Reader Question: Treating Emotional Numbness

Reader questionSometimes readers ask questions in response to one of my posts that  become fodder for a future post. This is one such time. A reader asked

 How do you help clients come back from emotional numbness?

as part of a response to my post on Complex PTSD. I want to provide a bit of background before I move on to addressing this question in more depth. PTSD can be diagnosed following a single traumatic event that occurs at any age. Complex PTSD (also referred to as complex trauma or developmental trauma) is characterized as a response to prolonged abuse and/or neglect in the context of important relationships, with onset in childhood. The following diagnostic criteria has been proposed:

History of prolonged subjugation resulting in alterations in

  • Affect Regulation (impulsive acting out)
  • Consciousness (dissociation)
  • Self-perception (shame, helplessness)
  • Perceptions of Perpetrator (preoccupation which may take the form of fear/sadness or identifying with and defending)
  • Relations with others (isolation, search for rescuer, revictimization)
  • Systems of Meaning (hopelessness)

What do we mean when we talk about emotional numbness? It may mean different things to different people. Emotional numbness can be a symptom of either type of PTSD.   Some in the trauma field think it is worth specifying that there may be a subtype of PTSD which involves numbing more than or instead of hyperarousal. Numbness can also be how clients describe their experience of dissociation. Overall, I see emotional numbness as a coping and survival strategy.

Emotional numbness can be an immediate reaction to a traumatic event such as sexual assault or relationship violence. With time and a supportive environment, such as trauma-informed therapy, this type of numbness is often self-limiting. The therapeutic relationship, coupled with prior strength and coping skills, may enable to trauma survivor to access and express feelings about the event.

When emotional numbness is a symptom of complex trauma or dissociative disorders such as depersonalization disorder or dissociative identity disorder, the focus in therapy may be different. In these situations numbness has often been of longer duration, has been used to cope with such intense experiences, and may have prevented the development of other coping skills. Decreasing emotional numbness then also involves building skills that allow for the capacity to feel and cope with intense emotions.

Skills building may involve things like:

  • learning to identify and express emotions: those who have been numb since childhood may not even know how to tell what they feel.
  • mindfulness to increase what Dan Siegel, MD calls the “window of tolerance”,  the capacity to look at traumatic experiences without becoming overwhelmed by the associated emotion.
  • grounding techniques like deep breathing, focusing on your senses.
  • learning to self-soothe, engage in self-care.
  • relationship skills: how to connect, who to connect with.

Think of your emotional numbness as having served a purpose. Perhaps this was the best way you had to cope for a time. However, the price of this form of coping is high. Being able to experience the whole range of our emotions is part of what makes life rich and meaningful. The good news is that you can build new skills now. You can lay the foundation that will make it possible, and safe, for you to be in touch with your authentic, emotional self.

This entry was posted in Dissociation, Dissociative Identity Disorder, Mindfulness, Psychologist, PTSD, Relationships, Self-care, Trauma and tagged , , , , , , , , , , , , , , . Bookmark the permalink.

14 Responses to Reader Question: Treating Emotional Numbness

  1. Amanda says:

    Great post!

  2. Kerro says:

    Wow, what a great post Dr K. Thanks so much for sharing it with us. I’ve been doing a lot of work on this in therapy, and boy, is it hard!! It was even news to me that feelings are called feelings because, well, you FEEL something. Who knew?!?!?!

    I can sometimes identify a feeling, but I’m still completely divorced from the physical sensation, if that makes sense. And that’s despite weeks of body scanning and similar activities that just don’t work for me. I’ve also been doing a lot of work on self-soothing. I had no idea most people knew how to do this! I mean, I figured there were alternatives to the various mal-adaptive mechanisms I’ve used over the years, but I had no idea what they were. I still have no idea, though occasionally I get struck by a bolt of lightening that helps me figure something out (eg, I was highly anxious yesterday and discovered that reading really helps – yay!!)

    If you know of any resources that would be good on either of these fronts, please let me know!

    Thanks again for another great post.🙂

  3. 1esmecat says:

    Thank you for addressing this topic. This is a huge roadblock for me, and I am looking forward to learning more.

  4. Britta Dueholm says:

    I am still trying to understand why it went so terribly wrong in my 19 years long therapy that ended in a disaster one year ago. I believe now that it has to do with my numbness and my therapist not knowing how to deal with that. Actually we didn’t deal with it at all. I don’t think that he even realized that it was numbness. I think that he saw it simply as resistance against treatment or against him. So I thought so too and got stuck not knowing why I was stuck. I was ashamed of it. Twice I had a psychotic episode (at home) after his rejecting me. The second time was after he terminated me with one unexpectedly shortened closure session before he retired one year ago. He rejected me when I asked for one last session. A new therapist? I wouldn’t dare. And I can’t afford it, financially or emotionally.

  5. Jon says:

    I am so glad there are therapists out there recognizing this as a problem. Everywhere on the web I see advice/questions on how to be “less emotional”…but what about those of us who need (and want) to be *more* in touch with our feelings?

    Sexual assault is a horrible thing I’ve never experienced, but I did suffer a really bad betrayal by my old friends at a vulnerable time in my life (I was 15 then). Stupid teenage drama, I know, but that was the world to me then. It “hurt me” really bad…and unfortunately the effects are still with me. I can’t trust anyone emotionally anymore, even though I want to, even though I rationally know I *can*.

    Ironically it only happened because I was a sensitive person to start with, and I liked being that way in spite of all the negatives, but now I don’t have a choice. I have been to several therapists but they all seemed to draw blanks, or brush those issues aside, or (worst of all) not even recognize them as a problem.😦 I hope to keep trying but it’s an expensive thing to keep looking for new therapists…I really wish there was a magic pill or something…

  6. Pingback: 2013 in review | Dr. Kathleen Young: Treating Trauma in Tucson

  7. Recognizing. says:

    Thank you for writing this. I’ve been in therapy mainly for childhood abuse and my therapist recently discovered that I have the tendency of when asked how I feel, I tend to simply state that “I’m fine”, even when this isn’t really the case. She gave me the project of writing down how I feel and being able to identify the emotions. Reading this article has made me remember about it yet, when I ask myself how I feel I keep getting the same answer. I’ve been liked this for so long that I never once stopped to considered that it was a form of disassociating myself.

  8. asurvivor says:

    I discovered this song – the lyrics are very moving. I have PTSD, or complex PTSD. I don’t know if I’m breaking through emotional numbness but it makes me cry. It is Paul McCartney performing “I want to come home” live. http://www.youtube.com/watch?v=jkGnXga5R2M

  9. Pingback: Treating Trauma and the Therapeutic Frame | Dr. Kathleen Young: Treating Trauma in Tucson

  10. Joshua says:

    I think I have this. I don’t know how to cry and laugh. I have no emotion?

  11. Amber says:

    Wow thank you so much i thought there was something wrong with me in whu i felt nothing its almost a year since ive been raped and i finally understand what im doing. I realize i did it because the police told me i was lying about what had happened to me now i have more of an understanding about being emotionally numb

  12. nessa3 says:

    I was taught very young that my emotions were wrong. My dad was very abusive,verbally,psychologically. He seemed to find great pleasure in tormenting and taunting us until we exploded in rage, or cried. Learned I had to control my emotions.
    Now I cant seem to feel much at all…..like Im just existing… theres no enjoyment.

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