Isaac Díaz Oliván: "Traumas can only be healed with psychotherapy"

Memory is one of the most important properties of the human mind, and thanks to it we can learn to unsuspected limits, accumulating knowledge related to the world, ourselves and the the rest.

But for better and for worse, this ability to spontaneously memorize also makes us vulnerable to certain emotionally painful experiences marking us psychologically. When this happens, we cannot adequately assimilate certain memories and what is known as trauma arises. In this interview with psychologist Isaac Díaz Oliván we will immerse ourselves in this kind of psychopathology.

• Related article: "Post Traumatic Stress Disorder: causes and symptoms"

Interview with Isaac Díaz Oliván: the most common types of trauma (and how they are treated in therapy)

Isaac Díaz Oliván is a General Health Psychologist and Director of Confia Psicología, center located in Madrid and where patients of all ages are treated. He also has a Doctorate in Trauma and Suicide, and in this interview he will talk to us precisely about the mental disorders linked to having suffered a traumatic experience.

In Psychology, what is meant by a trauma?

A trauma is a very painful experience that you cannot make sense of, understand and process the emotions that arise from it properly. It exceeds your assimilation capacity.

For example, a very common type of trauma is bullying childish. It generates a feeling of shame about oneself so great that being small we are unable to assimilate. The only thing we can count ourselves as children at that time is that we are weird. And we will carry that label all our lives. When we are adults, it will be difficult for us to relate to others because we will feel a lot of shame and fear of rejection.

Symptoms of trauma are: few or negative memories, apathy, guilt, extreme self-shame, emotional rollercoaster, memory gaps, extreme shyness, lack of concentration, tiredness, insomnia, obsessions, death, hypochondria, non-stop activities, migraines, fibromyalgia, muscle pain, constant alertness, etc.

Traumas are like wounds that are not disinfected. If they are not taken care of, they remain as open wounds constantly suppurating pus. And any event present can easily reopen the wound. They generate low self-esteem and self-abuse, especially the hidden trauma, which makes you feel like a bad person. Trauma can only be healed with psychotherapy.

Does the trauma only appear after a specific or sudden event, such as a car accident or the sudden death of a loved one, or can it also appear from experiences that last weeks or months?

Traumas due to excess are divided into big T (traumas in which one's own life is put in danger) and small T (traumas that have to do with bonds and attachment); another type of traumas are the default traumas, which are mostly small t's. Both big T and little T have devastating effects on the person.

As for traumas due to large T excess, we have attacks, earthquakes, car or plane accidents, physical and/or psychological abuse, sexual abuse, etc. As for traumas due to excess small T we have hits, screams, hateful looks, bullying, witnessing violence domestic, divorce, parental depression, death, loss, breakup of couples, sexual abuse (also a small t), etc.

Finally, the small t's of default traumas have to do with ignoring the emotions of the child or adult; and the big Ts with not meeting the physical needs of hunger or child care. Within this type of excess trauma, hidden trauma stands out, which is a default trauma in which the stimuli child's internal emotions (emotions and physical needs) are not attended to by their caregiver, causing a deregulation in the child emotional. In serious cases, it includes a caregiver who plays with anger, withdrawal of affection, making people feel guilty, emotional blackmail, silence, etc.

There are also preverbal traumas, which are traumas that occur in early childhood in which there are emotions such as loneliness and fear but without associated memories and cause more somatic or bodily symptoms such as hypochondria, fibromyalgia, panic attacks...

Betrayal trauma is a trauma in which trust in people or organizations that were supposed to protect the person is lost. Examples of this are sexual abuse in which there is a subsequent silence that occurs when the situation is reported. Or when a battered woman feels abandoned by the agencies in charge of defending her when she asks for help. Or when a person with an eating disorder suffers very painful hospital admissions (eating tube, poor care by health personnel, etc.).

Thus, there are also traumas that encompass experiences that last weeks or months, such as the small t that are experienced within the family and at school. Or, for example, when a person is subjected to workplace mobbing for a long time. This could also lead to relational trauma or small t.

Are traumas that originate in a traumatic childhood experience more severe than those that arise later in life?

Absolutely yes. The child's brain is much less mature and therefore less prepared to assimilate the emotional impact of a painful or traumatic experience. Fortunately thanks to psychotherapy These traumas can be healed.

As a psychologist, what are the most frequent types of trauma with which you have come across treating people?

Above all, relational traumas in childhood and at school. Highly critical families, abusive families, neglectful families, bullying… Also traumas Relationship problems that have to do with partner abuse are very common, and it is not always so clear to know what they mistreat us

But also other less obvious types of trauma, such as parents who judge their children in a much more subtle way. For example, the typical question: why didn't you get a 10 instead of an 8? Repeated over time, it can generate a relational trauma in the child because, without realizing it and with all our good intentions as parents, we are setting in me a feeling of constant pressure, a core belief that nothing is enough and a toxic self-shame enough big. Not to mention that you will associate your self-esteem with success at work.

We can already imagine what will happen when he is an adult and has to set limits to a very demanding boss. Well, she will cause work stress, depression, anxiety... and a reactivation of childhood trauma. It is as if the same childhood scenario were repeated. It is no longer my mother who demands me but she is my boss. And at that time, because I have childhood trauma from abuse (because this is it), I can't tell the difference. I keep seeing my mother. I'm still a child and telling myself that it's not enough and I can't complain. I can only be sad, have stress and keep working hard until my body explodes with anxiety-depressive symptoms. Or even with suicide in more serious cases.

The same happens in other different cases such as the emotional dependence. I find it a lot in adults who are not comfortable with their partners, but are very afraid of abandonment, of loneliness, or they think they are defective... Then they continue to stay in abusive relationships, as was already the case in their childhood. Analyzing childhood and family is always essential.

Broadly speaking, what are the stages of psychological treatment of trauma?

First we have to identify it. The second thing is to accept it. Accepting that I have an emotional wound is more difficult than it seems, I always find myself with a lot of resistance. The last thing is to work on it in psychotherapy. In this case, the EMDR technique can be very useful to reprocess and heal the trauma.

What are the most used therapeutic techniques for this kind of psychological alterations?

First, the stabilization techniques, which help us work on the symptoms of the trauma, which are usually very unpleasant emotions. From techniques that include diaphragmatic breathing, to more sophisticated techniques such as positive self-talk, focusing, visualizations, safe place, muscle relaxation, etc.

Subsequently, once the patient has tools to regulate her emotions, we work especially with the EMDR technique or with exposure to the entrenched emotions of memories painful.

At what point is it known that the person has overcome a trauma after attending psychotherapy for several sessions?

When your symptoms decrease until they disappear. The person internally feels that her self-esteem has grown, she speaks to herself much more kindly... You don't feel emotions as intensely. She feels empowered, that she can set more limits and is not so afraid of being rejected by others.

And as for traumatic memories, the most important thing is that they are seen from a distance. Like a scar from a wound that has stopped hurting. The past is left behind and one feels that one can now tolerate the positive and enjoy the present.