In our continued outreach for our films Boys and Men Healing from childhood sexual abuse and The Healing Years, we invite leaders in the field to share new insights on healing from trauma and childhood sexual abuse. We’re honored today to share a Q & A with Gretchen Schmelzer, PhD, a licensed psychologist trained as a Harvard Medical School Fellow. Her website “Emotional Geographic” is a place to create, extend and build a new conversation about the effects of trauma and healing from long term trauma” — “and to learn, explore and honor the journey back to wholeness and health.”
Gretchen is also a trauma survivor, who has worked for twenty-five years with the complex issues of trauma, integration and behavior change across every level of system from individuals, to groups, to large systems and countries. (see additional bio below Q & A)
1. I love the name of your website. Can you tell us a bit about how you came up with the name and your hope and intention for the site?
I spent about five years working on a book about healing from repeated trauma and in my writing I began to see what kind of courage and stamina it takes to start and then stay on a path of healing. During this period of writing I came across a stack of old National Geographic magazines from the 40’s and 50’s and was struck by how the articles were written by the explorer’s themselves, not by journalists, and how incremental and gritty the stories were. Healing from trauma is so invisible. We can root for the double amputee competing in the Paralympic games. We can see he has courageously managed to overcome a massive obstacle and we can watch his triumph. And we should cheer for him—it’s a huge and brave piece of work. But what about the veteran with PTSD? Or the man who survived priest sexual abuse? He has managed to get a new job, and is now volunteering in his son’s cub scout troop—and no one is on the sidelines cheering his accomplishment. It’s too hard to see, and difficult to understand, for those watching and for the survivor himself. But it is no less a triumph, and no less a journey. Inner wounds are invisible: we can’t see people overcoming them, we can almost never appreciate the triumph—not even with ourselves. It made me long for a magazine called Emotional Geographic with the brave people who have dared to heal on the cover. And maps to these difficult territories of healing inside, waiting to be hung on the wall. So I decided to create it.
For more on the courage to heal:
Courage to Heal
2. The tagline for the website is Healing from Trauma is possible. Healing is Brave. No One Heals Alone. These are powerful statements. Can you elaborate on this hopeful message?
I have worked in the mental health field now nearly thirty years and I can tell you that one of the most difficult obstacles in healing is the loss of hope. People go to treatment and they initially feel better, but the work of healing starts, they start to feel worse and they often quit. This has been my main motivation in writing about trauma. I want people to understand the healing journey so they can stay on it—and so they know where there are and can feel more confident, even if it is really hard. I want people to know that healing is possible. You can heal from trauma—it takes work and it takes perseverance and it has a lot of rocky spots, but you can get through all of that. Which is why I also say that Healing is Brave. It takes so much courage to back to the most difficult parts of your life. People have this misunderstanding that when you go for help you will feel better—and you might initially. But in healing from trauma there is also some really terrain, and it requires you to be brave—and really lean on your strength to get through it. And the last part is that No One Heals Alone. Trauma shatters trust, trust in ourselves, trust in other people and trust in the wider world. And trust is something that is primarily healed in relationship. Our brains are wired to heal trust and connection through relationship –it is something you can’t do by yourself. No one would tell you to do open heart surgery by yourself, and in a similar vein, you can’t heal yourself from trauma.
3. Can you share a few realities about the hope that’s available for adult survivors of childhood abuse in terms of advances in healing trauma?
We understand so much more about how childhood trauma impacts our development, our brain, and how we behave in relationships. This understanding now informs treatment. Trauma treatment is no longer something that is one-size-fits-all. You can work with your therapist to figure out the best methods to help you—whether it is working on the more relational aspects of trauma, the thoughts and actions, or the symptoms of PTSD. I think the most important thing that survivors can do is find someone who is willing to work with them to figure out what they need and explore the many options that exist now.
What are some basic thoughts you can share with adult in terms of the process of healing including the challenges, pitfalls and triumphs?
I think one of the main things in understanding the healing process is to first understand the impact of the trauma. Childhood sexual abuse is typically a repeated trauma—it doesn’t just happen once, like a car accident. It is more like being in a car accident every night for years. Repeated trauma is really three forms of trauma: what did happen (the abuse), the protections you used to survive the trauma, and what didn’t happen (the developmental challenges you didn’t get to do because the trauma was occurring). The challenges in the healing process are that you often have to work on the protections: the ways you survived the trauma—the walls you put up—the ways you shut down. You need to work on these first in order to be able to get to your story and protections can take a long time to work through. The other challenge is that people believe that in order to heal you just have to tell your story, but to heal fully you need to pay attention to the third form of trauma—to what didn’t happen: you have to be able to attend to what you didn’t learn about yourself, your relationships or your behavior during the time the trauma was happening.
