfamiliar, inappropriate conformity or inappropriate rebelliousness, defensiveness, overcompliant or overcontrolling behavior, and fear of or hostility toward others."
• "High self-esteem seeks the challenge and stimulation of worthwhile and demanding goals. Reaching such goals nurtures good self-esteem. Low self-esteem seeks the safety of the familiar and undemanding.  Confining oneself to the familiar and undemanding serves to weaken self-esteem."
• "The more solid our self-esteem, the better equipped we are to cope with the troubles that arise in our personal lives or in our careers; the quicker we are to pick ourselves up after a fall, the more energy we have to begin anew. The higher our self-esteem, the more ambitious we tend to be, not necessarily in a career or financial sense, but in terms of what we hope to experience in life--emotionally, intellectually, creatively, spiritually. The lower our self-esteem, the less we aspire to and the less we are likely to achieve. Either path tends to be self-reinforcing and self-perpetuating."
• The higher our self-esteem, the stronger the drive to express ourselves, reflecting the sense of richness within, The lower our self-esteem, the more urgent the need to "prove" ourselves--or to forget ourselves by living mechanically and unconsciously."
• "The higher or self-esteem, the more open, honest, and appropriate our communications are likely to be, because we believe our thoughts have value and therefore we welcome rather than fear clarity. The lower our self-esteem, the more muddy, evasive, and inappropriate our communications are likely to be, because of uncertainty about our own thoughts and feelings and/or anxiety about the listener's response."
• "The higher our self-esteem, the more disposed we are to form nourishing rather than toxic relationships. The reason is that like drawn to like, health is attracted to health. (Note: for more about this concept as it relates to intimate relationships, please refer to my blog posting "The Level of Our Dysfunction" from October 11, 2014.)
• "Opposites may attract about some issues, but not about this one...We do not see a passionate love affair, for example, between persons at opposite ends of the self-esteem spectrum--just as we are not likely to see a passionate romance between intelligence and stupidity...Medium self-esteem individuals are typically attracted to medium-self esteem individuals. Low self-esteem seeks low self-esteem in others--not consciously, to be sure, but by the logic of that which leads us to feel we have encountered a "soul mate."  The most disastrous relationships are those between persons who think poorly of themselves; the union of two abysses does not produce height."
• "The healthier our self-esteem, the more inclined we are to treat others with respect, benevolence, goodwill, and fairness--since we do not tend to perceive them as a threat, and since self-respect is the foundation of respect for others. With healthy self-esteem, we are not quick to interpret relationships win malevolent, adversarial terms.  We do not approach encounters with automatic expectations of rejection, humiliation, treachery, or betrayal."
• "Research discloses that high self-esteem is one of the best predictors of personal happiness. Logically enough, low self-esteem correlates with unhappiness."

LOVE

• "If I experience myself as lovable, then I have a foundation for appreciating and loving others. The relationship of love feels natural; benevolence and caring feel natural. I have somthing to give; I am not trapped in feelings of deficiency; I have a kind of emotional "surplus" that I can channel into loving. And happiness does not make me anxious. But if I lack respect for and enjoyment of who I am, I have very little to give--except my unfulfilled needs. In my emotional impoverishment, I tend to see other people essentially as sources of approval or disapproval. I see only what they can or cannot do for me. I am looking for people who will not condemn me--and perhaps will be impressed by my persona, the face I present to the world."
• "We have all heard the observation, 'If you do not love yourself, you will be unable to love others.'  Less well understood is the other half of the story: if I do not feel lovable, it is very difficult to believe that anyone else loves me. If I do not accept myself, how can I accept your love for me? Your warmth and devotion are confusing; it confounds my self-concept, since I 'know' I am not lovable.Your feeling for me cannot possibly be real, reliable, or lasting. If I do not feel lovable, your love for me becomes an effort to fill a sieve...."
• "I attempt love but the foundation of inner security is not there. Instead there is a secret fear that I am destined only for pain. So I pick someone who inevitably will reject or abandon me. Or, if I pick someone with whom happiness might be possible, I subvert the relationship by demanding excessive reassurances, by venting irrational possessiveness, by making catastrophies of small frictions, by seeking to control through subservience or domination, by finding ways to reject my partner before my partner can reject me."
• "What is required for many of us, paradoxical though it may sound, is the courage to tolerate happiness without self-sabotage until such time as we lose the fear of it and realize that it will not destroy us (and need not disappear). One day at a time, See if you can get through today without doing anything to undermine or subvert your good feelings--and if you 'fall off the wagon,' don't despair, pull yourself back and recommit yourself to happiness.  Such perserverance is self-esteem building." 

