The ACOA Trauma Syndrome

by Tian Dayton, Ph. D.

  During the stage of life that children naturally try on different identities in their daily play activities, children who are exposed to prolonged and severe trauma may even be capable of organizing whole different personality fragments in order to cope with traumatic experiences. Over a long period of time, and in cases where there is severe trauma, this may give rise to the syndrome of dissociative identity disorder (DID), which may occur in about 4 percent of psychiatric inpatients in the United States (Saxe et al 1993).

  Desire to Self-Medicate

  Someone who is coping with the sorts of symptoms here described may become engaged in a compulsive relationship with alcohol, drugs, food, sex, work, or money as a way of ­quieting the disturbing mental, physiological, and emotional disequilibration that the symptoms engender. Self-medicating can seem to be a solution, a way to calm an inner storm and restore “balance,” as it really does make pain, anxiety, and body symptoms temporarily abate. But in the long run, it creates many more problems than it solves.

  Hyperreactivity

  Living with relationship trauma can oversensitize us to stress, causing us to overrespond to stressful situations and blowing out of proportion conflicts that could be managed calmly; we overreact. This hyperreactivity can emerge whether we are in a slow grocery line, in traffic, at work, or in relationships. Triggers can be stimuli reminiscent of relationship trauma. Feeling helpless, rejected, abandoned, or humiliated can trigger old vulnerability. Being around yelling or criticism, or even observing certain facial expressions on others, may trigger a stronger reaction than is appropriate to the situation. So can being in closed-in places that make one feel trapped. Because traumatized people often have a loss of neuromodulation and self-regulation, they may not be able to “right size” their emotions once they have been triggered. They may explode and get aggressive or implode and withdraw. Working with these triggers and working through the unconscious feelings from the past that drive them is central to the treatment of the ACoA trauma syndrome.

  SEVEN

  Relationship Trauma:

  When Home Is No Longer Safe

  Lunatics are similar to designated hitters. Often an entire family is crazy, but since an entire ­family can’t go into the hospital, one person is designated as crazy and goes inside. Then, depending on how the rest of the family is feeling, that person is kept inside or snatched out, to prove something about the family’s mental health.

  —Susanna Kaysen, Girl, Interrupted

  Relationship trauma constitutes the cumulative and long-term effect of traumatic relational moments or relational dynamics on the brain and body. Virtually all the trauma I deal with occurs within the context of primary attachment relationships. Traumatic relational moments are a part of anyone’s life; they are not necessarily out of the norm but they can become more frequent and more intense in families that struggle with addiction and the cluster of abusive behaviors that often surround addiction. “While most studies on PTSD have been done on adults, particularly on war veterans, in recent years, a small prospective literature has emerged which calls attention to the differential effects of trauma at various age levels. Anxiety disorders, chronic hyperarousal, and reenactments have now been described with some regularity in acutely traumatized children” (van der Kolk and Saporta 1991). “In addition to the reactions to discrete, one-time, traumatic incidents documented in these studies, intrafamilial abuse must certainly be included among the most severe traumas encountered by human beings” (ibid).

  Relationship ruptures are experienced as traumatic because we are neurologically wired for powerful relationship attachments; “neurons are genetically primed to support connections through the relational experiences we have with those closest to us. The patterns of energy and information laid down in these early moments of meeting develop the actual structure of these limbic regions” (Badenoch 2008). We wire co-states or relationship dynamics into our very self and then we look to re-create both sides of those dynamics as we engage in relationships throughout our lives. The dynamics we experience as children template what we look for, expect, and re-create in adult relationships. “The biological effects of developmental trauma have best been studied in young nonhuman primates, who in many ways resemble young human beings. Forty years of primate research has firmly established that early disruption of the social attachment bond reduces the long-term capacity to cope with subsequent social disruptions and to modulate physiological arousal” (van der Kolk and Saporta 1991). In other words, when we have been traumatized in childhood within our primary relationships, we have trouble modulating the intense feelings that adult intimacy brings up.

  Growing children are practicing at mediating and managing overwhelming feeling states. They are learning how to restore balance and calm after feeling overwhelmed; they learn by modeling someone who can show them how to do that and being actively helped to learn how to restore balance. This builds resilience. But when this help is unavailable and when family chaos is causing the stress, the child is left to manage on his own. In a traumatic moment, the central nervous system (CNS) is simultaneously revved for fight and flight and flooded with body chemicals to inhibit fight or flight unless absolutely necessary. The firing of the CNS in opposing directions causes the child to freeze. The longer he spends in this state, the more likely he is to feel trapped and helpless and have no way of learning to manage his overwhelming emotions. Rather than learning lessons of resilience, his body is pounded with ever-increasing levels of stress. The child is not able to fully process the overwhelming emotions and impressions that are part of these traumatic moments so the fear he experiences as well as key fragments of experience and information may get split off or dissociated from. And because of a child’s limited intellectual development, he is unable to make mature sense of what’s going on. Children often imagine that they have somehow created the frightening situation and that it is somehow their job to correct it. They imagine that there is probably something wrong with them.

