Shirah Vollmer MD

The Musings of Dr. Vollmer

Is Trauma Interpersonal?

Posted by Dr. Vollmer on June 6, 2012

The baby growing up in a household who is unwanted and ignored is traumatized by lack of attention and responsiveness. Nomi, twenty-five, was born to a teenage mom, who was too ashamed to get an abortion, or so that is what Nomi has come to believe. Nomi was raised by her mom and her grandmother, both of whom, by Nomi’s report, treated her like a burden which they would have rather not had. Nomi clarifies that she was well fed, and all of her medical and dental needs were attended to. Money was not a problem as the grandmother was well-off and she was generous with her money. The problem, as Nomi has come to believe through our work together, is that neither her mother or her grandmother, was excited about her accomplishments-big or little. She went to Ivy League college, and then on to a prestigious law school. She does not remember hearing a “congratulations.” “Gosh, it sounds like you feel that you were very alone in the world, and I wonder if at some level that makes you very angry and scared to engage with other people on a deep level.” I say, highlighting the notion that trauma can be interpersonal, and as with all trauma, the downstream effect is one of constriction and numbness. “I don’t see myself as having rage, but maybe I do,” Nomi reflects. “Mostly, I see myself as lacking confidence,” she continues. “Well, that may also be a downstream result of not having someone who mirrors your developmental progress.” I say, pointing out that lack of mirroring has a multitude of unpleasant and undesirable outcomes, which often include a lack of self-assuredness and rage. ” I don’t know that I will ever get there,” Nomi says in despair. “The fact that we can talk about it is a large step towards metabolizing your rage and developing a greater sense of your own potential.” I say, trying to help her see that being in psychotherapy, particularly in-depth psychotherapy, takes courage to confront very challenging feelings and experiences. ” I still feel despair,” Nomi insists. “I can understand that your feelings of despair alternate with your feelings of hope in our process.” I say, stating that despair is a part of her experience, but our work together, our persistence in trying to understand her emotional interior, also gives her hope that she can learn to feel better about herself. Trauma can be interpersonal. Trauma, all kinds, can also heal.

13 Responses to “Is Trauma Interpersonal?”

  1. Shelly said

    It is true that trauma is interpersonal and it is unfortunate that Nomi’s mother and grandmother seemed to blame her for something over which she had no control. Two questions: I read elsewhere that a person can become extremely withdrawn and cold in instances similar to Nomi’s however, I know of an instance when this is clearly not the case–both parents were loving and interacted well with the young lady, she had a very stable home environment with no mental illness involved yet she is very detached and cold. What other reasons other than what you describe for Nomi’s could cause this detachment? My other question is whether or not Nomi could ever speak to her mother about her feelings and if that would help, or if these are only for the office only and not to be shared?

    • Shirah said

      Hi Shelly,
      Coldness is an interesting phenomena. It can be temperamental (nature) as well as nurture. Some people are fearful of interpersonal connections and hence they appear to be quite cold.
      In the fictional Nomi, she cannot talk to her mother because her mother only gets defensive when confronted with feedback. It would help if her mother did not get defensive, and sometimes that does happen, where a parent can really come to grips with their deficiencies and a rapproachment is possible. Thanks, as always.

  2. Ashana M said

    Nomi’s despair really struck me. The experience of not being cared for as a child who needs care is, I think, inherently one of despair, and yet you can’t despair–because there is no one but yourself to propel you forward. The despair is reasonable–how can you really survive without adult support, and really what is the point of doing so if no one loves you or wants you and you have little prior experience to suggest that they someday might? But it is untenable to feel that way. Feeling that despair creates a whole chain of decisions that will lead to a psychic death, if not a physical death. So neglect of the kind Nomi grew up with can involve a childhood marked by an intense, suppressed hopelessness. Adulthood means it is safe to engage with the despair. The trick to despair is feeling it without allowing it to become your totality.

    • Shirah said

      Thanks, Ashana. I think the “trick” is to feel the despair and recognize that feeling despair is not the same as living despair. As with all feelings, however intense and challenging, once we know it is a feeling, we also know that it will pass through and other feelings will come to us as well. It is when we feel that the despair is somehow “deserved” that we keep the despair alive, despite opportunities to move to a new experience. Thanks Again.

      • Ashana M said

        I was thinking that despair is not the best place from which to make decisions about our lives and it tends to distort out thinking so that the future seems even worse than it is. But it’s possible to just feel the despair without thinking or deciding anything based on it. I’m not sure if that’s what you mean by not living the despair.

        I don’t have any insight into or answers to despair beyond that. There are important ways that my experience is probably different from Nomi’s, although we share the neglect.

        For me, the despair is also about finding the world so horrifying it’s almost unbearable to be in it. I don’t want to know what I know or to have seen what I have seen. I don’t want to think what follows that. It’s a very different kind of despair and seems to require a different resolution, because what I cannot come to terms with is not in me, but outside of me.

        • Shirah said

          I agree that despair is not the best place to launch a decision. I think you are describing a terror in which the future can be unbearable, since the past has been unbearable. That kind of anxiety is a deep challenge, since the world can be a terrible place and it is hard to live in the world and accept the horror which may be around the next corner. Thanks.

          • Ashana M said

            There is a difference between horror and despair, although I’m not entirely clear on what it is. Horror involves a moral revulsion, and seems more closely related to disgust than to fear. Horror offends the conscience.

            It seems neither located in the past nor in the future, but as simply an ongoing state because my suffering was not unique, nor were the perpetrators. Atrocity simply lies within the capacity of human beings to carry out, and not always for any particularly good reason.

            The United States has tortured detainees at Guantanamo because individuals agreed to carry it out. Periodically, entire groups of people decide to humiliate, frighten, and destroy other groups of people. These are not aberrations, but regular occurrences.

            Most of us, I think, know that but are able to keep it at a distance. It’s closer to me, and I can’t. I need another way of making peace with that knowledge.

            I’ve thought a great deal about the meaning of despair for me here:

            You are more than welcome to take a look.

            Thank you for the most interesting and helpful exchange.

            • Shirah said

              You raise a good issue about what I call the “membrane issue”. The thickness of this membrane determines how one can keep out the “despair” in the human condition. I agree that evil permeates our society. A thicker membrane allows one to know this without suffering from it. A thinner membrane makes suffering inevitable. How one can change their membrane is not clear to me, but the awareness of this membrane helps with understanding. Thanks for sharing your link.

            • Ashana M said

              I think I can accept the world the way it is without it causing me suffering, but I needed to understand the meaning that the despair had for me. Let’s see.

  3. Shirah said

    Sounds good. Interesting discussion.

    • Ashana M said

      Upon a great deal of further reflection, I would say the “membrane” is a form of denial or avoidance. It allows us to “know” without really knowing. It allows us to remain comfortable with a slightly inaccurate view of the world rather than attempt to manage difficult feelings that would come with seeing it in a more realistic way. When there is no compelling reason to confront those feelings, denial is a reasonable approach. But other approaches that are more honest are possible. They just require more tools.

      In my experience, the world is both a wonderful and a horrifying place and the people in it are both terrible and splendid. I can live with that. But we all have our unique experiences and unique views they lead us to hold.

  4. […] One of my fellow bloggers, Dr. Shirah Vollmer calls this “the membrane issue.” She says, “The thickness of this membrane determines how one can keep out the “despair” in the human condition. I agree that evil permeates our society. A thicker membrane allows one to know this without suffering from it. A thinner membrane makes suffering inevitable.” (From Is Trauma Interpersonal?.) […]

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