Keep Pain in the Past. Dr. Chris Cortman

committed infidelity and/or other egregious offenses. To aim for a happy marriage—or life—there must be forgiveness (letting go) with reconciliation. In that context, forgiveness must be repeated thousands of times in a fifty-year marriage, hopefully for lesser violations. Recall the Jesus quote when asked by Peter, “Lord, how oft shall my brother sin against me, and I forgive him? Till seven times?”

      Jesus answered, “I say not unto thee, until seven times: but until seventy times seven,” or indefinitely (Matthew 18:22, King James Version).

      When working with trauma clients, my chief goal is to help them live in the present, while looking forward to the future. Consider whether this is a goal you’ve achieved. You should be able to remember the past, laugh, and tell stories about painful events and the lessons learned from them. But you should not be stuck in the past with pain, avoidance, resentment, intrusive recollections, recurrent nightmares, or excessive guilt, etc. These symptoms point to unresolved pain in the past and require forgiveness, or letting go.

      Modern Day Prophet?

      An eighty-two-year-old woman sat on my couch one day and said, “So what I’m hearing you say, doctor, is that you want me to let go of everything that makes my head crazy.” She was no prophet, but to me, that remains the best definition of forgiveness I’ve ever heard. In the chapters ahead, I will show you how you can learn to let go of those things that make your head crazy. Remember that by definition, what you don’t let go of, you hold onto for the rest of your life. More importantly, the unresolved trauma owns you for the rest of your life.

      What counterbalances the horrible stories that trauma clients tell me is their ability to finish their traumas once and for all. In the chapters to come, I will refer back to these six contributors and describe how their emphasis on closure and release comes to life in my approach to overcoming trauma. In fact, I’ve named the procedure after Fritz Perls, as a tribute to his brilliant understanding of healing from pain in the past. In chapter three, I’ll explain what “The Fritz” entails and how you can apply it to your unfinished business.

       Chapter Two

       Trauma Destroys the Soul Thanks to Mr. Avoidance

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      “Now, don’t hang on. Nothing lasts forever but the Earth and sky. It slips away, and all your money won’t another minute buy. Dust in the wind, all we are is dust in the wind. Everything is dust in the wind.”

      —Kansas

      Trauma is Bad

      You know about the nightmares, the insomnia, the rage, and the deep despair and hopelessness. The hypervigilance (constantly watching and scanning) makes you feel crazy, and the exaggerated startle response (jumping when unexpectedly tapped on the shoulder) is downright embarrassing. Your anxiety remains high, and your intrusive recollections of the event are just that, intrusive. They ruin your conversations, your productivity, your peace of mind. You look at the world through a glass darkly, as if someone had blotted out the sun permanently. You may still smile, but not as frequently or as sincerely. You can’t remember when you were last at peace.

      But trauma has many effects, many of which aren’t widely known.. For instance, we now know that trauma is a big contributor to substance abuse. Research studies have noted repeatedly that traumatic experiences are associated with an increased risk of substance abuse. Najavits, Weiss, and Shaw (1997) noted that of women who experienced childhood physical or sexual assault, between 30–59 percent go on to develop substance abuse problems.28 Another study found that out of thirty-eight male veterans who were placed in an inpatient substance abuse clinic, 77 percent of them had been exposed to severe childhood abuse.29 Another study shows, again, that the prevalence of PTSD among chemically dependent adolescents is five times that of their peers who are free of such dependency.30

      There’s more; recent research from Newtown, Connecticut, after the school shootings suggest that when experienced by children, traumatic events are tremendous contributors to many symptoms and illnesses, especially mental illness and addiction behaviors. When children had gone through six or more traumatic events between birth and age eighteen (defined as an incident of physical or sexual abuse, parental arrest, or parental conflict, etc.), children had a 4,600 percent greater chance of using recreational intravenous drugs than those who had none.31

      Katelyn was an IV drug user who preferred shooting crystal meth as her drug of choice. It took me several inpatient hospital visits to learn that she had been a victim of human trafficking in her teens and had been forced into prostitution. She was physically and sexually assaulted repeatedly, totaling “about 20” traumatic incidents. Little wonder, then, that she found solace in mood-altering chemicals.

      Trauma is also linked with mental illness. You know about PTSD, depression, anxiety, and now addictions. Trauma is also a contributor to psychotic illnesses and is the cornerstone of dissociative illnesses, especially Multiple Personality Disorder (now called Dissociative Identity Disorder) and possibly also of Bipolar Disorder. A client of mine who had been diagnosed with Bipolar Disorder as a teen once said candidly to me, “I was never bipolar before I was abused.”

      Dr. Steven Sharfstein, former President of the American Psychiatric Association (APA), has said, “Smoking is to cancer as trauma is to mental illness.”32 Let me summarize with one of my own quotes, “Unresolved trauma is bad.”

      Trauma Symptoms are Understandable

      If you accidently hammered your thumb (to the delight of the nail), several predictable responses would occur within the afflicted area: your thumb would throb, swell, and likely turn the color of a California plum, all because of the body’s natural inclination to heal itself.

      The mind is very much a part of the same system and also responds in a predictable manner. All trauma symptoms, as painful and dysfunctional as they may appear, are rooted in survival. While some of them may seem incomprehensible to the untrained eye, they all make sense when viewed within this survival context.

      This context will become apparent as you read further, but here, let’s use an analogy that helps illustrate how PTSD symptoms function: the splinter in my middle toe.

      One afternoon at the office, my client failed to show up for an appointment, so I had a free hour to myself. The top of the middle toe on my right foot had been sore to the touch for several months, so I decided to remove my shoe and sock to investigate. The top of the toe was layered with excess skin, unlike any of the other toes. Looking below the skin, I saw a black dot embedded deeply in the toe. I decided to scratch at the layers of skin to remove the excess from the toe in order to gain access to the black dot. I squeezed the toe, only to reveal a small amount of liquid pus encasing a half-inch long wood splinter. Upon removal of the splinter, the excess skin did not grow back, and the toe never hurt again.

      And then it occurred to me—my middle toe story is a perfect metaphor for Post-Traumatic Stress Disorder. Let’s explore the metaphor further. My toe, unbeknownst to me, was traumatized by a very intrusive splinter. The splinter was invasive and did not belong within the toe; it needed to be expelled. But the owner/operator of the toe was oblivious to the intruder and only remotely connected to the pain. As such, the intrusive splinter remained. Since the splinter was not being removed, the body found it necessary to protect the toe from further attacks and sensitivity to the pain by providing the protective coating of excess skin. In this way, the toe (and the surrounding foot) was still quite functional despite the now buried and well-protected splinter. And yet, because something was wrong, pain and discomfort were the result.

      Your