The ACOA Trauma Syndrome

by Tian Dayton, Ph. D.

  I think it is important to understand that for at least a year, all Kathy did was comment on other people’s psychodramas, often giving well-thought-through commentary and congratulations that often sounded somewhat removed from the emotion of the moment. It took her a long time to trust the group and herself. Initially, she gave us the facts but without much feeling. For some time, Kathy said it was enough “work” just to sit in group and tolerate being around the intense emotion sometimes expressed and the feelings, or lack of feeling, that she became aware of in herself. She bonded and trusted a little more each week, hesitant but very sincere. She had a long pattern of dissociation from her abuse, so just coming back into her body and mind was a challenge. She could remain physically present, but her consciousness was somewhere else.

  When sharing, she might say something like, “I just feel so . . . I just . . . he . . . and I couldn’t.” Small tears and withheld sobs would work their way toward the surface and then disappear. Kathy would bring her hand to her chest and throat as she tried to breathe and speak. I would ask questions like, “If your throat could talk, what would it want to say? What would your hand like to do?”

  “I don’t know. Go away? Get away? Get off me? Push?” Then muffled sobs, then quiet, then nothing.

  This sort of narrating happened many times. For a while, I just made use of opportunities to draw out another sentence or two. As Kathy began to speak more about her abuse, she had some sensations of choking and not being able to breathe, along with a combination of helplessness and burning rage. These feelings remained unexpressed, though she became increasingly aware of how they felt inside of her (she later described them as tingly, shaky, queasy, blocked, and shivers). Kathy became more able to allow herself to experience and articulate her feelings rather than shut them down. She regularly experienced feelings of being trapped beneath her father’s weight and having her breathing choked off. Her body was recalling the experience it had recorded, and in doing so, the sensations that accompanied the scenes of abuse emerged as well. The words were at first tentative, few, and far between. But she got a tremendous amount from other people’s work; it felt safer to watch and learn rather than to enter into her own role-play. This is the beauty of psychodrama: you can heal in and from every role whether that of “group member,” auxiliary role player (playing a role in another person’s drama) or protagonist (the person whose story is being role played).

  Kathy talked about what she learned from someone whose story provided a link into her own:

  Sally has been in group longer than I have and also has “father issues.” She taught me how to scream. It was one of the most beautiful sounds I have ever heard. She could scream so loud at her father . . . with hate and rage. I loved coming to group and hearing Sally scream at the top of her lungs, and now I can do it, too . . . even while beating the crap out of him with a bataka (foam bat). I always feel lighter and freer after one of those sessions. Recently, wanting more freedom from my “death sentence” so that I can live life more fully, I got to beat the crap out of him again, while yelling NO! What a gift. Another glorious feeling.

  Kathy literally felt that she would die of her father’s abuse, for obvious reasons; she could barely breath when it was occurring. Simply shouting “no” over and over again allowed Kathy to move away from her collapsed, helpless position toward the emancipation of outrage, which was the appropriate and natural response to being subjugated by her father. Because psychodrama is experiential, we can bring the body into the work. In the case of sexual or physical abuse, it can help to allow the protagonist to feel they are fighting back, successfully defending themselves or really expressing their stored rage and helplessness, to take the reempowering actions that they never got a chance to take, to stand up straight and fight back. Experiential expression of rage is always done in safety, using only a bataka and a tackle dummy. This kind of rage, if not expressed in therapy, can easily leak out in other ways; therapy allows us to become conscious of how much of it we may be carrying. But rage is by no means the whole story; beneath it is often helplessness, collapse, sadness, confusion, distorted bonding, yearning, and so forth. The rage needs to be experienced in a context and the full flush of feelings, mentations, and actions explored.

  In a traumatic moment, children may not have had the opportunity to discharge the adrenaline of the flight response if they were outpowered by a drunk or abusive parent. Their freeze response is stored in their bodies. As feelings and ­memories return, so does their urge to shake, move, run, or take defensive action. Kathy wanted to shake off the “energy, prickles, and tensions” inside of her, and she did—over and over again. We did a combination of talking about what happened, participating in the work of others, empty chair work, and psychodrama role-plays to work with Kathy’s abuse. Her work spanned about three years before this next drama occurred.

  After talking to her father in a role-play and raging at him (which she had already done a few times), I asked her what she would like to do next. “Today he would be sent to jail for what he did to me. I want him to be sent to jail,” was Kathy’s firm response. The beauty of psychodrama is that a scene like this, so appropriate as a part of retribution, can actually be structured and played out. Kathy chose group members who arrested her father and “took him to court” for his crimes against her.

  I was in charge of the sentencing. At first, I thought I’d sentence him to death. But then, as a big smile came on me, I realized what would give him the most pain. Torture even. So I sentenced him to silence. He could never utter another word. My father, the narcissist, who demanded that everyone listen to him, could never say another word. I was in heaven. And then the jailor took my father to prison. I stood there, drinking in the picture; heaven doesn’t begin to describe my feeling at that moment.

