confession

The repressed emotion coming to the surface in therapy has always been present, only outside of conscious awareness. Telling the story exposes Cain directly, consciously, to the traumatic material. It allows him to reconnect with the biochemistry associated with the event(s) and helps him make meaning of this part of his story in a supportive and compassionate container.

It’s not unusual for traumatic material to surface in therapy, stories that patients haven’t thought about in years (van der Kolk & Fisler, 1995). In some cases, early childhood trauma results in memory fragmentation, making the retrieval and processing of traumatic events difficult (Brewin, 2014; Brewin, Dalgleish, & Joseph, 1996). In such cases, patients often can’t access emotions associated with the event. For example, a patient will recall only a fragment; none of the other details before, during, and after the traumatic event are accessible. The fear and sadness associated with the memory have been seemingly lost.

Humans, especially children, are protected from having to recall overwhelming experiences. The nervous system represses emotionally charged material to support daily functioning. In Kalsched’s (2013) book, Trauma and the Soul, there’s a story about a child who is told to take her father a cup of coffee. She returns to her mother without having delivered it. Her mother asks her why she didn’t give her father his coffee.

“The angel wouldn’t let me in,” she says.

Hearing this, her mother rushes to the office and finds the man on the floor, dead. It could be that an interdimensional being intervened and, in fact, turned the girl around so that she didn’t find her father’s dead body. Another proposition is that she did witness her father lying lifeless on the floor, but her nervous system immediately repressed it to protect her and fabricated an angelic being to explain why she didn’t deliver the coffee.

Either way, the girl was protected from having to integrate this traumatic material. Her nervous system was spared the trauma. This protective mechanism is especially active in children.

In working with adults, in rare cases, early childhood trauma has been repressed and remains inaccessible. Occasionally, patients will retain fragments of traumatic memories without any associated emotion. Most of the time, however, patients are able to recall and fully re-experience traumatic material in session, as in Cain’s case. It’s in those instances that we support the patient in reconnecting with his, or her, trauma.

As we can see, Cain is totally overwhelmed at his first pass processing the traumatic event. He sees a bloody mess and himself holding a weapon. His nervous system becomes dysregulated and requires the therapist’s assistance in keeping grounded. Shortness of breath, trembling, elevated heart rate, and knots in his stomach are some of the somatic symptoms he suffers upon recalling this event, and as we stated before, the therapist’s primary role at this juncture is to help support his body’s capacity to regain homeostasis.

It takes courage for patients to reconnect with parts of the story they’d rather forget. The reward for doing so is integration, to feel whole again.