Empathy may be ill-timed in treating trauma

By Katrina Wood, Ph.D.
November 18, 2018



empathy treating traumaUnder-recognized in the treatment of trauma is the negative impact that may result when an offer of compassion or empathy is ill-timed.

Children, now adults, often continue to adhere to entrenched allegiances of accommodating parental caregivers – pathological states which long served to negate the unique existence of that child as an evolving individual.

A sustained, well-timed inquiry is key to an effective intervention. An offer of compassion or empathy may be met by deeply held instinctive rejection. A steady neutral hand is required to unravel a psychic cloth of such immense, complex textures and colors.

As traumatized children practicing accommodation with pathologically adaptive behaviors, serving to protect parents or caregivers from their unconscious harmful behaviors, these accommodations often manifest as externalized shame, pain, rage and emotional disconnection or dissociation. The child’s desperation, now as an adult, fiercely maintains the “indispensable tie,” a committed bond which speaks to the depth of this powerful allegiance.

Thus, offering empathy or well-intentioned compassion as a fundamental step to healing may be met with suspicion, hostility, aggressive defensiveness or dissociation for good reason. Vulnerability is not always welcome in the world of trauma. Vulnerability causes anticipation of more pain, loss and suffering.

The impact of trauma on the psyche and human condition must not be underestimated. Its skillful and protective coping structures have been applied with precision. As with the sun and light, too much too soon may be overwhelming, particularly in the early stages of unraveling extreme pain. One must tread lightly. Timing is key for the emergence of developmental results.

Impacted trauma states are embedded deeply into the psyche. They may have set in motion a lifetime of deep systemic conflict. Over time, as the psyche attempts to heal, painful internal wars manifest between allegiance to a painful system and differentiation from that system, triggering further isolation and loss.

Vulnerability becomes the enemy, and empathy the ally of vulnerability. Herein lies the conflict. Trapped between natural, emerging development and frozen states of mind and affect, the adult fights and flails to regain a sense of developmental self-hood. A one step forward, two steps back journey frequently ensues.

Compassion may be experienced as a painful reminder of sustained traumatic losses. At the same time, where the depth of the trauma goes under-recognized, the stage is set for the onset of deeper states of anxiety and depression.

Beware the well-intentioned intervention.

Individuals often develop life-long organizing principles in response to trauma, which become embedded as protective methods of coping. Some primary affect states, such as anger or rage, are maintained to keep pain, shame and longings and loss at bay.

Anger must be recognized as a primary affect. Anger may represent a fierce guardian against vulnerability. The value of anger must also be recognized. Righteous anger and outrage have kept many alive, providing an illusion of aliveness when no other affect is bearable or acceptable. When anger begets aliveness, the notion of compassion may be viewed or perceived through a lens of defeat.

Interpreting anger or rage as unacceptable affect states, tempered and often encouraged by well-meaning clinicians with compassion and empathy misses the mark. It may be more productive to acknowledge the validity of the anger, which may provide a sense of safety and security.

Validating harsher affect states through therapeutic interventions may loosen their grip over time, allowing entrance to an isolated existence. Journeying with caution and guidance, recognizing the acute vulnerability present beneath harsher affect states, may finally enable development to emerge. But the road is crooked, its pathways uncertain.

Backlash may be inevitable.

When the individual is unable to face, bear and integrate forbidden truths of deep losses, especially those stemming from neglect and narcissistic dominance of parental needs at the expense of the child, the systemic traumatic cycle repeats itself.

Parents may have enacted unconscious, neglectful emotional disconnectedness or over-involvement with their children, using them inappropriately as friends or confidantes. A cycle of emotional harm may have been perpetuated, unseen and unacknowledged, as material wealth, achievements and accolades became a veneer over abiding loneliness and sorrow.

Most parents are unaware when they fail their children in these areas. They are unable to understand why their children have become so angry or distant or refuse to speak with them.

In extreme cases, some children may commit suicide after suffering from long-term isolation. Dual diagnosis substance use often concurs with severe depression or chronic anxiety, a particularly familiar contemporary presentation.

Simple, healthful, viable solutions exist. Addressing core needs and longings, prioritizing relational connectiveness without judgment or shame and cautiously testing the waters regarding empathy are a beginning.

What to do when compassion hits a boulder.

To presume that compassion is a royal road to connectivity fails to acknowledge the powerful historical attachment and allegiance a child internalizes with parents or caregivers. This is particularly so when a history of cold, non-compassionate, emotionally disconnected interactions have been their experience.

A child will unconsciously believe, “There must be something wrong with me. Clearly, I don’t deserve compassion or kindness. It must be my fault. I must be stronger, tougher, less needy.” The truth of such deep emotional pain, loss and neglect of normal needs must be masked and buried.

Preserving the “indispensable tie” to the caregiver becomes all-important. The traumatized child, now adult, will shun both kindness and compassion to maintain the semblance of connection they had with their primary caregiver. Now, often in adulthood a partner, husband or wife will be selected to reinforce the well-honed organizing principle, maintaining the illusion of defensive protection. Familiar historical patterns trump the here and now. At the outset of intervention, these must be respected and trodden upon lightly.

In the 1950s, Harry Harlow, Ph.D., studied infant monkeys and their relational instincts and attachment behaviors at his laboratory at Goon Park. He found that baby monkeys, when boxed ruthlessly by mechanical monkeys wearing boxing gloves, continued to relentlessly attempt to crawl their way into the “mother’s” lap, only to be punched back to base.

Rather than relinquish the indispensable tie, they tried and tried again. They appeared to internalize that this treatment was what they deserved and that they did not deserve compassion.

Compassion may succeed at a later time.

Compassion’s attempt to wedge a foot in the door will surely fail over and over, but may succeed later in treatment. Risking vulnerability is treacherous territory for the traumatized individual. When allegiance to caregivers overrules the power of compassion, it is best to defer to principles guided by one who knows just how much vulnerability can be tolerated in any given session.

The journey of trauma may last a lifetime.

Reflective insight begins the journey of a thousand miles. This journey may not begin with an inquiry that employs compassion in looking for masked pain. Pain reveals itself when the teacher is ready. The teacher may not be the therapist.

References available from author

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Katrina Wood, Ph.D., is a clinical psychologist in private practice for over 25 years and owner and director of Wilshire Valley Therapy Centers in Los Angeles. Her website is: www.wilshirecenter.net.

 

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