I think one of the biggest pitfalls is people moving too quickly in to the trauma work and not preparing adequately. I liken trauma treatment to a high-altitude climb. You need to spend time at ‘base-camp’ before you can take on the more difficult terrain. You need to build a strong and trusting relationship with your therapist, you need to have solid strategies for managing your emotions, and you need to have a solid platform in your life—safe place to live, supportive relationships and a meaningful activity to be your fixed ropes as you climb. Only then is it safe enough to do the work necessary for healing.
The triumphs in healing are moments that feel big: moments of trust, moments of being able to hold your story in the context of your larger life, moments of really feeling that the past has become the past, and is no longer driving your present emotions or decisions. Often these big triumphs will be fleeting at first, and sometimes unseen to the people around you. That’s why it is important to really honor your hard work and know how brave you are in taking on this challenge.
4. In sharing our films about healing from childhood sexual abuse, we have also met survivors who have had incredible courage in the healing process. Can you share a bit about the role courage plays in healing?
I have heard that the definition of courage is feeling fear and doing it anyway and I really don’t think it is possible to heal without courage. Healing is not an event—it is a process that requires a lot of work and the ability to ‘show up’ over and over again. One of the hallmarks of trauma is that it renders us helpless as the moment of trauma—and this helplessness embeds deep shame. Healing from trauma requires us to work through that shame which is very difficult and scary. People who are healing from childhood sexual abuse have to have the courage to try—the courage to show up again and again. They have to have the courage to speak up—to learn to trust their voice and be brave enough to hold their story, and the courage to trust—to trust in relationships even though a relationship was the very place that the trauma occurred.
I think one of the confusing things about the term courage is that you don’t feel courageous through a lot of the healing process. I used to cringe when my therapist used the word courageous. Long term trauma involves repeated experiences of helplessness and terror. These experiences usually result in shame, not courage; in fear, not bravery; in hopelessness, not resilience. But I misunderstood my therapist when she was using the term courageous. I heard the word ‘courage’ and thought she implied that I had acted courageously as a child. But I had done what all people who come through trauma hope to do, I survived it. Some people might say that survival takes courage, but mostly it takes perseverance—the perseverance of feeling hopeless and going forward anyway—the perseverance of finding hope wherever you can. It takes the ability to put your head down and keep going. It takes some kind of hope. But healing from trauma –that does take courage. You may not feel it at first, but you do eventually, and that’s pretty great.
5. How about resistance to healing. What are the main culprits and how can a survivor move through resistance?
I take resistance to healing as a good sign. It means that there is an internal system of wisdom—of knowing pacing and limits. Keeping in mind that repeated trauma is really three traumas: what did happen, what didn’t happen, and the defenses created to survive the trauma—the resistance is exactly what helped someone survive. It needs to be honored, understood and worked with. You work through resistance by acknowledging it, by talking not about the abuse, but about the resistance itself: what is hard about getting help, what is hard about talking, what is hard about trusting. This is tremendously powerful and difficult work. The resistance isn’t separate from healing, it is actually one of the main pathways to healing. The resistance is often a way that we tell or act out our story of abuse—how we can or can’t trust help. Working with resistance requires a lot of patience and compassion, and your best bet is to go slowly, one sentence at a time.
For more on resistance in healing:
6. Can you offer your thoughts that could help survivors coping with repressed or confused memories?
I think that one of the most important things to understand is that memory is really complicated and traumatic memory even more so. If you experience a one-time trauma, often memory for this is clear—it is almost etched in to your brain. That is the very nature of flashbacks. But if trauma is repeated—often this isn’t the case–our physiology is designed to protect us. Our defenses against being overwhelmed and incapacitated help us not take in trauma as it is happening. There are a number of things that happen with the physiology of our brains that keep us from taking in the whole story. Trauma keeps our brains from encoding or storing the information in the way it typically takes in information. Stress activates our fear or emotional memory so that the memory gets stored as a memory that you know but don’t know how you know–they call this a procedural memory (like riding a bike or tying your shoes).
To make this even more likely, the high levels of stress hormones from trauma inhibit the neural networks of the hippocampus-cortex circuit —effectively taking our memory for knowledge “off-line” which means that the details of the memory, the story of the memory and the context of the memory are not properly “written down.” The memory is there, your brain recorded the information, but the information was stored without a connection to context and often, time. Think of it as memory scattered. Even more striking is the loss of language during and after trauma. During trauma, and even recalling trauma, the language center of the brain has reduced blood flow which inhibits the capacity for language. This inhibition impairs encoding the event into language and can impair the retrieval of memory into language. When we say that trauma is ‘unspeakable’ or that language fails us—it’s not just a metaphor: the language centers in our brain keep us from the story.
