Dr. Ruth Wimsatt, PhD, is a clinical psychologist in Newport Beach, California. A former nurse, she has practical and experiential knowledge of trauma’s impact on the mind/body connection.
In this interview we discuss how trauma seeds in the body, ways that it can show itself when we don’t realize it, and reteaching the body how to handle and recognize triggering events.
Meredith: What would you like people to know about trauma that can be difficult to understand, especially for a person in the midst of its effects? And by midst, I mean anywhere from minutes, days, weeks, months or years after.
DR. RUTH WIMSATT, PhD: The most difficult thing to understand, for my patients who have experienced trauma, is that the strategies they utilized in order to thrive and stay alive in the moment of trauma, can keep them from living in the present.
Some of those coping strategies which made sense and were vital in their experience of trauma can make their current lives more difficult. It’s very hard when the brain circuitry is re-wired by trauma, for them to conceive of and accept that certain behaviors are [actually] “coping strategies”—especially when they’re ingrained and a part of the person’s life.
Meredith: Trauma is universal but it is very, very personal. At the same time, it can be hard to be in one’s own skin during intense suffering. How might individuals navigate particularly difficult moments? Should they create a kind of plan to get through the moment—journal immediately, call a friend or therapist, or the like?
RUTH: Present day experiences which act as triggers can re-traumatize people. If so, then what’s helpful for a person in therapy, is to learn strategies for increasing tolerance for triggers—in my practice we talk a lot about mindfulness and I teach mindful meditation to patients when they are ready.
Although I work primarily with psychodynamic approaches, there are vital interventions not in my wheel house, including neuro-biofeedback and EMDR. I often refer patients when it’s appropriate to other therapists who are experts with those therapies.
Meredith: In therapy, particularly social work, there is a concept known as person-centered therapy. This means, essentially, meeting the individual where they are emotionally, and honoring their process. When trauma occurs, that individual may be in a rush to get out of the pain. How do you help your clients remain person-centered—on themselves and the time they need to take to integrate and feel more whole (rather than what they wish it would be)?
RUTH: It can be harmful for therapists to attempt to nudge patients into “getting in touch with” their painful memories or requiring re-experiencing of the trauma. If I have a patient who is in a rush to get out of the pain, that’s my signal to just let them get out of the pain for now—I let them be right there. If I stay with patients right where they are, they can develop a trust and in that trusting dyad (relationship), they may teach me how to safely approach the traumatic event—or events.
Meredith: You were previously a nurse. How does your relationship with the medical inform your clinical work as a psychologist and understanding trauma? Is there anything you’ve noticed that might help others understand their own recovery?
RUTH: I volunteer to see members of the military at no fee, and most of those patients have experienced trauma in battle. Many (or most) of those people were medics and exposed to horrific scenes of wounding or death, and quite often were unable to rescue their patients or even to help them at all. It helps that we speak the same “medical-ese” language—many of them have come home and now work in the E.R. or as paramedics, and they can be exposed to triggers on a nearly daily basis.
Meredith: What is one thing you’d like readers to remember as they move through their day during an emotionally strenuous time?
RUTH: If the emotionally strenuous time is their response to a trigger event, then I encourage them to work closely with their therapist on re-teaching the body how to react to such triggers. We know that trauma actually changes the brain physically, so we use ways to engage with that change and live with some changes and reverse others.
Since we know that posttraumatic stress is a neuro-biological experience, we can help patients become better by growing their sense of agency over the way they react to various stimuli. It could be a vet who hears a loud noise, or a woman whose husband touches her shoulder in exactly the way her abuser did. Early abandonment and trauma are especially difficult because often people have had years to perfect their coping strategies which limit their lives without their being aware of their own lack of freedom.
Meredith: To end, please share a favorite quote or perspective from now or over the years that speaks to growth, self-care, and attunement to one’s own process. Can be something you’ve seen or your own.
RUTH: A quote I love is from Henry Maudsley:
“The sorrow that has no vent in tears makes other organs weep.”
Patients who have experienced trauma frequently go on to have chronic pain/psychophysiologic issues such as migraine, interstitial cystitis, IBS…and we now understand more about the brain and can see how this makes perfect sense.
Also, the title of Bessel Van der Kolk’s book,
“The Body Keeps the Score”
is a a great quote.
My own personal note would be that when I was about 5, I was sent from home to live with my grandparents and aunts in a different town, for about 4 years. Growing up, I tossed this reality away as something “normal” because it made sense in a practical way, based on what was going on with my family. Later, in marriage, we experienced huge bumps in our road together when I experienced normal separations (a business trip, working late, spending time with people besides me!) as abandonment. I was fortunate to be in therapy at the time and was astounded when my therapist suggested a link between my early abandonment and the present day fears of being left at any moment. I think we all normalize childhood events, often chalking them up to “well, that’s just life” when they are actually brain-changing and life altering.
Ruth Wimsatt, PhD is a clinical psychologist in Newport Beach, California, and works with adults of all ages, down to age 18.