No one who experiences repeated trauma goes in as a ‘blank tablet.’ Even babies and very young children differ in their temperaments and their resources and are differently impacted by trauma. Who we were going in to the trauma, who we were during the trauma and who we were after the trauma is all part of who we will become. In healing we are putting pieces together, but in order to do that it might be helpful to slow down and look at the pieces that we brought with us. What might have been impacted? What are our resources?
Repeated trauma is almost always connected to personality change.2 But what is personality? Rutter and Rutter state that, “personality reflects the pattern that each person, as a thinking being develops as a way of dealing with her temperamental traits, the social contexts that she encounters and the experiences she has undergone.”3 Personality is who we were, our temperament, the sum of our experiences and the interaction of these things. And then long term trauma shapes our personality once again.
So we all come in to the world with a different paint box of traits. Anyone who is a parent of more than one child recognizes that these temperamental traits are evident early. Whereas one child would run headlong off the deck if you don’t watch him, the other brother won’t go forward without holding on to your hand. Same parents, same genetic pool, same household: different traits and capacities. All with their upsides and downsides.
In healing from long term trauma it can be useful to think about your temperament and the aspects of self that make you—you. It will help you understand the self you were before the trauma, it will help you see how the trauma might have affected you, how and why you protected yourself (or didn’t) as you did, and what might be supportive in the healing process. Each part of temperament has a different impact on how we function. Brazelton summarizes the nine elements of temperament 1) activity level 2) distractibility 3) persistence 4) approach/withdrawal (how does you deal with new and stressful situations?) 5) intensity 6) adaptability (how do you deal with transitions and change?) 7) regularity (how predictable are you with routines and rhythms like sleep?) 8) sensory threshold (are you easily overstimulated?) and 9) mood (are you primarily positive or negative in your mood?).4
So let’s go through each aspect of temperament as a way for you to explore aspects of your personality—how you know yourself. For you to consider the impact that these aspects had on your development and how you interact in the world. You may get a sense of how these aspects of yourself were impacted by the trauma, and how they are impacting your healing. As you move through the various aspects of temperament think about what aspects serve you and which ones hold you back? What aspects are serving your healing journey and which ones are making it more difficult. When I work with parents and children I help parents understand their role with regards to their child’s temperament. Their job is to help a child learn how to expand and build on their strengths and help their child learn how to manage and mitigate their challenges. Your role with yourself in treatment is no different.
Let’s start with activity level. Are you a person who is normally ‘on-the-go?’ Or a person who is normally sort of sedate? Did your experience of trauma have you experiencing life with a lot of motion—or more shut down? Are you currently living in your body in a way that is congruent with your natural temperament? Or are you living more congruent with the way you had to live during the trauma? What might make you feel more whole?
Distractibility is about attention and focus. And we all fall somewhere on the continuum from completely distractible to intensely over-focused. The most well known distractibility disorder is Attention Deficit Hyperactivity Disorder (ADHD). In ADHD it is difficult for people to intentionally focus their attention. When I explain it to parents of children who have ADHD I talk about how hard their child has to work in order to start a task and maintain focus on it—they use up so much more energy than a peer who doesn’t have ADHD. Distractibility can impact how much information you take in —that is how much you learn and how much you enjoy learning. It can impact how competent you feel doing different tasks and how others view your competence. The other end of the pole from ADHD is something more akin to compulsive focus. At its best it can be a sort of laser-focus—the person who studies the brain of a certain fish for their whole career or a craftsman who can do intricate woodcarving. At its worst it can be a persevarative stuckness where you can’t seem to think about or work on anything else.
In my training years at Cambridge Hospital, I had a wonderful neuropsychology seminar instructor, David Dinklage, who used to explain that attention was to mental health what temperature was to medical health—it often signaled a problem, but wasn’t the problem in an of itself. He used to say that if someone had a fever, we wouldn’t call them ‘temperature disordered.’5 We would find the cause of the illness. The same was true for attention as for fever. Many things impact distractibility and attention: mood, sleep, nutrition, anxiety for starters. Poor attention is a typical symptom of traumatic stress, but so is hypervigilence—a laser focus on certain situations. The treatment of choice for ADHD are stimulant medications which paradoxically slow down the distractibility and hyperactivity by engaging the frontal lobes of the brain—putting a ‘driver’ in the driver seat to organize and control the action. The irony is that trauma can work similarly, if not inconsistently like the stimulant medications. During situations of high stress people who are really distractible may actually feel better than they do when they are calm—they may feel like their brains are working and they are clear headed. The adrenaline from the stress can mimic the stimulant medication. For those who had never been medicated—it might be the first time they have experienced this kind of clarity. But it can be a double edged sword: they finally gain clarity and thus, memory, for situations that are overwhelming. And they may be inclined to seek out stressful or dangerous situations in an effort to experience this kind of clarity more regularly.
