I dreamt about Ruby last night for only the fourth time since she died 21 months ago.
It was a long aimless dream as I wandered around a large Hogwarts-type school, avoiding running children. But it ended when I entered a long corridor and stood still, waiting impatiently for what I knew was about to happen. A teacher smashed through the door at the other end of the corridor and shouted to me "it's OK, I found her" and then Ruby walked in. She was wearing an outfit she loved which made her look like a character from Middle Earth- pointy ears, cape, short hair, bow and arrows acrosss her back- she saw me, shouted "DADDY" in that way she used to and ran full tilt towards me as I ran towards her. When we were only yards from each other I woke up.
I was cheated, I didn't get my hug. I cried in a way I hadn't cried since I was deep in the raw pain of early grief.
It was a mini-grief all over again. I was ragingly angry and I felt pain, ache, denial, cheated and, after an hour or so, eventual acceptance that I had to fully wake up and face the day.
I have been startled how much it hurt because only last week I had written about how much I have moved on and that the raw pain of longing has decreased. But this dream threw me back to the harshest early days of vulnerability and fragility.
What follows is a brief explanation of why some experiences become "traumatic" and why we have to spontaneously relive such negative feelings. There have been various theories over the decades but there is general agreement between neurologists, psychologists, psychiatrists and others about the basic brain processes that explain why some people develop Post Traumatic Stress Disorder (PTSD) or a similar post-trauma psychological distress that takes months or years to be resolved. The area of cognitive neuroscience is bounding ahead of other brain research and has tendrils of influence that help explain my chosen field, psychopathology (mental illness):
Our sensory experiences are processed by the hippocampus into memories to be stored. When we are under great duress during those experiences, such as having a serious accident, being assaulted or during a disaster, our "stress hormones" such as adrenaline are greatly raised which inhibits the effectiveness of the hippocampus. Our related memories are then stored incorrectly as the hippocampus struggles to cope and, in the future, we have little control in recalling those poorly processed memories. In addition, as we recall those memories our adrenaline levels remain high which cause anxiety and poor sleep.
The most common symptom of PTSD is "reliving" the trauma through flashbacks and recurring nightmares. In essence these two symptoms of reliving are simply a spontaneous, undesired recall of those traumatic memories in a way that is frightening, realistic and reminiscent of going through the original event again complete with the smells, sights, sounds, etc. Other common symptoms include hyper vigilance, whereby you feel constantly "on guard", as if you may be at risk of attack and have to be on the offensive all the time and avoidance/ dissociation, whereby you psychologically distance yourself from the event and can become numbed and disconnected from everyday life.
Flashbacks can "just happen" but can also be triggered by sounds, smells and other sensory stimuli and can be a distressing, horrifying experience.
There are gradations of distress caused by trauma. This can range from the occasionally triggered upsetting memory, spontaneously recalled from goodness-knows-where, towards diagnosable PTSD through to the more extreme types of complex disassociation which causes a serious breakdown of relationships and coping mechanisms.
There is help for all this distress. This type of problem is well researched and there is a breadth of professional experience relieving such suffering. Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitisation and Reprocessing (EMDR, in which I am partly trained) are the primary psychotherapies for trauma and some antidepressant medications have been proven very effective too, not only in helping one's depression but in the actual successful processing of those distressing memories.
By far, our greatest help comes from an initial recognition of symptoms and then telling someone, anyone. Maybe someone has read what I have written above and it has echoes. Maybe the self-education of coping can sometimes be a myth, that maybe underneath it all we are naked, alone and just want our mummies. Maybe this is why we deserve gentle, moderate handling from others. Maybe our fragility is a sign of our humanity. Maybe a delicate approach from others is a sign of their sophistication and sensitivity and maybe it can be applauded.
Grief, distress and trauma are well-studied phenomena. A great deal is known about their aetiology, diagnosis and prognosis. There is successful, evidence-based treatment that is easily available and I can vouch for its effectiveness through professional and personal experience. Don't suffer needlessly.
