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Coping with Trauma During Triggering Times: A Q & A with Dr. Sheela Raja

Hand writing the text: Q&ASheela Raja, PhD, is a licensed clinical psychologist and co-author of “The Sexual Trauma Workbook for Teen Girls: A Guide to Recovery From Sexual Assault and Abuse.”

Dr. Raja is an associate professor at the University of Illinois at Chicago, where she researches the impact of trauma on health. She is a highly sought-after national and international speaker, a blogger for The Huffington Post, and a frequent contributor to various print and television media outlets.

Tell us a bit about your background and how you became interested in working with trauma.

As an undergraduate, I was interested in psychology and I was also interested in women’s studies. I started taking classes and learning about the rates of sexual victimization in our country. I heard story after story about people who had lived through campus sexual assault, and I started volunteering at a rape crisis center.

When I went on to graduate school in clinical psychology, I had wonderful mentors that helped me put together the pieces—that various types of trauma are related.

What we used to call rape trauma syndrome (RTS) back in the day, we began to understand was actually a form of post traumatic stress disorder (PTSD). The field of PTSD was learning that what a veteran goes through after having been through war is in many ways the same as what somebody goes through after experiencing domestic violence or sexual assault.

Putting those pieces together was a full circle moment for me. It helped me to understand that while each trauma is different and people’s reactions vary, the commonalities are actually immense.

 So how do you define trauma and what are some of the lesser known or unexpected sources of trauma that people may overlook?

Obviously there’s the DSM-5 definition of a traumatic event; your bodily integrity or the bodily integrity of somebody close to you is being threatened. But when I’m training providers, particularly non-clinical or non-mental health professionals, I always say there’s a really easy way to think about what trauma is: It means there is a situation where very serious harm has happened to you or someone close to you or there’s a risk of harm occurring.

Also, it’s important to remember that people don’t’ “ask for” trauma, it’s not voluntary and the victim is often in fear or unable to cope.

In addition to trauma, I think now the field is also moving towards a better understanding of toxic stress that involves things like living in poverty, micro aggressions, bullying or being mocked or stereotyped on a regular basis for your race, ethnicity, religion, sexual orientation or a disability. Those types of micro aggressions also add up in terms of people’s mental health and even their immune system functioning.

I think we have a deeper understanding that trauma can be a discrete event—like surviving a robbery, going to combat, being in a domestic violence situation or being sexually assaulted—but trauma can also be that toxic stress environment that people might be experiencing.

If I’m a part of a particular group and that group is being negatively targeted or spoken about in the media, what is the impact? Is it possible for a large group of people to experience trauma or toxic stress all at once?

When you grow up in an environment where you are faced with bullying and harassment on a regular basis—whether it’s based on having a disability on race, ethnicity, religion, sexual orientation—many people are extremely resilient and emerge from those experiences and are functional adults.

However, when you see something on the national stage play out that feels personally dehumanizing and disrespectful, it can potentially be re-triggering trauma for people on a very large scale. It’s re-triggering those toxic stress memories, psychologically, emotionally, spiritually and physically in our population.

That’s why social support and reaching out to each other right now is so important.

When you say “re-triggering,” what does that mean for people specifically? How does it affect people’s lives?

In many ways, our country learned a very deep lesson after our Vietnam veterans returned home. I’ve worked at the VA hospital; I’ve worked with veterans who have described in detail to me about walking down the street in America after having been to war and being called a baby killer or worse.

Emotionally, even if you are a very strong person, how people treat you really does matter. Those types of things re-trigger people, they stay with you.

When you’re coming back into civilian society, for example—trying to reintegrate; building bridges with people who are different than you; doing all you can to give back in life; taking care of your family—a trigger puts you back into that state of depression, that state of anxiety, that heightened mistrust of people.

Secondary trauma—the idea that trauma survivors may be re-victimized when they reach out to institutions for help—is on the minds of a lot of people these days. We need to ask ourselves, “How does the mental health community help survivors?” Do we believe them? Do we support them? What about the medical, legal, or governmental institutions? Do we treat survivors with respect or do we re-victimize people who talk about sexual abuse?