All of this combines to create memory that is not always a clear narrative. As both a therapist and survivor I think it is important to understand your memory and story as something that can help you understand your history and help you heal—separate from our culture’s understanding of your memory and story as testimony that would be used in a courtroom. I think what gets in the way of healing is the desire for something hard and definitive in the courtroom sense and with childhood sexual abuse—both its often early onset, and repeated nature can make it harder to have a definitive clear memory.
For more on memory and trauma:
7. Can you share about the role creativity plays in healing?
I should probably give my bias up front—I spent the first 15 years of my psychology career working with children—so creativity—using play, having to figure what each kid could do and not do—was integral to my work as a therapist and I brought this same approach and attitude in to my work with adults. And I also brought it in to my own healing as well. Creativity is really a flexibility—an ability to break out of seeing things the same way, or stay rigid—so I see creativity as one the main paths to healing. If someone is having a hard time talking—can they describe their feelings as a picture, as a color, as an animal? Can they move objects in my office to represent how they feel? Can they bring in something from home that helps them describe it?
Are they feeling stuck? What if they switched chairs and just felt that kind of movement from one chair to the other? Are they feeling afraid to talk or be seen? Can they wear sunglasses as they talk so they have some control over that? Creativity is really about experimentation and learning—and both of those support the healing process. They allow the survivor to be in a position of not-knowing the outcome which can be really scary, but they can experience it in tiny doses and in safety.
For more on creativity and play:
A question adult survivors beginning to heal later in life ask is – is it really possible to change, to heal and to thrive. Can you elaborate based on your experience as both a psychologist and a trauma survivor.
The short answer is yes. And the honest answer is yes, and it is hard work. Much of healing from childhood abuse is about learning trust and relearning attachment and these two things are things that in the best of circumstances we learn very early in life—over many years with a lot of difficulty and holding (think of the ‘terrible twos’). I can say unequivocally that you can learn it in adulthood but you have to be patient with yourself. It would be the moral equivalent of learning to walk as an adult. You have to go slowly, really lean on help, and be proud of each step.
I can also say that for some trauma I think it is even better to heal in adulthood than it is in adolescence. As an adult you have more of your brain available to help you—you have more ability to build the self-control muscles so necessary to healing—and you often have more lived experience—more proof that despite a difficult past—you have strength and ability. You often have things that are important to you—a family, loved ones, a career—that can be big motivators to help you through the hard parts of healing and remind you that you are more than your trauma. So while it can be hard to heal as an adult, in many cases I think it actually is safer and more successful.
For more on the journey of healing as an adult:
8. Can you share a bit of wisdom about your own healing process from trauma – wisdom that could help encourage those still in a healing process.
I think that the first thing I would say that was said earlier is that you can’t do it alone. Trust me, if there was a way to do this alone I would have found it—I was really stubborn about that for a long time. The best thing I did was find someone who could help me—and that took a number of tries—six in fact. It can take a while to find a person or group that you feel like you can work with. And the next thing I would say is that healing from trauma is really like having two tracks going on in your life at one time. In my view healing from any repeated trauma is a long term project—so you have to be able to work at healing AND you have to keep living your life. I think there is often a fantasy that you can stop your life—fix your trauma—and then move on, but in my experience, this isn’t what happens. You have to hold both at the same time which is why it takes so much courage. And the last thing I guess I want to say is that it does get better. It doesn’t always feel as painful as it does in the beginning, and you will be able to do things in the world you would have thought impossible. But you have to stay patient and compassionate. What you build through healing is your ability to not abandon yourself. You have the help of a therapist or a group, but you also become your own teacher/friend/guide.
Gretchen Schmelzer, PhD Additional Bio:
Gretchen also was an expert consultant Frontline for their documentary on Alaskan survivors of priest sexual abuse (aired April 19, 2011). She has also worked with individuals and groups in large clinics, and clinics in housing projects, in residential treatment facilities, on psychiatric units and medical hospital units, and in private practice. Her work includes over a decade of working with traumatized children and adolescents in residential treatment and psychiatric units.
Since 2002, Dr. Schmelzer has also worked as a senior consultant with Teleos Leadership Institute, an international consulting firm serving leaders of fortune 100 businesses and major not-for-profit organizations such as the United Nations. Her expertise in long term trauma was used to inform the design and delivery of a four year large scale intervention for the UN in Cambodia. She and her colleagues worked with 150 leaders each year who were survivors of the Khmer Rouge in a large scale leadership initiative to strengthen the county’s response to HIV/AIDS. The program integrated work in self-awareness and self-regulation, gender issues, communication skills, relational skills and action learning. This program was rated one of the most successful leadership development programs run through the United Nations Development Programme by an independent research team.
She graduated in 1987 from Mount Holyoke College with a BA in German Literature, in 1993 from Springfield College with an MS in Counseling Athletes, and in 2002 from Northeastern University with a PhD in Counseling Psychology.
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