  This is the kind of retribution for being hurt that people seek in life that can get them into trouble. Psychodrama allows them to seek it therapeutically. One way trauma becomes intergenerational when we reverse roles with our abusers and pass pain down unconsciously—when we, in a sense, become them. Psychodrama allows the abused person to gain conscious retribution so that both their pain and their need to act out their pain is done consciously and in service of healing rather than ­unconsciously.

  Kathy walked around freely repeating variations of “you are never to speak again, the court has sentenced you.” Her ability to put her father away from her and to actually “see” him locked up and punished was deeply relieving to her. She could see and record a picture of her father behind bars and feel safe from her memories, safe from the nightmares that he could still find her and come into her bedroom. It also reduced the intensity and frequency of her intrusive memories, significantly lessened her hypervigilance, and allowed her to feel supported, protected, and

  cared about by other group members. Kathy was unable to get away when she was a child, but now she could get away and take back her authority; she could empower herself.

  Kathy continued:

  When it was over and it was time for people to “de-role” and process, I looked out onto the group of people who were sitting in the room. In that moment I heard person after person tell me what a horrible thing my father had done to me. Many were angry, upset, and a few wanted to kill him on my behalf. It was glorious.

  I am blessed to be surrounded by people who I trust and who “have my back.” And, for the first time, I felt like I was out of jail. The experience of my secret horror being witnessed and validated gave me a sense of freedom I had never felt before. It also gave me another first: the ability to recognize and feel the courage and bravery that I had heard so many people speak about after I would work. I could now give myself the “standing ovation” that I deserved by surviving and, thanks, to psychodrama, I could now use that courage to go beyond surviving to the living part.

  Kathy speaks here both to the power of letting the body not only “tell” but �
��show” or express its story. And her story speaks to the value of compassionate witnessing. It is remarkable what giving someone the “stage” on which to show his or her story can do for someone.

  As a child, Kathy had been completely disempowered. She felt she had no one to go to for comfort or protection. She experienced her father as having the authority to subjugate her to his needs and she could not “tell.” She felt also that she had no part in deciding what was going to happen to her, let alone any influence over her father’s feelings. We reversed this pattern in psychodrama. We allowed Kathy to “lead the way.” She was the person structuring scene after scene, deciding who she wished to talk to and when that would happen. She was able to mobilize the resources available to her in the room by showing her story, choosing people to help her by playing roles, allow others to witness her story, and take in their support. And finally, she was the one handing out punishment to her father with the help of her “community.” The child within her, who naturally wished for some form of revenge or retribution, had her day in court. If she could not completely replace the old experience, her new one could slide in beside it. She could finally separate past from present by psychodramatically redressing a wrong that had been done to her.

  Dealing with Dissociation and Frozenness

  Our frozen fragments of self can hold much information about what drives us—they whisper to our inner ear about who we are or who we aren’t. While Kathy’s experience is extreme, sexual abuse is not uncommon when alcohol and drugs reduce inhibitions and drive behavior. Sexual abuse, in its many forms, can contribute to dissociation and lack of physical and/or emotional expression. By processing these fragments of self, we make significant moves toward integration. Pieces of the puzzle begin to fall together and we feel more empowered, whole, and self-

  aware. Because Kathy has frightening “sense memories” and relationship moments or dynamics woven into her memories of her father, she can get thrown back into a frozen and dissociated state when she feels triggered by intimacy, sex, or even closeness. What triggers each of us is uniquely individual. But for ACoAs, it is often something that returns us to that childhood state of feeling trapped, vulnerable, helpless, humiliated, scared, minimized, or less than. “If you do not discharge the freeze response, you loose resiliency and the ability to face further threat” (Scaer 2007). While Kathy’s example is extreme, being repeatedly raged at or at the whim of a drunk parent and told we are the problem, or being unprotected by the sober parent, can also be traumatizing over time.

  Dissociation remains the bête noire of psychiatric diagnoses. Its features include . . . a disruption in the usually integrated functions of consciousness, memory, or perception of the environment (dsm-iv 477), but a unitary diagnosis continues to evade us. We refer to states of depersonalization, derealization, distorted time and sensory perception, fugue states, amnesia and dissociative identity disorder. . . . But psychotherapy practitioners in the field know full well what dissociation is. It’s that confused, distracted state in your patient that prevents you from breaking through the fog into any semblance of meaningful contact. It’s the patient “leaving the room,” losing contact with you when you’ve barely touched on the meaningful traumatic material, or when an obtuse reference to some supposedly benign topic causes a short circuit to a traumatic cue in their memory. . . . It’s that state of detachment . . . regardless of technique or therapist (Scaer 2012).