  The Unique Dilemma of the CoA and the ACoA

  Children love their parents and want to rely on them, and they do relay on them no matter who those parents are. But addiction plays havoc with family dynamics. For example, spouses of alcoholics can become less available to their children and can build up years of resentment toward the position their alcoholic partner has put them in. Spouses often get stuck “keeping the show on the road,” so to speak, as their alcoholic/addicted partner falls in and out of sobriety. The sober parent becomes the reliable one. And as they are repeatedly put in this role, they may even lose their own spontaneity and ease. Their resentment builds, and the more it builds, the more unavailable they become to the child and, for that matter, to themselves. Then the child is robbed of easy relating with two parents. In this scenario, the alcoholic may even emerge as the fun and available parent. After all, they aren’t always drunk or high. Sometimes they are sober, or relaxed from a couple of drinks, or in a generous, expansive mood. The reliable parent, the one who takes the child to the dentist and buys new shoes, may powerfully resent it when it is obvious that the child prefers the fun parent.

  What a confusing mess to untangle. So confusing that ACoAs often don’t want to go near to it. This primary but disorganized attachment with an alcoholic parent (and perhaps the other parent) can present problems for ACoAs later in life. They cling to their happy moments with all their strength because the very same person who cut them to the quick may have been the one they went to in order to feel reassured and good about themselves.

  The human response to trauma is so constant across traumatic stimuli that it is safe to say that the central nervous system (CNS) seems to react to any overwhelming, threatening and uncontrollable experience in quite a consistent pattern. Regardless of these circumstances, traumatized people are prone to have intrusive memories of elements of the trauma, to have a poor tolerance for arousal, to respond to stress in an all-or-noth
ing way, and to feel emotionally numb. All of these psychological phenomena must have a basis in biological functioning, some of these relationships between biological states are now ready to be explored. PTSD as defined in the DSM-III-R highlights those post-traumatic symptoms that are most clearly biologically based (for reviews see van der Kolk, 1987; Krystal et al., 1989); the secondary post-traumatic changes in identity and interpersonal relations are slated to be classified in the separate category of Disorders of Extreme Stress Not Otherwise Specified (DESNOS) in the DSM-IV (van der Kolk and Saporta 1991).

  The fact that the emphasis in the psychiatric manual that defines PTSD is on biological rather than relational effects of trauma means that those who have been traumatized in relationships fall randomly into and all over the healthcare, legal, and penal system, and receive a variety of “diagnoses” that do not speak to the trauma that may have engendered their symptoms. Healing actually needs to be about adopting a new design for living as well as receiving therapy aimed at resolving the unconscious effects of trauma to the mind, emotions, and body.

  Why Traumatic Moments Get “Sticky”

  When the people we have a profound need to stay close to are the ones hurting us, our experience of those traumatic moments and relationship dynamics can become very “sticky,” holding us like psychological glue to old, rigid, and reactive patterns of relating that do not easily change. Here’s why: our previous experiences set us up for how we see ourselves and how we live our lives. They prime us for what to expect from others, from life, and from relationships. Daniel Siegel, author of Mindsight: The New Science of Personal Transformation, explains: “Prior learning sends related information down from the top layers of our six-neuron-deep column to shape our perception of what we are seeing or hearing or touching or smelling or tasting . . . perception is virtually always a blend of what we are sensing now and what we’ve learned previously” (2010). Because sense impressions get overlapped with emotions, and in the case of relationship trauma, those emotions may be fraught with fear and anxiety; we may defend against feeling or “remembering” them. Thus we feel closed, defensive, and unwilling to change.

  Dr. Siegel describes the neural process of “stuckness” and “openness” as states of mind:

  Sometimes the adhesive holding a state [of mind] is flexible, enabling us to be receptive and open to bringing in new sensory data and new ways of behaving . . . but sometimes engrained states are more “sticky” and restrictive, locking us into old patterns of neural firing, tying us to previously learned information, priming us to react in rigid ways. This locked-down state is “reactive”—meaning that our behavior, in large part, is determined by a prior learning and is often survival-based and automatic. We react reflexively rather than responding openly . . . primed by old learning (2010).

  In other words, we get stuck repeating and re-creating varieties of thinking, feeling, and behavior from the past that overtake the present moment. We worry that if we enter the “we” state, we will get slammed. We need to learn that a “we state” is safe in order to enter it, or we need to be able to examine why it isn’t, so that we can learn a new way of being with others while sustaining ourselves, so that a “we state” starts to feel manageable. All of this becomes part of a therapeutic process, part of recovery from trauma.

  Trauma-Engendering Family Dynamics

  Just as a person can get stuck in living in extremes, so can an entire family. The pattern of alternating between imploding and exploding, or cycling between states of high intensity then numbing or shutting down, or the opposite of going from a numb, imploded state toward explosiveness, can become part of a disregulated emotional and behavioral pattern that is common to addicted and/or trauma-engendering families. These families can be steeped in patterns that may have been building over a period of years. For these reasons, they may have trouble seeing themselves clearly or seeking help or having the leftover energy or motivation to make ­positive changes. They are focused on survival, and the more they “survive,” the more “glued” they become to their survival mode.

