Something Scary Happened the Other Day, and I Wanted to Talk to You (and a PhD Trauma Researcher) About It

(19:48):

And each file folder needs that narrative content. So I can tell you the story, the emotional content, so I can feel a little bit of how it feels, and then a tag that tells me in my brain what it means, how do I find it, how do the file room people go and find it. So when you have an overwhelming event, this adaptation happens in the brain and in the system. And what that then means is that the file room workers aren't there. So you get this fragmented file, the file room workers come back into the room and they're like, oh no, we have a fragmented file. We don't like a fragmented file. We like everything to be in order. We don't know where to put this, we don't know where it goes. So they kind of keep it sort of in a queue so that it can go to the front of your mind whenever you experience anything that is similar to something in that fragmented file, which will give you the opportunity to organize it all over again.

(20:39):

So this is the origin of the trauma trigger. Again, this is your brain trying to help you by telling you, oh, okay, so let's say you have this fragmented file, it has post-it notes in it, your brain doesn't know what it means. It's just sitting there in the file room on top of one of the drawers, and let's say the color red is in that file. And then you come across that same exact shade of red in the universe. Someone walks across your periphery and they're wearing that same color. The file room dudes say, oh my God, here's the chance you need to organize the file. And so they throw that to the front of your mind to give your brain the opportunity to organize it. Hey, we have a fragmented file. We don't like that. Let's throw it to the front of mind, give you this opportunity. And then the problem is your amygdala. That limbic system also recognizes that color red and it has coded that red as mortal danger. So it goes and sets off the alarm system all over again, and then you're off and running even though you're sitting at your desk at your office. So that's essentially what happens between when you have a regular event and then when you have a traumatic event.

Dr. Mary Catherine McDonald (22:40):

That's a great question. I think there's a fine line between adaptation and maladaptation, and I think it's really important that we understand. So what I've just described is essentially the origin of the trauma response, and I think it's critical that we understand that the trauma response is adaptive and it's designed to help keep you alive. It is sort of born of a will to survive. And the reason that's important is because when we try to heal from trauma, we often go immediately to a shame place. If I have trauma and I'm dealing with these symptoms, this means there's something wrong with me. I am broken. And so when we start by understanding that it is an adaptive move that gives you the symptom that is eventually maladaptive, then I think it can help us heal. We can peel away that layer of shame. But you're right, it is something that started out as adaptation that becomes over time maladaptive. And what you're describing is kind of like the trick when it comes to treating trauma, which is integration. How do we take that file folder and figure out how to organize it and put it away so that it looks more or less like the rest of your files without continuing to get triggered over and over and over again?

Mel Robbins (23:51):

Exactly. I mean, for me, that's the a hundred million question. How do you integrate as you say, these experiences so that you're not re-traumatized? Because that's exactly what I've been doing to myself. I mean, this is also just a few days old in terms of my experience, but I continue to go over and over and over in my mind, how are these poor parents feeling and the family members and oh my God, the anguish of them going back and forth on the beach. And I saw that there was a GoFundMe page and I donated to it, and I just keep feeling this heartbreak over and over and over again. And then of course I feel bad because I go, why am I torturing myself and why do I feel so gripped and devastated by this? I'm not even a member of their family. I didn't know who died.

(24:44):

And so I would love to talk about both why you feel conflicted when you have these sort of traumatic experiences. Why are your emotions kind of unsettling? And I also think for the sake of everybody listening, this is so fresh for me, but every one of us has had a traumatic experience in our life, whether it is a death when you were in high school of a classmate or maybe somebody in your family or something that happened in your community, every single one of us has either had an experience like this or will have one. And I would love to learn the specific steps, Dr. Mary Catherine, that we all can take so that even after the fact, we can properly file these memory files of what we saw, how we feel the emotions inside of us into the right file cabinets so that we can move on with our lives.