The third aspect of temperament is persistence—how long will you stick with something? Are you a dog with a bone who won’t let go until you ‘get it right’—or are you someone who can shrug their shoulders and move on to the next thing easily? There are upsides and downsides to persistence. Persistence can help you achieve your goals and especially get through the challenging aspects of learning something new. But it can also hold you back when its time to move on. You can keep, as my therapist says, ‘pounding on the hinge of an open door.’ If you can’t let go sometimes, especially when something is actually done, or it is no longer serving you, then persistence can actually hold you back. In healing from trauma persistence is mostly an asset. It is often long and tiring and persistence can keep you reaching forward. It can also be difficult to navigate the many channels of getting treatment—whether through insurance, the VA system, or community mental health. It takes persistence just to stay on the phone line long enough to get to an actual person! While persistence is part of our innate temperament, it can be impacted by our experience. Is your persistence the same or different than it was before your experience of trauma? Is it serving you now? Is it supporting your treatment? What would it take to shift it?
The temperament trait of approach/withdrawal is probably the one that I look at first when I have a client, and especially a child client. Under stress do they head towards the problem? Stand their ground? When they are unsure, do they investigate? Or, under stress do they retreat? Stay back until they are more sure that everything is okay? I worked with a 2 year old group for early intervention and you could identify this temperament trait as soon as the door opened and the kids walked in: half the group charging toward the toys, toward the teachers, toward each other—and the other half of the group hanging back with their parents, or by the door, playing with the zipper on their coat, or sucking on their pacifier happily watching the action of the others. Within a short time, both groups had mingled and you couldn’t notice the difference. But anytime a situation was stressful because it was new or because things were shifting or changing, then you could see the split in the group again.
You could see this category with different labels: bold and timid, extrovert and introvert, relaxed and anxious. And each of these styles interacts with the environments we grew up in: timid kid in a bold family? Bold kid in a timid family? It interacts with the way we naturally protect ourselves: bold kid who readily seeks out others? Bold kid who keeps to himself? These different ways we manage under stress require different coaching from our caretakers and require different strengths to offset the pitfalls that come with them. This is one of those aspects of self that changes the least across our lifetimes and where happiness often comes from having our life balance with and fit this aspect of us. Sometimes we choose a life that has us on our edge: a job that requires approach when we are naturally more withdrawal—but usually this is because we have social support or some other reward which balances out the stress of being out of sync with our style. Trauma can exacerbate the style: stress can make bold people even more ‘in your face’ and timid people ‘even more anxious.’ Or it can be the opposite. There are so many possibilities given the complicated environments we can live through both through development and through long term trauma.
In terms of healing from trauma this aspect of ourselves is important to consider when we are learning how to manage stress, seek help and lower our discomfort. Under stress do I feel better when I am with people or when I am alone? Has trauma changed this? When I am tired —do I recharge my batteries better when I am active and with others, or quiet and with only one or two people? Under stress am I more likely to head towards help or away from it? If you can know these things about yourself and tell the people in your life who are supporting you—you are more likely to be understood—and you are more likely to actually get the support you need. It might be interesting to take this whole list of temperament qualities and talk about them with someone in your support network—and maybe even have your spouse or partner share theirs. It can help you understand each other and how you approach things. It can help you both understand what is part of the fabric of who you are that you aren’t hoping will change—and what is part of the fabric of surviving long term trauma that you are hoping may change—but may or may not.
The fifth element of temperament is intensity. Consider intensity the ‘volume’ button of personality—it makes other aspects of temperament louder or softer. It makes the pull towards stronger or the stay away stronger. But another way to understand it as the energetic threshold that is most comfortable. At what energy level are you most awake, alert, alive? When are you best able to learn, pay attention, take in information? When do you feel most connected to other people? Intensity is typically something you don’t notice unless it is not in the right range for you. You notice when its isn’t intense enough—you are bored or feel disconnected, you don’t feel like you can engage—and you notice when it’s too much, when you are looking metaphorically for the dial you can turn so the intensity will go down.
Trauma is almost always high intensity—so even people who would have been ‘low intensity’ people can get used to high intensity through exposure to long term trauma. And naturally high intensity people can believe that the world is only rigged on that frequency. Like the other aspects of temperament, it is the congruence—the fit—of the aspect of yourself and how it is showing up in your life and your healing that matters. If you are a natural low intensity person and post-trauma you seek high intensity situation—this will drain your energetic bank account more.
Adaptability is another trait of temperament that is often visible from very early on, but we are taught that we need to manage it, or that it is unlikely to change much. Adaptability is how we manage transitions and change. Some people charge right through them and some people are dragged through them kicking and screaming. I have a friend whose son loved the color of paint of his first bed room. When he had moved into a new bedroom and the parents wanted to change the room into a den, they painted the room a new color. The son was so distraught over the change in color that the parents agreed to leave the old color in the closet of the room. Any time he wanted to see the old color he could open the closet door. He is a confident, outgoing and adventurous kid who is now in high school. But he always need a bit more time and a bit more coaching through transitions. That’s just his temperament.