  Impulsivity versus Rigidity/Control

  When family members have a hard time tolerating or “holding” intense states of emotion, those emotions may surface and be acted out through impulsive behaviors that engender chaos. Painful feelings that are too hard to sit with explode into the container of the family and get acted out rather than talked out. Blame; anger; rage; emotional, physical, or sexual abuse; collapsing into helplessness; withdrawal or yelling; over- or underspending; and sexual acting out are some ways of acting out emotional and psychological pain in dysfunctional ways that engender chaos.

  When the family starts to feel like things are getting out of control, members see the solution to that as clamping down hard to restore order and reduce chaos. They get rigid and controlling. Parents may tighten up on rules and routines in an attempt to ward off the feeling of falling apart. Or family members may become both controlled and controlling in their behavior in an attempt to manage inner feelings of chaos. Thus the dynamic of cycling back and forth between impulsive or chaotic behavior and rigid control takes hold. There is a lack of middle ground where strong feelings can be talked over or even explode momentarily but then be worked through toward some sort of tolerable resolution. Again, there is the tendency to alternate black-and-white thinking, feeling, and behavior, with no shades of gray—another reflection of the family’s problems with regulation.

  Enmeshment/Disengagement/Avoidance

  Over closeness that doesn’t really allow for much breathing room and natural space in relationships is called enmeshment. Huddling together to form “special” bonds, seeing eye to eye, triangulating (two family members talking about a third but never addressing the issue directly with that third person), or allying together against the powers that be can help scared family members feel less alone and crazy. Siblings may form covert bonds or a parent may turn a child into a surrogate ­partner and confidante to compensate for the absence of ­intimacy with the partner. But this sort of enmeshed closeness does not really allow much breathing room, and it can split the family into factions. The loyalty it demands can also preclude honest, comfortable relating.

  Enmeshment is a relational style that lacks boundaries and often discourages differences or disagreement, seeing them not as healthy and natural but as disloyal or even threatening. Enmeshed styles of relating formed in childhood tend to repeat themselves in adult relationships.

  The other side of enmeshment is disengagement. Many addicted families cycle back and forth between enmeshment and disengagement; they yearn for closeness but lack the kinds of healthy boundaries that would let them take space, hold ­different points of view, or hang onto a sense of self while in each other’s presence. Consequently, enmeshed forms of closeness becomes suffocating. Then family members see disengaging through withdrawing, fighting, or avoiding each other as the only way of getting some personal space. They see the solution for feeling overwhelmed with too much closeness as doing the direct opposite: they disengage. Or they avoid subjects, people, places, and things that might trigger discomfort or disagreement, which also can lead to emotional disengagement.

  Overfunctioning versus Underfunctioning

  When people don’t play their position in a volleyball game, the ball drops. The same thing can be true in the alcoholic family system. Balls are dropping all over the place. Who is going to pick them up? In an attempt to maintain family balance, some members may swoop in and play more than their own role; they overfunction in order to compensate for the underfunctioning of others.

  Overfunctioning can wear many hats; children may become little parents and overfunction by taking care of younger siblings when parents do not fulfill their normal duties. CoAs may take care of parents emotionally, becoming little partners. Or they may work overtime striving to restore order and dignity to a family who is rapidly slipping. Spouses may overfunc
tion to maintain order while the addict falls in and out of normal functioning.

  The learned helplessness that is part of the trauma response, in which one comes to feel that nothing they can do will make a difference or make things better so they give up, can lead to underfunctioning. Family members may find themselves unable to mobilize, get their lives together, and make useful choices.

  It is also not uncommon that the addict or the spouse may do both, overfunctioning to make up for periods of underfunctioning. Again we see yet another version of a lack of ability to self-regulate or for the family system to work as a team where each member is expected to carry their load, to suit up and show up.

  Caretaking versus Neglect

  When monkeys grieve, they step up their grooming and caretaking behaviors. Suddenly their partner’s coats are full of nits that need attending to or their children need extra rocking. Sometimes, we take care of something in others because we yearn for some sense of closeness and connection; we try to give to another person what feels missing for us. We project our own unconscious anxiety or pain onto someone else, seeing it as about them rather than understanding it as our own. Then we set about fixing them instead of ourselves. It is a form of caretaking that is all too often motivated by our own unidentified pain rather than a genuine awareness of another’s. Because this is the case, neglect can be its dark side. We neglect or don’t see real need within another person because we can’t identify real need within ourselves. Not surprisingly, our care of the other person is not always appreciated by them, nor does it necessarily feel all that good to them. In fact, it can even ask them to become needy in the same area that we’re needy. This can actually have the effect of distancing them because our “care” feels cloying and ­unattuned.