Emotional Trauma: Wounds, Scars, and Everything in Between
Posted Sep 14 2012 2:20am
(This beautiful excerpt is from the book "Trauma and the Twelve Steps: A Complete Guide to Enhancing Recovery" by Dr. Jamie Marich who is an amazing individual and published here with her kind permission).
The word trauma is the Greek word for "wound."
Think for a moment about the word wound in a physical sense. What do we
know about wounds and the way they heal? When I present live trainings
on trauma I ask participants this question because I find that
discussing what we know about wounds in the physical sense helps us
better understand trauma in the emotional sense. Let’s examine some
Wounds come in many shapes and sizes.There are open wounds, which
include incisions (like from knives), lacerations (tears), abrasions
(grazes), punctures, penetration wounds, and the granddaddy of them all,
gunshot wounds. Then you have closed wounds, such as contusions
(bruises), hematomas (blood tumors), crush injuries, or the slowly
forming chronic wounds that can develop from conditions like diabetic
ulcers. Each wound has its own distinct character, and various causes
can lead to the respective wounding. More importantly, different wounds
can affect different people in different ways.
Wow, I used different a lot in that last sentence. That’s because the
word different is so important in our discussion of wounding.
Even as I look at the scars from old injuries that are still apparent on
my skin, I am amazed at how no two of my wounds look alike. Sure, there
are some similar patterns, especially with certain blisters—not to
mention scratches from my pets. However, each one has left its distinct
imprint on my body. Many of my past wounds have healed quickly, leaving
no sign of physical scarring at all, whereas others have healed without
complication but have left a mark, a reminder. And what I’ve mused on so
far in this paragraph just applies to me!
One of the miracles of creation is that no two people are alike. Add
this idea to the reality of wounding, and we see that even if I
experience an injury similar to yours, it is quite unlikely that we will
wound in exactly the same way. Furthermore, even though wound healing
follows a similar process in human beings, a myriad of other variables
complicates the process. As an example, if one person experiences a
laceration as a result of a sporting accident but her white blood cell
production is poor and her overall Vitamin C levels are low, it is
likely she will take longer to heal than her peer with better white
blood cell production and higher Vitamin C levels who experiences the
same injury. These are just two examples of possible variables that can
affect physical healing. Think about other factors like age, health
conditions, overall skin plasticity, genetic disorders (e.g.,
hemophilia), location of the wound, and how soon the patient received
Most will agree that failure to receive the proper treatment after a
wounding can complicate the healing process. Sure, some wounds,
especially minor ones, often clear up on their own with little or no
treatment. Consider the difference between a healthy man experiencing a
minor scrape and a hemophiliac getting that same scrape. Treatment could
be a life or death matter for the hemophiliac because of his condition.
Most wounds require some level of treatment, even if that treatment is
as simple as cleaning the wound and putting a bandage or anti-bacterial
cream on it. Significant wounds may need sutures or stitches accompanied
by a dose of precautionary antibiotics. The most severe wounds—stabs or
gunshot wounds—require immediate medical attention, or the sufferer
risks loss of a limb in the long term (especially if infection sets in).
Death can result in the worst cases. In sum, if the injured neglects
requisite treatment, the wound can get worse, and this worsening can
lead to other debilitating physical symptoms.
When wounds don’t receive the proper treatment, there is a great chance
that complications will result from the wound worsening. What if the
wound never gets a chance to heal because outside forces keep picking at
the wound? This question is a no-brainer for most people. We know that
if wounds don’t receive treatment but instead become further assaulted
(e.g., the old cliché, salting the wound), then the wounds are going to
get worse, which will delay healing. If this concept makes sense to you
when it comes to physical wounds, my challenge for you is to apply this
same knowledge to emotional trauma.
Like physical wounds, emotional traumas come in various shapes and sizes
for people, resulting from a variety of causes. For some people, simple
traumas (wounds) can clear up on their own, but for others with more
complicating emotional variables (many of which can be biologically
based), the healing process may take longer. If an individual who has
experienced a major emotional trauma doesn’t obtain the proper
conditions to heal (which can include formal mental health treatment) it
will likely take longer for the trauma to clear up, and it could end up
causing other symptoms. A major factor when drawing parallels between
physical and emotional trauma is the notion of rewounding. If a person
experiences a traumatic event and does not receive the optimal
conditions in which to heal, that is bad enough. But then imagine if
other people in his life keep picking at the wound with their
insensitive comments and potentially retraumatizing behaviors. Of
course, the wound is never going to get better, or, in all likelihood,
it will worsen.