Now consider the impact of long term trauma on adaptability. The very nature of trauma is that it catches you off guard and renders you helpless. If you are someone who doesn’t like change or transition to begin with, this is even more difficult. And if you are someone who naturally rolls with things, you might have a bit more resilience in your experience. Since most people who experienced long term trauma seek to avoid getting caught off guard again, they often look like people who are not adaptable, and who do not like transitions. Long term trauma can make people rigid and inflexible—or go the other direction as inconsistent and unpredictable. Both are extremes at either ends of the poles. It is important for you to think about your natural adaptability style before the trauma, during the trauma and after the trauma. How does your current approach to adaptability impact your healing?
Partnered with adaptability is regularity: how are your routines and rhythms? Are you someone who goes to bed at the same time every night and gets up at the same time? Do you eat regular meals? Are you more comfortable with a routine way of life: same thing each day? Or something new all the time? There are some babies who easily sleep through the night and some babies that never do. There are some people who need more structure and routine in their life and some who need less. Post-trauma most people do better with more routine, and more structure—especially when routines and structures were destroyed during that time. Our limbic systems appreciate constancy—and seem to heal best in it.
Sensory threshold is an aspect of temperament we are learning more and more about. How do you take in information—more through your eyes, your ears, through touch, through your body kinesthetically? It seems that we each have a particular mode that we operate in best—and we each have a threshold which is ‘too much.’ For some people this threshold is really high and for some it is really low. I have friends who can’t have any tags in their shirts—the feeling of the tags in the neckline of their shirt is so irritating they can’t concentrate. I have synaesthesia— I see colors where there aren’t colors—for me every alphabet letter is a color. So a printed page is not black and white, but in color. I have always found video games overwhelming and now can find powerpoint overwhelming. My visual sensory threshold can be low. And when I am stressed it is even lower.
Since we take in trauma through our senses, it is important to understand how that impacted the way we normally take in information. And because trauma often results in heightened sensory awareness such as the startle repsonse— it is important to tease out what your threshold was prior to the trauma and what it is now. What helps you buffer yourself when the incoming data is too much and what helps you tune in when you feel too dull? In some ways trauma creates a system that is entirely focused only on the dangers you experienced during the trauma. It will use whatever your resources were before the trauma to direct your behavior in the most self-protective way it can figure out. But it is like a radio with only one station playing. Getting to know your various aspects of temperament is one way to begin to gain access to otehr stations. Other ways of receiving and transmitting information. Other ways of expressing yourself and caring for yourself.
The last aspect of temperament is mood. Are you more a glass is half full or glass half empty kind of person? Are you someome who was naturally optimistic and the experience of trauma has stolen that from you, or are you someone who was always fairly dark and the experience of trauma was congruent with the way you felt the world worked? Since the experience of long term trauma can also impact mood—it is important to think about what your baseline was before the trauma. I have seen this be important in treatment. People who are naturally more melancholy don’t really want to be ‘jollied’ out of their mood and they tend to resent any attempt to shift them from a depressed state. Helpers trying to say reassuring thing often irritate them. For people who were more optimistic before the trauma—sometimes their bright mood masks their pain. They are the ones who say, “it could have been worse” and have a hard time talking about what did happen. The dark parts of their trauma don’t fit with the way they want to see themselves so it stays buried—but they are always fighting it back. Knowing how your mood typically is and what affects it can help you know when you are in a safe place as you get treatment or you are in a place that is too difficult. Too difficult can be both too sad, too hopeless, too depressed or it can be too disconnected or too numb.
Temperament is just one aspect of yourself that you can use to explore what makes you who you are—and how trauma might have impacted that. You can’t change what happened to you. You can understand it, you can see how it impacted you and you can begin to heal what needs to be healed so that you create actual live in your life and experience the people around you, now. Experience the love they have to offer, now. And begin to live into your future.
1 See R.M. Scurfield, “Treatment of Posttraumatic Stress Disorder among Veterans,” in j.P. Wilson & B. Raphael (Eds.), International handobook of Traumatic Stress Syndromes (879-888) (New York: Plenum Press, 1993); and R. M. Scurfield, “War related trauma: An integrative experiential, cognitive and spiritual approach,” in M.B. Williams & J.F. Sommer (eds.), Handbook of Post-traumtic Therapy (179-204) (Westport, CT: Greendwood Press, 1994) Quoted in R.M. Scurfield War trauma.p.97
2 Herman, J. “Concepts of personality developed in ordinary circumstances are frequently applied to survivors without an understanding of the deformations of personality that occur under conditions of coercive control.1” Herman, J. Trauma and Recovery, p.97
3 Rutter & Rutter, Developing Minds, p. 188
4 Brazelton & Sparrow. Touchpoints. p. 102-103.
5 Dinklage, D. (1999). Child Neuropsychology Seminar, April, 1999.
