Traumatised by Life

from The Times UK 25-7-22

When a therapist suggested to Dr Sarah Woodhouse, then aged 23, that her anxiety and panic attacks were down to the fact she was carrying trauma, Woodhouse’s response was “how dare you?” “I stared at her in stunned silence,” she says. “I’d had a stable upbringing, I’d been to a good school, I was struggling, yes, but I hadn’t been through anything traumatic.” She walked out.

Like many of us, Woodhouse believed that trauma was something associated only with events such as fire, flood, rape and war. In hindsight, now 40 and a clinical psychologist, she sees she was wrong. “My response was classic of the mainstream response, which is full of false truths: mainly that trauma is something that only happens to people like veterans, an unlucky few who’ve experienced very extreme events.”

For years, psychologists thought so too, for decades dividing traumas into “big-T” events that encompassed natural disasters, bereavement and severe childhood neglect.

Yet in recent years, thinking has begun to embrace the notion that even what psychologists used to call “little-t traumas” — say a medical procedure or a fall — can have long-term effects on our physical and mental health.

“Calling these kind of events little-t traumas is quite stigmatising and dismissive. Of course some events are more severe than others, but trauma is anything that can make us feel overwhelmed, threatened and out of control, and these can be very commonplace experiences,” says Woodhouse, whose book You’re Not Broken: Break Free From Trauma and Reclaim Your Life was a bestseller in Australia last year and was recently published in the UK.

“Maybe the event was small at the time, but as time goes on we see the lasting effect isn’t small at all. It’s not about how big the experience is — it’s to do with your response to it.” When it comes to experiences in childhood, virtually anything from playground name-calling to listening to parents arguing can have huge implications. “A trauma is anything we feel ill-equipped to handle, which applies far more to children than to adults,” Woodhouse says. “If they’re told, ‘It was nothing’, or ‘Grow up’, it can lead them to feeling they must be to blame, that something is wrong with them.”

At the moment, the world around us feels particularly fragile: war in Europe, a pandemic and extreme weather events of the sort we saw last week leading to unprecedented wildfires. “The world’s been very unsafe for the past few years, and I can very confidently say that everyone’s level of fear, which was already high, has now gone up a notch again.”

About 90 per cent of men have suffered a big-T trauma in their life and up to 80 per cent of women. “So when you broaden the definition to experiences we consider everyday, then trauma’s almost certainly affected 100 per cent us — and it’s trauma that sits at the heart of most human pain and dysfunction.”

Woodhouse, who lived in Australia for the past three years but has now returned to the UK, where she lives in Tunbridge Wells with her husband and three young children, is acutely aware of trauma’s potential effects if we ignore them.

“Research has shown that trauma can lead to all sorts of cognitive, emotional and behavioural issues, from learning problems to depression, eating disorders and anxiety — to name a few. Living with all those stress hormones over time can lead to physical conditions including strokes, lung disease, cancer, obesity and diabetes. It’s mind-blowing,” she says.

Of course, not everyone is defined by every bad thing that’s happened to them. The problems come when people become unable to “process” trauma and can’t move on. “That can be influenced by all sorts of social, emotional and individual factors from what your personality is like to whether you got the support you needed in that event. My trauma will not necessarily be the same as your trauma. This is what we have to figure out.”

Learning more about Woodhouse’s childhood, in Buckinghamshire, you’re surprised she initially rejected the suggestion she was traumatised. “When I was about seven I was molested multiple times,” she says. “I had a typical freeze response to it, where I shut it down. I didn’t tell anyone at all. Cognitively and emotionally, I completely avoided it because I felt so ashamed. But it was an experience that had a profound effect on my relationship with myself, with my body and with other people — and became the first trauma in a stack of others.”

This trauma initially manifested itself as anxiety and a compulsive desire to excel and please. At secondary school, where she was bullied, it morphed into anorexia and bulimia. “That bedded in and flourished. I was trying to cope, and it’s really, really common to do so in these compulsive ways.”

