Six Ways to Beat Childhood Trauma and Stop Self-

Sabotage
Grant H. Brenner M.D.

Addressing trauma can seem impossible, but there may be hope.

It isn't easy to deal with developmental trauma, and many readers have responded with their
own heartfelt stories. Because so many people struggle with these issues, I wanted to offer
some thoughts on how to proactively deal with them. There is no substitute for doing the
work, but I hope these unavoidably incomplete ideas will be useful:

1. Know what you are dealing with. When making a plan to address any complex
problem, it is necessary to know what we are dealing with. Developmental trauma is no
exception. However, because one of the most common ways of responding to distress is
with avoidance, in adulthood developmental trauma can manifest in many ways which are
not obviously connected with earlier experiences. In my experience, although public
awareness is higher and health-care provider training better, many people only recognize
the traumatic origin of their problem after years of suffering.

It's not uncommon to have been diagnosed with other mental health disorders, such as
bipolar disorder and various personality disorders, before the developmental component is
recognized (bearing in mind that traumatic issues are often co-present with other problems).
Post-traumatic and dissociative symptoms fly under the radar, and the enactments of those
issues in personal relationships, self-care, and professional life are attributed to other
factors often reinforcing self-blame, self-defeating patterns, and the tendency to push
others away. Why? Because there is often a "don't ask, don't tell" feeling to trauma. This is
typically institutionalized, and is arguably a core component of our culture to ignore and
downplay trauma. Doing so helps maintain the status quo, preserving stability at great
expense.

Even in clinical evaluation settings, it is very common for patients to omit traumatic
experiences, and clinicians are often poorly trained about how to evaluate for them and
their consequences. Often the focus is on a presenting problem depression, anxiety,
addiction, eating disorders, and so on and sometimes trying to address the underlying
factors leads to individual and family resistance. The omission of addressing the underlying
problems creates a vicious cycle, often driven by feelings such as shame and psychological
pain, to create chronic non-recognition. Patients often repeat a core pattern from their
family of origin, intended to cover up abuse and neglect and pretend everything was fine.

Work toward putting trauma in perspective: Even suggesting keeping trauma in perspective
can feel like an insult to someone who has lived through terrible experiences. It is difficult
to recognize the presence of developmental trauma in oneself, because of the challenging
feelings evoked, and the tendency to either avoid or become overly preoccupied with it. It
is a delicate balancing act that takes time. Being over-identified with trauma can reinforce
an identity of victimization, leading one to live only as a traumatic self in a traumatizing
world. Likewise, with unresolved trauma, we are more likely to perpetrate against others
without knowing it. We may become compulsive caregivers, sometimes even over-
empathizing with those in need, to our own detriment. Putting traumatic experiences in
perspective working toward having a context for understanding trauma in the broader
sweep of one's life, while building new experiences which are healthy and self can lead
to greater empowerment and a shift toward a non-traumatic sense of self.

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2. Be aware in the moment. Emotional dysregulation is a common feature of unresolved

trauma. Often there is numbing and dissociation, as well as fixation and preoccupation, or
some mix of either extreme. Because traumatic experience is often driven by avoidance of
one's core self, memories, and emotions, many people with unresolved or resolving
developmental trauma struggle to remain present with themselves and others. That basic
capacity to sit with and name difficult experiences didn't develop properly because of early
trauma, but can be cultivated as part of recovery and post-traumatic growth. Various forms
of meditation, typically in the mindfulness tradition, can be helpful for this. There are
structured forms of mindfulness as well, such as mindfulness-based stress reduction and
mindfulness-based cognitive therapy, which are becoming more common in clinical
practice. Compassion-based meditations and loving-kindness practice, based on eastern
traditions such as Tibetan Buddhism and Hinduism, can be additionally useful, because
they are intended to directly fix core consequences of developmental trauma. However,
mindfulness and compassion-based practices can sometimes be problematic, because they
can make one aware of emotions and memories which one is not ready to handle
properly, can lead to the worsening of other problems in response, triggering re-
traumatization, and generally are most effective as part of a broader recovery plan. It's
important to take self-awareness in small doses, building up proficiency and gradually
digesting whatever experiences come up.

Learn to regulate emotions: Because of the emotional regulation challenges that unresolved
trauma presents, it is crucial to learn how to cope differently. This goes hand in hand with
basic awareness, because having effective coping tools empowers one to recognize and
respond to challenging experiences in oneself without as much fear of making things worse
as a result. Rather than getting stuck in vicious cycles of failed recognition and further
suffering, focusing on basic coping and awareness can lead to virtuous cycles of developing
greater capacity and making headway with problems which once were intractable. It's
typically a slow process, especially in the beginning, but positive changes build up over
time and become more established, hopefully eventually leading to stable and enduring
changes. Dialectical-Behavioral Therapy (DBT), Skills Training in Affect and Interpersonal
Regulation (STAIRS), and Trauma Affect Regulation: Guide for Education and Therapy
(TARGET) are examples of structured approaches which start with basic awareness and
skills and move on to more advanced work in a step-wise format.