FANOS--An Opportunity for Emotional Connection

FANOS

In spousal-type relationships, there are two types of intimacy: physical and emotional.  Physical intimacy takes place when two people feel a sexual attraction to each other and seek to explore that with their physical bodies.  Acting on this physical connection is an important "glue" for most couples seeking to spend time together.  It is a challenge to use this glue in meaningful and thoughtful ways throughout a relationship.

What often is the greater challenge of couple relationships, however, is to experience emotional connection, that feeling of honoring each other, that we are  afe with each other, that I understand you and you understand me, and that each of us has wants and needs that are equally valid.  Without emotional connection, whether it be through selfishness or ego, addiction, dissatisfaction, or any number of reasons, it can get in the way of a couple experiencing a fulness of joy.

I have found a tool that has helped many couples reestablish emotional connection, or start the journey of finding, establishing, and nurturing that sweet connection.  It helps to build emotional intimacy ('in-to-me-you-see") that creates that connection.  The tool is known by an acronym--FANOS.  This is a couples emotional check-in using subjects based upon these letters:

• F eelings
• A ffirmations
• N eeds
• O wnership
• S truggles

Both partners need to be willing to do this emotional exercise.  They need to be invested in the relationship and be willing to be as vulnerable as they possibly can be, which may be scary as a couple begins using it.  Vulnerability can be challenging for one or both partners, if for no other reason than that they have felt hurt by their partner.  But this intimacy experiment can only work if both are willing to put themselves out there and take the risk.  As couples become more vulnerable, they can become more able to empathize, and empathy is a basic food for relationships to work and flourish.

I have found that the following 10 Step Strategy seems to work best, at least in the beginning of doing the FANOS exercise:

HOW TO FANOS

1. A couple decides ahead of time (ideally) upon 30 to 90 minutes, hopefully when there can be few interruptions (particularly children).  Think of it as an investment in your relationship.
2. At the appointed time, each asks the other if they are in a place where they can focus on each other.  If responses are positive, the sharing begins.
3. One of the couples shares with their partner 3-5 feelings they are currently experiencing.  These feelings can be about the speaker (his/her own emotional or physical state) or about those of the receiver.  If it about the receiver, it must needs be sent in an "I-message."
4. After the speaker is finished, the receiver then states verbatim or paraphrases what their partner has just said.  The idea for this is so that the listener must offer their full attention without thinking of a response (defeats the purpose).  Often, it's a good idea for the listener to ask the speaker, "did I get everything?" or "did I get it right?" (Note: the listener does not respond to what has been said, not matter what.)  The listener needs to listen, not rebut!
5. The speaker then becomes the listener and the listener becomes the speaker, and follows steps 3-4.  The new listener then repeats what the new speaker just said.
6. The listener then reverts back to being the speaker, and the speaker moves on to affirmations.  These ought to be 2-4 activities or attributes that they speaker admires or affirms in their partner.  It can be what the speaker admires in the listener's interactions with others, particularly children, or it can be in the interactions with the speaker, or just about anything!  After the speaker is finished, the listener repeats what was heard.
7. The speaker then becomes the listener and the listener becomes the speaker, and follows step 6.  You get the idea!
8. The next step is what the speaker needs.  These 3-5 needs can be what the speaker needs in general for one's wellbeing, or it can be what the speaker needs from the listener.  If it is the latter, it should also be stated in an "I-message."  The listener repeats what was heard and then they switch.
9. The next step is ownership.  These are usually 2-4 feelings or behaviors that the speaker knows is a personal weakness or shortcoming.  Again, it can be about his/her life in general or it can be about less- than-stellar interactions with the listener.  They own the problem.  The listener repeats and then they switch.
10. The last step in struggle.  This is to share the real difficulty that the speaker is experiencing being his/her best self.  Generally, this is usually 1-3 struggles.  If one or the other is struggling with some kind of addiction, the S of struggle can also stand for sobriety, and it can be a check-in with the partner as to how they are doing in sobriety and recovery.  Of course the listener repeats then switches again.