  When Kathy entered group, she had just been fired for the third consecutive time. Though she is very talented in her work, she went blank when confronted with paperwork, and she felt too intimidated by her various employers, too disempowered and frozen within herself, to ask for help. After all, asking for help when she was young was not possible; that got her nowhere at best and abused at worst. Those core beliefs, that opening her mouth and speaking up would lead to trouble and that no one could help her, had lasted through adulthood. When Kathy could not manage an important part of her job, it triggered her back into the helplessness, choicelessness, and immobility she felt as a child. And she could not take action to improve her situation. She dissociated and disappeared into what felt like nowhere, but was not nowhere at all: it was somewhere, and that somewhere was associated with her traumatic experiences with her father, an authority figure in her life. When she bumped up against the authority of a boss, a system, and a workplace, her past become triggered. When she could not manage the task in front of her, she froze; she became unable to take action on her own behalf, just as when she was young. Instead, she went into a place of feeling totally overwhelmed. Gradually working through her “frozen feelings”, reestablishing a sense of autonomy, freedom of movement, and choice allowed her to literally “create new memories,” ones in which she was a functioning, empowered adult able to both enjoy her life in the present and muster the resilience to meet continued life challenges. Kathy has now been at her current job for three years and is very happy, effective, and valued.

  THIRTEEN

  Resilience: Mobilizing

  Help and Support

  Your time is limited, so don’t waste it living someone else’s life. Don’t be trapped by dogma­—which is living with the results of other people’s thinking. Don’t let the noise of other’s opinions drown out your own inner voice. And most important, have the courage to follow your heart and intuition. They somehow already know what you truly want to become.

  —Steve Jobs

  While it is indeed critical to go back and rework significant issues that block our ability to be present in the here and now, focusing exclusively on the negative qualities of ourselves, others, and the damage they wreak on our lives can sometimes have the adverse effect of weakening the self and our relationships rather than strengthening them. Nothing is black and white, and no one—not even the most fortunate among ­us—makes it through life unscathed. So what questions do we need to ask ourselves in order to find that invisible line between too little and too much focus on a painful past? Is there some sort of magical number of adverse events or circumstances that become too many to overcome, or can they be offset by positive events or the way in which we handle the difficult cards that life deals us? If the latter, what are the determining factors? Following are some of the most common questions that I see clinicians and those in recovery grappling with:

  • What factors actually do go into creating what we call ­resilience?

  • Why are some people able to meet adversity and overcome it or even grow from it while others seem more disabled by it?

  • Is there a healthy version of “psychological defenses” like repression, denial, intellectualization, or minimization that allows us to move forward and cope?

  • Is there such a thing as too much therapy or self-reflection?

  • How can I build and sustain strength and resilience?

  Resilience is a dynamic and interactive process that builds on itself; it is not just a state of self but of self in relationship. The ability of the child to access friends, mentors, and community supports is a significant part of what allows one child to do well where another might experience a tougher time. Resilient kids tend to have “protective factors” that buffer bad breaks. In studies of children, two of those resilience-enhancing factors that have emerged time and again are good cognitive functioning (like cognitive self-regulation and basic intelligence) and positive relationships (especially with competent adults, like parents or grandparents). Children who have protective factors in their lives tend to do better in some challenging environments when compared with children, in the same environments, without protective factors (Yates et al 2003; Luthar 2006).

  Resilient children are able to adapt when they encounter adversity or stress and use their support system to their advantage; they soak up positive feelings from their environment “surreptitiously,” incorporate them, and use them to their advantage (Wolin and Wolin 1993). A kind neighbor, a grandpar
ent or relative, a faith-based institution, or an unchaotic school environment, along with a child’s ability to make positive use of them, are formative to resilience. Terrible things happen to people all over the world, but interwoven with those terrible things are often the meaningful sources of support that help people to overcome their circumstances and go on to have purposeful and meaningful lives. In working through the pain of a traumatic past, it is important to help clients to identify not only what hurt them, but what sustained them.

  Take Annette, for example. Her father is a lawyer and her mother has a successful career in marketing. She lives on Manhattan’s Upper East Side and attended a private girls’ school; she lives in a world of financial and social privilege.

  At the age of ten and a half, when her parents decided to split up, Annette says that she “brokered a deal” with her parents that she would live with her dad if he promised to stop pressuring her mom for her sister to live with him, too. After the separation, her mother and sister moved to northern California. She saw her mother one week per year and her sister for two.

  I am a perfectionist. I just try to get everything so right and I am exhausted. I do well in my work but I work so hard, I dot every “I” and cross every “t” and then do it all over again. I love what I do but it’s using me up. I feel depleted. I think I am a workaholic; [work] is where I feel good about myself, but I can’t work like this anymore. I am always available to everyone, all the time, that’s why they like me, I never say no. My last consulting lasted four years and now I am taking a leave of absence. But I feel depressed.

  I say I want to get in touch with my feelings and acknowledge the fear and sadness coming from my heart, but when it comes down to it, I am too terrified to sit in dialog with all that I have successfully stuffed down since I was 11.