Still suffering from anxiety, she found herself in her late teens “in an extremely dysfunctional relationship. If you’ve experienced a trauma, you see threats everywhere, you’re constantly scanning your environment, and if you’ve got relationship traumas, as I did, you’re constantly scanning relationships: ‘What did I do wrong? What did I say wrong? Do they love me?’ It’s completely exhausting. When I left that relationship I suffered from completely overwhelming panic attacks that lasted about six months.”

Wondering if her therapist’s suspicion that she carried trauma was not an insult, but on the money, Woodhouse — who was drifting from job to job, and finding it hard to engage in potentially fulfilling relationships — began to tackle her demons.

At first, she “intellectualised it” by reading everything she could on the subject. Fascinated, she abandoned her lobbying career to study psychology, spending ten years researching the relation between trauma and the mind.

Meanwhile, she began to practise yoga and meditation. Generally, she’s fervent about such somatic techniques, including reiki and t’ai chi, which may sound woo-woo but have been proved to help overcome trauma.

“You need to learn how to enter a state of being totally present, connected to your body and grounded, because this is the state you need to return to after you’ve experienced any overreaction.” This is also the state you need to learn to be in to help loved ones. “They need you to be a rock, to anchor them into the moment so their own reaction doesn’t run away with them. Your regulated body will help their body return to calm, and prevent the reaction from spiralling.

Woodhouse’s book is full of other techniques people can use at home to tackle trauma, however long-buried. Top of the list is simply noticing our feelings and allowing them release. “Trauma tamps everything down. Next time you’re scared — say — socially, go next door and punch the air. It sounds silly but that’s how we get things moving,” she says.

When it comes to professional help, she’s a fan of approved techniques such as eye movement desensitisation and reprocessing therapy, which was used by Prince Harry to treat trauma from his childhood, where eye movements are used to dampen the power of emotionally charged memories.

She also advocates internal family systems, a form of psychotherapy which posits that the brain is made up of several parts and a core self. The aim is to develop a trusting relationship between the two. “When a person realises their traumatic reaction to a situation is separate to their core self, then healing can start.”

Like many psychologists, Woodhouse is a great believer in delving into people’s childhoods, where they may not have experienced abuse or violence, but nonetheless grown up amid dysfunction.

“People often think it’s disloyal to consider this, that you can save your family a ton of heartache if you don’t bring these things up. But — say, for example, my parents are incredible, very strong, loving people, but they brought their own past traumas with them, for example my father was adopted and we now know, many adoptees carry trauma — you see them constantly criticising, constantly shouting, because they suffer from insecure attachment. I’m painfully aware if I don’t heal my past traumas, it will negatively impact my children’s nervous systems, they will be disregulated by proxy.”

Today, her main goal is to reassure people that for all its scary connotations, trauma is not something that it leaves people irreparably “broken”, but in fact can lead to great things.

“The message I want to convey is hope. Around 80 per cent to 90 per cent of the women I work with believe they are fundamentally damaged, beyond repair. But in fact, between 50 per cent to 70 per cent of people who experienced trauma also experienced growth in response to the trauma. People don’t skip away from these experiences, they are really painful. But the process of navigating adversity can be painful, but it also makes us strong. A lot of people describe the quite spiritual shifts that come from quite dark places, feeling so low at rock bottom and deciding then ‘no, enough’ and pulling themselves up and out of it.”

She points out many famous names who endured notoriously traumatic childhoods. “Oprah Winfrey, Charlize Theron, Kelsey Grammer, Christina Aguilera and Curtis Jackson [50 Cent] overcame the likes of abusive families, family tragedy, poverty, abuse and drugs.

“But for most of us this isn’t about international fame and having private jets,” Woodhouse continues. “It’s about finding positive relationships and joy and happiness in the everyday. And day in, day out, I see healing.”

You’re Not Broken: Break Free From Trauma and Reclaim Your Life by Dr Sarah Woodhouse is published by Penguin Books Australia in paperback at £15.99, and in ebook and audiobook;