And so, for somebody who has been the survivor of a sexual assault, what might it be like to be exposed to media that implicitly or explicitly rewards or encourages sexual assault?

I think that it’s re-victimizing and I think that it’s extremely painful for people to have some of those feelings unearthed.

One of the most difficult things for rape victims, second to living the assault, is having to tell people what has happened to them. It is, unfortunately, one of the few crimes where the actual victim is the one who has to carry the shame, the blame and the stigma for it.

And because of that, coming forward takes such courage. So to be met with victim-blaming and being questioned is extremely painful for people. Living in a culture where rape is seen as a joke or not taken seriously can also be extremely difficult for survivors.

One of the best hallmarks of healing is actually how people around you react and the social support you receive when you disclose a sexual assault or any kind of trauma.

In the case of veterans, for example, when you come back and society says, “thank you for your service,” it is just words, but it means a lot to people. If they blame you for what you did, that also hurts.

Marsha Linehan talks about the invalidating environment, in which a person says, “I’m suffering,” and then somebody comes back with, “no, you’re not really.” That’s problematic for healing and resilience.

What can people who feel triggered by media, information or current events that are beyond their realm of control do to protect themselves?

We have to really focus on self-care. This includes limiting our media consumption, but that is not the same as burying our heads in the sand. Self-care also means getting active, either locally, nationally, in your community, in whatever way feels like a good fit for you. There is great importance in community connection and activism, as methods of healing.

Remembering that you’re not powerless; you may be choosing to limit media consumption, but you’re also choosing to give back to your community, get involved or make changes in certain ways. I think that can help people to feel empowered.

It also helps to remind ourselves that we get to choose our own role models– in our own homes and our own communities. Surround yourself with people you respect because those are the role models that matter. For our girls, the most important thing is to have men in their lives that respect their mothers, and men in their lives that respect them.

What can we do to be supportive of loved ones who are feeling triggered or really struggling?

If we’ve learned anything from acceptance and commitment therapy and dialectical behavioral therapy it is that when we try to push emotions away, it often doesn’t work. Obviously, we can support each other in self-care, but the other thing you can do to help somebody who’s struggling is just to allow them to their emotions in a supportive environment.

Allow those struggling to express some grief and some sadness. Allow them to have a couple of weeks where they feel upset or where they have to process things. That’s okay. In fact, it makes them human.

Our attention span—how long we can pay attention before we want to do something else—is about eight seconds. And I think that contributes to our inability to sit with each other’s grief and suffering and pain sometimes.

Part of the idea that “okay, now we have to move on, it’s time to move on,” comes from our 24/7 culture that has a very short attention span. We have to work on being able to sit and listen to each other, to support each other. Just allow your loved ones time to process.

We should not give survivors a rigid timeline for how long they will have to process feeling disrespected.

So then, what happens when re-triggering events or content are repetitive? What happens when something isn’t going away? How do we deal with that?

I think that this is where we have to get creative and we have to get resilient. Resilience is a word that’s used often in our culture and I don’t think it’s very well understood.

Resilience is something that doesn’t happen overnight. It’s something that has to be cultivated, it has to be practiced. Every day when we get up, we have to make a decision. And it’s something that happens over time. Part of resilience is finding meaning in what we’re doing, whether it’s giving back to our community or doing anything else that matters to us.

 So, making an ongoing commitment to being active toward what we believe in is not only good for society, but it can also be beneficial for our own healing?

I think we see this across the board. The path to empowerment doesn’t include just saying “okay, this happened, now I have to accept it.” It’s about asking, “how do I integrate this into my identity, give back to my community, educate others and feel a sense of belonging?”

I used to work in spinal cord injury at the VA, and I’ve seen it there too. I’ve seen that the veterans that really adjusted the best to something that was so difficult were the ones who emerged as leaders in spinal cord injury; who ran support groups; who were active in their church; who found a way to contribute. And other people benefitted from their experience.

 Do you have any resource recommendations for people who are dealing with trauma symptoms or feeling re-triggered?

International Society for Traumatic Stress Studies, and also the National Center for PTSD. These are both really good resources for people to start.

For more information about Dr. Raja or her books, visit her online.

Coping with Trauma During Triggering Times: A Q & A with Dr. Sheela Raja