(25:51):

We can stop being retraumatized by it. And that's exactly where I want to go with you when we return. So stay with us. Welcome back. I'm Mel Robbins and I'm here with Dr. Mary Catherine McDonald, who's a trauma specialist who has been researching trauma and working with people for decades. And we're talking about a very traumatic incident where a swimmer went missing and the search and recovery mission took place right in front of the house that we went for days. So Dr. Mary Catherine, let's talk about integration. How exactly do we integrate a traumatic incident into our life moving forward?

Dr. Mary Catherine McDonald (26:33):

This has been the thing that sort of the field of neuroscience and psychology and psychiatry have been trying to figure out since the 18 hundreds, how do we circumvent the alarm system and organize the memory file? There are a lot of different modalities that can accomplish this, but basically at a base level, what you're looking for when you're aiming at integration is a narrative of the event that doesn't have any holes. So it has a coherence, a beginning, middle, and an end, and some amount of emotional content. So if I tell you a funny story, I'm going to maybe laugh. I feel some of those emotions. If I tell you a sad story, I'm going to maybe tear up and feel a little bit sad. That's okay. Our memory files are supposed to have emotion and then a set of meaning tags. What does this event mean in the larger story arc of your life?

(27:17):

So typically I think I am a huge advocate for multiple modalities when it comes to integration because we're always in it for a quick fix and we want to say, okay, I want to do five sessions of something and then get this integrated, but typically we need more things because your entire system is along for the ride. It's not just a file problem. Your body is involved as well. So just to give you a quick rundown, EMDR eye movement desensitization and reprioritizing is a modality that's designed to sort of short circuit the fear center from setting the alarm off. So what happens is the clinician will occupy your vision usually, I mean, 

Mel Robbins (28:44):

One thing that I keep thinking about is the fact that other people in my family and some friends of ours all witness this exact same thing, and our two friends were just as shaken up as I was, but some of our family members were not, at least on the surface as triggered as I have been by this. Can you talk a little bit about why that is? Why you can witness the exact same event or have the exact same traumatic experience, but two people side by side have a very different trauma response to it?

(30:07):

And in reality what's happening is that the fragmented files can be creating different emotions. For some people, that creates a whole lot of upset distress, crying outward feelings of anxiety. For other people, it causes total shutdown. And so they seem to be talking about an event and not having any emotional response to it, or they just don't feel anything at all. And in the media we use when we talk about somebody who has P ts D or someone who's dealing with trauma, we usually use an example of someone who's having an overly charged response, they're crying too much, they're having this sort of hysterical response. But from a clinician standpoint, if someone comes in and they're telling you this story that is the most horrible thing they've ever seen and there's no emotional content, then we can see really clearly that part of the file folder isn't there. So they have the story, they don't have the emotional content that still requires integration. Right.

Mel Robbins (31:04):

So are you saying that everyone who sees a traumatic event has some kind of trauma or fragmented file?

Dr. Mary Catherine McDonald (31:12):

Good question. No, because it depends on whether or not the file gets consolidated between four and 24 hours after the event. For some people, they have the opportunity to consolidate that memory, even if it was really overwhelming in the moment. Let's say they get home and they're able to talk to their partner or their family about it, assign some meaning to it and put it away, then that file is going to start looking really quickly like the other files in their file cabinet. So there was a study, I think it was in Israel, and they took folks who had just been through a terrorist attack in the emergency room and they had one group go through a narrative therapy exercise where they had to talk through the event, kind of over and over, assign it meaning feel through some of the content with someone who was able to attune to them.

(32:03):

And then the other people just got sort of the standard of care in the emergency room, the people who went through that event, and they were able to narrate and integrate the memory right away where something like 80% less likely to have PTSD from going through the event than somebody who just went through this standard of care that you get in the emergency room. So it really depends on what goes on immediately after the event. We focus so often on the type of event and whether it's traumatic and not the person who went through it, and then what happens in the aftermath, if someone is there to help you in the right way to integrate the memory, it's a lot less likely to become traumatic. In my work, I've kind of readapted the definition of trauma because this is the thing we've been arguing about in the field of psychology since the 18 hundreds, which events are traumatic, which are not.