FANOS EXAMPLES

Feelings  (With all FANOS examples, there is usually more to be said than just the introductory line)

• "I am really feeling overwhelmed at work...."
• "The children have really been fighting a lot, and I find myself getting angry with them." 
• "I felt upset when you didn't come home until late last night."
• "I have been feeling underappreciated this past week."
• "I often feel fear about whether you are taking recovery seriously."
• "I have been feeling nauseated the past 24 hours and I don't know why."
• "Having your mom here is bringing up feelings of resentment in me."
• "I am feeling appreciation for how you have been paying extra attention to me recently."
• "I enjoyed our date last weekend."
• "I am feeling sad that we just can't seem to connect these days."

Notes about sharing feelings: 1) nobody can make us feel anything so don't say that; a person can act or react negatively towards us, but we are agents and can choose how we respond, 2) feelings aren't facts, they're just feelings, 3) eliminate as much "you" as possible as you share feelings and use "I" more often.

Notes about interactions between each another: 1) if the listener feels the need to get more information, he/she can request it,  2) while the listener may disagree with what the speaker has just said, the listener is to faithfully repeat what has just been heard, 3) try to be present for your partner in order to review with them what they just said, 4) ultimately, one of the major purposes of FANOS is the opportunity to be heard by your partner.

Affirmations

• "You have been extra nice the past few days.  Thank you."
• "I can tell you're making an effort to spend more time with the kids."
• "I appreciate the effort you make each day to give me encouragement."
• "You did a great job cleaning out the garage on Saturday."
• "I really like those new pants you bought last week."
• "I find that I am enjoying spending more time with you."
• "I want to acknowledge and thank you for putting the dishes in the dishwasher."
• "I appreciated the delicious dinner you made last Sunday."
• "You were really present with the kids yesterday."
• "You are doing a real great job with the garden."

Needs   there is usually more to be said than just an introductory line)

• "I need recognition from my boss that I chose to work extra all last week to finish a project."
• "I need for you to be honest with me."
• "I feel the need to stop walking on eggshells around your parents."
• "I need to have fewer salads at dinner."
• "I need to feel appreciated more often."
• "I need to have a discussion about our sexual intimacy in the near future."
• "I need help keeping the house clean because I am feeling overwhelmed these days."
• "I feel like we're drowning in debt and I need for us to set up a time when we can discuss my anxiety."
• "I need some time away to process some things."
• "I want us to be more connected, and I want/need us to FANOS each week."

Ownership

• "I take ownership over my financial issues with spending."
• "It has become very apparent to me that I have an anger problem."
• "I own that I am having a real difficult time not checking your phone."
• "I own that I have grown tired of failing over and over again."
• "I own that I am easily triggered when I perceive you being critical of my house work."
• "I am constantly reminded of my shortcomings as a mother."
• "I own that my ego gets in the way of our relationship."
• "I own that I sometimes take what you do for granted."
• "I own that I feel like I am being attacked by you when that is not your motivation."
• "I take ownership that I become very codependent with the kids."

Struggle  (or Sobriety, if in addiction recovery)

• "It's really hard to not feel completely overwhelmed by our bad financial situation."
• "I struggle with my feelings of inadequacy at work."
• "I struggle to not have intrusive suicidal thoughts."
• "It is clearly a struggle for me to not play the victim in our relationship."
• "I have reached 60 days of sobriety, but it's really hard some days."
• "I struggle to not go on the defensive in our conversations."
• "It's really hard these days for me to give up my dream of a home."
• "I struggle to find motivation to do things these days that I used to enjoy doing before."
• "I struggle to make time to exercise and do other things to take care of myself."
• "I struggle to be present in the moment and not to be anxious about the future."

FANOS is an emotional exercise that can be done regularly.  Usually, in the beginning, I recommend that the couple set aside a fixed day and time (or more than one day or time) each week and that they keep that time sacred for this dialogue.  FANOS really is an opportunity for emotional connection!