By: Jesse Gill, LMSW
There was a time once, much more recent than I care to mention, that I bought my first set of bathroom towels. I know this is a mundane action that most people don’t think twice about, but there is a first time for everything. Even if we don’t always remember it, it was there and it did happen. And when it comes to bathroom towels, I remember it. In simple terms, I was excited, and I’m sure those around me found that excitement, at best, amusing. I know for them it was probably a bit confusing, but for me it was everything. It was my whole life and existence all summarized into a set of soft, salmon and green waffle hand and bath towels. For someone who had never lived alone and who spent much of their life not taking their emotional needs seriously, picking home décor for the first time was like discovering a part of myself that had been growing and begging to stretch its legs. This new person felt like it encompassed all of my emotions and thoughts in all their beautiful and painful glory. It can be both exciting and scary to meet that person and give them access to the life you have carefully constructed. To welcome that person in is to welcome a part of you that’s vulnerable into a world where vulnerability is feared.
What Are You Made Of?
A colleague and good friend of mine, Kay Solomon, once proposed a question based on an old children’s poem about girls being made of sugar, spice, and everything nice, and boys being made of snips, snails, and puppy dog tails. Kay asked the more inclusive and seemingly simple question, “what would you say you are made of?” Like me, some of you may realize how truly difficult this is to answer. What are we made of? Many of the trauma survivors I work with become stuck in trauma. In the pain and surviving. In the what was lost and what could have been. In grief and anger and shame. Some get stuck on simply doing what is necessary to survive, recognizing little else. A world full of personality. A world full of life. And, yes, a world full of bathroom towels.
In her 1992 book Trauma and Recovery, Judith Herman incorporated the idea of losing who we are in her creation of the Tri-Phasic Model, a method for organizing trauma-focused therapy. In Judith’s writing, the Tri-Phasic Model is broken into three main phases of treatment. The first is safety, where the focus is on psychoeducation about trauma, coping, and regulation. The second is remembrance and mourning, which is where the bulk of processing of the trauma takes place. Lastly, reconnection is where we learn to live again and find life after trauma. While my trauma-focused Intensive Out-Patient (IOP) and Partial Hospitalization Program (PHP) groups often focus on the first phase. However, what I see time and time again is that the idea of finding ourselves in all of the chaos of trauma and its aftermath is often a more daunting task than overcoming the triggers themselves. For some, the identity of who we are is as lost to us as the person we once were. Trauma changes us. So much motivation has waned in the emptiness of life. So many have reached the point of kicking aside most of their survival behaviors but then ask themselves “what else am I if not a survivor?”
To address values, there is a week in my curriculum where we veer off of the topic of trauma to examine values. The central focus of this week is the Values Matrix. This is a part of Acceptance and Commitment Therapy that can be used to work with trauma survivors trying to see both the reality of their current behaviors while also finding what is missing. This matrix forms a cross-section with four topics. On the bottom left side are the things we are trying to avoid: memories, thoughts, feelings, stimuli, etc. Above those are the actions we take to respond to the things we don’t like. These can be healthy behaviors, such as exercise or taking medication as proscribed, or unhealthy ones, such as isolating or abusing substances. On the bottom right side of the quadrant are the values that make our life worth living and give us vitality, i.e., family, friends, nature, hobbies, music, etc. Above those are the actions we take to recognize those things we value so much. Oftentimes people will have quite a large array of things on that left side that they are trying to avoid and ways they achieve avoidance, but not much else. There are usually a few people who become alarmed to discover that not only can they hardly think of things to put in the bottom right section, but that they have absolutely nothing to put in the upper right. In simple terms, they are spending their lives focused on surviving and have spent little to no time living. For some, this is the moment of clarity as to why everything has been so hard on them for so long, providing context as to why every second of every day feels like it is hanging by a thread that could snap at the slightest tug. They are soldiers who have come home from the war but are still fighting every second of the day as if they are back in the trenches. There is no room for living when you are stuck trying to survive. Being stuck is exhausting. The Values Matrix helps provide perspective on living versus surviving. As Andy Dufresne said in Shawshank Redemption, “It comes down to a simple choice, really. Get busy living or get busy dying”, and they have been choosing the latter for far too long.
Identify Values
So, you might be thinking, “Okay, thanks for the existential crisis. But how do I know who I am?” And this is a major part of the struggle. Who am I after this horrible thing has happened to me? Who am I after all this time stuck in survival mode? These questions circle around in our heads, mocking us and adding to hopelessness. This search for meaning can lead us to think there is no coming back and no end to the pain. Judith Herman compares this part of the work, the reconnection to the self, to refugees being forced to enter a new world. There must be rebuilding and finding life in a world that is different from the one we were just in. One of pure survival. It is not always exciting to pick out bathroom towels for the first time. Sometimes it is downright frightening.
The fact of the matter is, we are someone, even if we don’t recognize it. Sure, we are survivors, and probably very good ones at that. But there is so much more to us. We play so many roles and wear so many hats, but it’s hard to see the roles through fear of discovery. With all change comes grief in some form. Overcoming the hold of trauma and rediscovering ourselves is not an easy journey. It’s a journey in which we must trust ourselves in an ever-changing world.
One way I like to challenge my patients to rediscover themselves is through a Values Deck. Simply put, this particular deck is comprised of 83 cards showing different possible values someone might have. Participants sort the cards into stacks of three: important to me, very important to me, and not important to me. Once the three stacks are fully formed, I ask my group to revisit the “very important to me” stack and think about how these values are present in their lives. This allows participants to examine the values they hold dear, and also empowers each person to question what they are doing to honor their values.
Reconnection is a stage of pure exploration, adventure, and creativity, where we have removed ourselves from the world of repetitive trauma and can now look at the life before us and find who we are. We may look a little different, possibly with new values to match our experiences. Exploring and reconnecting to ourselves is an act of unlocking and welcoming us back into the world. And maybe the us that we are accepting into our world is one that gets excited about shopping for bathroom towels. Maybe those bathroom towels mark the beginning of our healing self that has been dying to see the light.
I have put good thought into the question Kay proposed to me and I have discovered two things. First, is that I am no good at rhyming. The second is that I am made up of many things, some fun and some hard to accept. I am made up of coffee, tea, and people pleasing. Cowboy boots and fights with internal boundaries. Hard work and not always acknowledging my own values. I am made up of nature and the world around me. Empathy, creativity, and the smiles I put on people’s faces. Wants and needs and valid feelings. The love I have for others and the love I have for myself. And yes, I am made up of bathroom towels and all of the things that I thought didn’t matter. I am a person I am not afraid to say “hi” to anymore. And that is something to get excited about, don’t you think?
Jesse Gill, LMSW, is a program therapist for Adult Trauma Partial Hospitalization Program (PHP) and Intensive Outpatient Program (IOP) at our Denton, Texas location.
Resources https://motivationalinterviewing.org/sites/default/files/valuescardsort_0.pdf https://www.google.com/books/edition/Trauma_and_Recovery/unhFswEACAAJ?hl=en