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3. Rewrite your story. Because fear-based brain systems dominate in trauma, one's story
of oneself becomes dominated by generally one-sided, negative perceptions of oneself and
others, as well as the expectation of an unsafe and indifferent, or even malevolent, world.
This is a self-protective story, but sadly comes with high costs as a result of erring on the
side of staying away from new experiences, which may be positive and useful because of
exaggerated fears. It is common to interpret others' intentions and events in one's life
negatively to manage expectations and try to avoid repetition of injury and disappointment.
Mistrust is a dominant theme and shapes decisions. It makes sense surviving a traumatic
developmental experience often called for such measures, but out of context in adulthood,
as a sole view of life, it is too rigid and too often leads to repetition, which is painful, but
confirms the belief in a traumatizing world.

Rewriting one's story, putting trauma in context, has been shown to be an effective method
for getting out of survival mode and shifting our approach to ourselves, others, and life in
general. It's easier said than done, because doing so involves further engagement with very
challenging subjects. Narrative therapy and narrative exposure therapy are structured
approaches that are intended to recontextualize trauma, and help to re-tune the brain so
that fear-based systems exert the right amount of control neither too much nor too
little. Regular talk therapy may also be useful, but sometimes is not geared toward
addressing trauma and related issues specifically.

It's key to practice new patterns in real life as part of rewriting our stories. Seeking out
positive experiences, cautiously at first, over time leads to building a track record of more
optimistic expectations and chips away at the belief that life is incontrovertibly bad. Even
just the idea of doing so can feel upsetting, challenging basic adaptations to chronic
distress, and the suggestion of doing so can be met with confusion, anxiety, and even
hostility. Making a sustained effort to be rationally optimistic can seem like a very
misguided concept. Hand in hand with banking positive experiences, resisting repetitive
negative experiences is just as important, and just as challenging. For one thing, as
mentioned, a lot of self-protective perspectives and behaviors, out of context, lead back into
disappointment and even re-traumatization.

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Further, many drivers of traumatic experience are habitual or unconscious, and efforts to
make better choices can lead to disappointment and feelings of helplessness when they
inadvertently don't work out. It's important to have the basic ability to be aware of and
manage emotions in order to understand that unlearning old patterns and re-learning new
ones is going to have ups and downs before becoming more consistent and reliable. There's
a lot more to this, because taking emotional risks isn't always going to work, and the times
it doesn't can lead to major setbacks if one is not well-prepared.

4. Practice self-care. Unresolved developmental trauma too often leads to a negative sense
of self. We can feel undeserving of love and care, we can be too self-blaming and have a
basic sense of unworthiness, and we can come to belief that any attention to ourselves is
"selfish." In addition, taking care of oneself can simply be unfamiliar, a skill set which
never fully developed, especially if self-care is overly focused on basic survival. Self-care
is about both taking care of oneself physically, but also emotionally, psychologically, and
spiritually.
The basic orientation toward self-care can be minimal, almost absent, and the idea of
anything more than the barest minimum, especially if neglect was a major part of one's
upbringing, can be alien. It's important to work toward self-care in a gradual manner as
well, first working toward accepting the idea that self-care is not only not bad, is not only
ok, but also is potentially a source of accomplishment and even enjoyment. Building self-
care over time leads to a sense of greater self-efficacy, creates resilience, and reduces the
negative health impacts of trauma, both mental and physical. Forgiveness, permission to
grieve, gratitude, and related practices can come with time, and are an important part of
self-care as well.

5. Work with others. Because trauma often divides people, especially in families, leading
to fragmentation and an "every man for himself" mentality, it is important to recognize that
working on recovery alone may not be efficient, and may even stall at some point. Working
with others can be informal, or can involve seeking out groups of people in different
settings ranging from meditation groups to recovery groups and clinical settings. Being able
to ask for help is an important part of self-care, and can be difficult to do, especially when
trauma came from trusted others who betrayed that trust. Having a supportive group is
important during periods of forward motion as well as during challenging periods, and
having a plan to reach out for help, especially when things are at their worst, is often the
decisive factor.

6. Cultivate patience. Growth takes time. There are periods where things may get better,
and other times where it looks very bleak and terrible things happen. The overall goal is to
establish a different pattern and to have a goal of maintaining the process, rather than
focusing on short-term successes and failures (though goals along the way are useful to
establish, as long as they are flexible). Patience, compassion, and curiosity are likewise
long-term process goals, good to cultivate with the understanding that the ongoing effort is
worthwhile, rather than having an expectation of developing them overnight. Our basic
attitude about change itself may change, providing relief and room for development in new
directions.