(32:52):

And it's like, guys, this is not the point. And the definition that I use is that anytime you have something that gives you an unbearable emotional experience that lacks a relational home, you have a potential for a chronic trauma. So unbearable emotional experience plus a lack of a relational home means you potentially are going to have these symptoms, and that means, I love this term relational home. I got this from a clinician, Robert Sto because it can be a lot of different things. What it means to listen to someone and provide them with a space to help them feel through and organize what was too overwhelming to organize in the moment can look like so many different things and different people are going to require different amounts of a relational home based on the event. So if you're going through a divorce or a breakup, you might need a relational home every day for six months, and what that relational home might look like might be really different depending on the day.

Mel Robbins (33:50):

When I was researching this, I bumped into his work and this concept of a relational home, and so I'm glad you're talking about it because the way that I thought about a relational home is sort of this notion of where can I put this? I mean, I just witnessed something, but I've got all these complicated feelings about what I witnessed and about what just happened, and it's the feelings that I'm trying to make sense of, and I know that wishing it hadn't happened doesn't make it go away. But how do we find a relational home for feelings that keep coming up? I mean, for example, is it normal to feel guilty or conflicted that I'm so affected by this when I wasn't even someone that was part of the family or part of the search team? I was just watching this.

Mel Robbins (35:34):

That's true. That's a good point. How do you stop getting that incident to play out in your mind over and over and over again? That's what's really been haunting me.

Dr. Mary Catherine McDonald (35:44):

Yeah, that's a great question. So one of the primary symptoms of trauma is intrusion. And so this can be intrusive thoughts during the day. You're trying to go about your day and the thing just keeps popping up. It can be kind of this flashback memory where you sort of lose track of the moment and you're thrown back into the past fully. It can happen in memories, and it can also be people can end up repeating behaviors that kind of put them back into traumatic situations. This probably wouldn't be the case in this situation, but this happens a lot when it comes to relationship trauma. So how do you stop the intrusion? Basically, the short answer, which is also the long answer is that you integrate the memory. And so what that looks like depends on the event.

Mel Robbins (36:32):

Well, let me just share what's happened for me. A big part of the process for me is peeling away this shame that I'm having a response that's outsized in some inappropriate way that I don't deserve to be having this response. I don't even know this person.

Dr. Mary Catherine McDonald (36:52):

Right? Let's put that down and now let's look at what's coming up, because I think shame is the biggest barrier for integration, and we never really think about that. The trauma response is happening for a reason. It's something that's going on in your biology that you cannot stop. So let's stop shaming ourselves for it and then turn to it and see what it needs. Then I think if you sit down with someone, you can kind of figure out what fragments are sticking out and what do those fragments mean? How am I going to fit them into this narrative of what happened? And then how am I going to fit this into a larger narrative of my story? And I think you can see really directly where shame gets in the way, because when you're talking about something that happened that you witnessed and you didn't even know the person, it feels like, how am I going to fit this into my story?

(37:38):

But the truth is that something really intense and meaningful happened to you as well. And so how are you going to fit that into your larger story? What kind of meaning can you assign to that? Right? Doing a podcast episode for example, using it to talk about to your listeners about trauma and normalize the response, that's a great way to assign meaning to this event that feels really out of control and meaningless. Once you do that, and you may need to do it kind of a couple of times, typically what happens is that the intrusion starts to recede. You stop having those intense intrusive memories and the memory starts to, it may come up every now and then when you have a reminder, but when it does, it's a lot less intense.

Mel Robbins (38:21):

You know what? I know exactly what you're talking about because I have had an experience in my past that was extraordinarily traumatic. For those of you that listen to the Mel Robbins podcast or have read any of my books, you are very familiar with this past experience where 15 years ago, my husband and I were about to lose everything. We were going bankrupt. I was drinking myself into the ground. We were fighting nonstop. I could barely get out of bed, and when it was happening, it was traumatizing. The anxiety was crushing, the depression was crushing. The just bills and the financial stress were crushing. The amount of stress in my marriage was crushing and I couldn't talk about it. It was like I was frozen. And even as we started to climb out of it, Dr. Mary Catherine, I couldn't talk about it without getting choked up or feeling stressed out.

