The First Stage of Trauma Recovery Is Often a Luxury

I first met Linda over Zoom as a potential roommate through Airbnb. It was August 2016, and I had just driven my red Honda Fit from Columbus, Georgia to my parents’ house in Cedar City, Utah. A few months earlier, while teaching a summer course at NYU, I had made the decision to leave academia and move to Los Angeles to become a full-time writer.

• What is PTSD?

The Zoom went well, and I moved into Linda’s apartment on Halloween a few months later. I never left. We didn’t start dating until late December, but long before then I grew to care about her as a close friend. One day, when Linda asked me how I liked living in her apartment, I told her I felt safe.

That might seem like a strange answer to that question, but I remember meaning it. Something about the apartment and being around Linda made me feel safe, and as a trauma survivor it makes sense. And it was feeling safe that kicked off a years-long trauma recovery process. That process, with its highs and lows, is covered in great detail in other blog entries so I’m not going to do that here. Instead, I will focus on the idea of safety, the first stage in trauma recovery as outlined by Judith Herman in her 1992 book, “Trauma and Recovery.”

Trauma robs the victim of a sense of power and control. The guiding principle of recovery is to restore power and control to the survivor. The first task is to establish the survivor’s safety. This task takes precedence over all others, for no other therapeutic work can possibly succeed if safety has not been adequately secured. No other therapeutic should even be attempted until a reasonable degree of safety has been achieved (159).

In the 40 years between my abuse and when I finally sought help, I stuffed it as far down as possible. Looking back, my trauma had come out in a myriad of ways, not the least of which was 20 years of alcohol and drug abuse, but my main coping mechanism was to suppress everything and anything connected to the abuse at all costs.

According to Herman, “traumatic events ultimately refuse to be put away. At some point the memory of the trauma is bound to return, demanding attention. Often the precipitant is a significant reminder of the trauma –an anniversary, for instance — or a change in the survivor’s life circumstances that brings her back to the unfinished work of integrating the traumatic experience” (174).

For me the precipitant was feeling safe with Linda. For a long time, I put it this way: I had to feel safe in order to fall apart. My PTSD symptoms manifested as jealously, anger and insecurity. And yet Linda had seen something in me before I fell apart that gave her faith in me, that I was not the sum of my worst behaviors, that there was a problem that needed to be addressed. She advocated for me as we tried to figure out what the problem was, and she was sitting next to me when our therapist delivered the news. “You live with PTSD.” Once I received that diagnosis, my life came into focus, and that was the beginning of my recovery. I don’t know if and how I would have gotten there without Linda.

Establishing safety begins by focusing on control of the body and gradually moves outward toward control of the environment. Issues of bodily integrity include attention to basic health needs, regulation of bodily functions such as sleep, eating, and exercise, management of post-traumatic symptoms, and control of self-destructive behaviors. Environmental issues include the establishment of a safe living situation, financial security, mobility, and a plan for self-protection that encompasses the full range of the patient’s daily life. Because no one can establish a safe environment alone, the task of developing an adequate safety plan always includes a component of social support (160).

I was fortunate. I had a safe place to live, a supportive partner, health insurance (though not great I had some coverage), and I happened to live in a city with one of the few trauma recovery programs for male survivors of childhood sexual abuse (Peace Over Violence). In addition to these resources, I have amazing parents and future-in-laws who supported Linda and I as we weathered the trauma recovery storm.

Even with all the resources we had, trauma recovery is the most difficult thing I’ve ever experienced. And though the aftereffects of sexual abuse will always be with me, I am living a mostly symptom-free life (especially in comparison to how bad it got). The point I want to emphasize here is this: a lot of things went right for me when I sought help, and it was still really, really difficult. Even with all that help, I went through two visits to a psych ward and a suicide attempt. I lost my kids in a divorce. I suffered terrible financial problems. So what would have happened to me if only one of those elements wasn’t available? I shudder to think.

That’s the thing about safety. It’s a luxury. Sure, it’s easy to say a survivor needs to experience safety in order to recover, but our social infrastructure is set up to keep survivors in recurring trauma. I know how I felt when my insurance prevented me from getting the best care. And how many therapists did we call to find someone who would accept our insurance? I lost count. The only way I finally saw one was under the guise of couples’ counseling through Linda’s insurance. The point is that to be denied care was a trigger for me. A trauma survivor’s brain has been rewired by the traumatic event, and then to be denied the things that might help them get better, plays into the trauma dynamic that caused the problem in the first place.

Ask for help.

“Please help me.”

Sorry, we don’t take your insurance.

Rinse. Repeat.

Fold in more problems and see how it goes. Hold down a job while going through emotion dysregulation and dissociation. Get help with your addictions (another recovery process all together). Be a parent. Be a good partner. A good friend. Just ignore those flashbacks. Grin and bear it through it the panic attacks.

Try it without health insurance.

Try it without family support.

Try it alone.

Judith Herman is right about safety. No meaningful recovery work can be done until a survivor achieves a kind of safety, but safety for survivors is hard won. “No single, dramatic event marks the completion of the first stage. The transition is gradual, occurring in fits and starts. Little by little, the traumatized person regains some rudimentary sense of safety, or least predictability in her life” (174). I’m mindful of all that went my way, and I’m grateful that I found Linda’s ad on Airbnb. I’m also thoughtful of all those for whom it is a more difficult path, and my thoughts are with you as you search for your own safety.