Sometimes 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
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.