(39:20):

But here's what I realize in hindsight, I have now told the story of that rock bottom moment nearly losing everything so many times, and I've allowed myself to feel the emotions of that moment so many times that I have integrated the story into my life. I do talk about it all the time, and I don't feel that traumatic trigger at all. I can access kind of authentically what I felt like, but I don't feel the intensity of the emotions. So you're right, telling the story over and over and over again does help us process. And there are a lot of you that have experiences that you have survived, that you have lived beyond, that you have moved through, but that emotional file and the ability to talk about it and tell the story, there's a huge opportunity for you here, and I want you to really seriously consider what Dr. Mary Catherine is telling you. So one of the thing that I loved is that you talked about this relational home and how telling the story and feeling the emotion allow you to file those fractional files in the proper place. What are some things that people could do right now if this is resonant? If they want to lean into the advice that you're offering and the expertise that you're offering, can you name some things that you would recommend that anyone listening could do right now?

(41:42):

You often don't narrate it because it happened and you all know what happened, but could you sit down and write out the events as if you were telling someone who wasn't there and had no idea what happened? Have you done that yet? Continue to do that. If you've done that already, maybe once a day, if you can stand it just to get the narrative straight because you're already having these intrusive thoughts, you might as well tell the story. The second thing is to try to connect the narrative with the feelings. What feelings come up? What feelings came up in the moment, what fragments seem to be sticking out? There will naturally be moments in the story where you feel something really intense, and so what is that feeling? What is it tied to in the rest of your life story? What kind of meaning does it carry?

(42:31):

And try to do that with someone else. So if you can feel through those things with someone who can be attuned to you and say things like, oh, I can imagine, or You must have felt so helpless and I've felt helpless before, and that's terrible, then those things can kind of help put the emotional fragments in the right place. And then again, that last thing is just to what meaning are you going to assign this thing? What importance does this have in your life? Did it give you some kind of message? What can you do with it as you go on? How are you going to carry that forward? If you're having a trauma response, just know that you are not broken. The trauma response is an evolutionary adaptation, and it is there to keep us alive. Of course, it causes distress and can become maladaptive over time, but its source is survival. And so I think that's really critical. The second thing is that the trauma response is something we can work with. We have a lot more say over our nervous system than we think. So we assume because we don't have control over that initial trauma response that we don't have control at all, but that's not true. We can walk back some of these responses when they're getting in the way.

(43:48):

And then the other three things that I have to say I think are about triggers. One, I think we get the mistake that we are always conscious of our triggers. We are not, sometimes triggers are really kind of subterranean and in the back of the brain and are not consciously connected. So it's really critical that we start, I think anyone, but especially if you're doing trauma healing, treating your body as a barometer, it's giving you data all the time. If you're feeling upset around a certain person, that's something you should listen to because it's possible that there's kind of a buried trigger there. The second thing is that triggers are not assigned to avoid the thing for the rest of time. As we talked about, triggers are maybe a painful way, but a way that your brain is trying to get you to organize a memory that is not organized.

(44:37):

So we need to kind of look at them as opportunities rather than reasons to avoid something forever. And then the last thing is that not feeling is not a realistic goal. Our memory folders have emotional content in them for a reason. If I want to tell you about the most joyful day of my life, I would like to feel some of the joy. We don't question that when it comes to happy memories. If I tell you about the morning that my father died, I'm going to feel some sadness because I pulled out a folder that has sad in it. Our memory files are supposed to have emotion, and when we set as the goal, not feeling like we say, oh, I know that this is integrated. When I don't feel anything, we've got that totally wrong, and we are asking our brain to do something that it is not equipped to do, nor would we want it to.