Trauma Phobia and what they have to do with Dissociation
Let us start like this. Trauma is complicated and confusing, sometimes for clinicians and trauma survivors alike. Is this PTSD or a generalized anxiety disorder? You might be anxious and apply lots of avoidance behavior, but you do not know what you are actually phobic about. Are you having panic attacks or emotional flashbacks? Often it is all a bit muddled up and layered, and trauma might be challenging to comprehend, primarily because various phobias cover the trauma fully.
This article sheds some light on the so-called invisible phobias.
Traditionally, phobias are categorized in the group of anxiety disorders and have been understood as a fear or reaction to an external stimulus such as heights, dogs, spiders, blood, people, etc. Often phobias are rooted in evolutionary fear and have some protective survival value.
However, phobias can also be an inner phenomenon, and trauma survivors can become phobic of particular thoughts, feelings, fantasies, sensations, and memories. Therefore, chronically traumatized individuals are often extraordinarily fearful of mental actions and external stimuli that remind them of the traumatic experience.
1.) MENTAL PHOBIA
The phobic avoidance of the traumatic memory protects the survivor from ultimately realizing the traumatic experience and its effects on one’s life. Therefore, action and mental avoidance strategies are needed to prevent what are perceived as painful realizations about one’s self, history, and meaning. This, on the other hand, leads to maintaining structural Dissociation.
When survivors associate an increasing number of stimuli with the traumatic experience and memory through stimulus generalization, they may start to fear and avoid more and more of inner and outer life. As a result, survivors can become anxious and avoidant of any mental action, such as having particular feelings, sensations, and thoughts that are consciously or unconsciously associated with the original traumatic experience(s).
Often the core phobia of the trauma involves the survivor’s fear, disgust, or shame about mental actions he or she has associated with traumatic memories.
As long as the trauma survivors are afraid of their inner life, they cannot integrate their internal experiences, so structural dissociation is ongoing.
2.) ATTACHMENT PHOBIA
Phobias of attachment and attachment loss quickly develop because other human beings, especially caretakers, have hurt chronically traumatized individuals.
While insecure or dangerous attachment is experienced, it is also necessary to attach to a caregiver to guarantee survival. Therefore, the phobia of attachment is often paradoxically accompanied by an equally intense phobia of attachment loss. It manifests in desperate feelings and behaviors that motivate the individual to connect to another person at all costs.
Typically, different parts of the personality experience these opposite phobias. For example, chronic childhood abuse and neglect furthermore elicit a phobia of attachment and attachment loss regarding abusive or neglectful caretakers, which can generalize to many other interpersonal relationships.
They evoke each other in a vicious cycle, with a perceived change in closeness or distance in a relationship resulting in a disorganized/disoriented attachment.
This might be accompanied by ambivalent communication: “I hate you- do not leave me.”
3.) NORMAL LIFE PHOBIA
Another manifestation of generalization is the phobia of everyday life. Since normal life involves at least a basic level of healthy risk-taking and change, many ordinary life experiences also become vigorously avoided.
Chronic trauma survivors often associate risk-taking with failure. Thus they are typically afraid to take a healthy risk, fearing that it will result in humiliation, shame, and disaster, which is their common childhood experience.
Paradoxically, many survivors take dangerous and impulsive risks. However, these are not the calculated and reflective risks necessary for adaptive change.
Finally, more mature levels of attachment, such as intimacy, are avoided due to the plethora of phobias related to attachment and trauma-derived mental actions that have become conditioned stimuli because most chronic traumatization is interpersonal.
What to do with those invisible phobias?
Overcoming trauma-related phobias is essential to successful treatment.
Unfortunately, survivors waste much energy and time to keep up the avoidance, which eventually leads to exhaustion and decompensation.
The phobia of trauma-derived mental actions, including the phobia of dissociative parts of the personality and the phobia of attachment and attachment loss, must be worked through with a trauma-informed therapist.
In addition, the phobia of change and everyday life will begin to be addressed and continue at more complex levels throughout treatment.
The following article discusses integrative treatment options for working on their underlying unresolved issues, including schema work, attachment work, and EMDR.
If you want to work on your trauma phobia, please reach out to Dr. Julia Andre
Reference: Moskowitz, A. (2007). The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization. By Onnovan der Hart, Ellert RS Nijenhuis & Kathy Steele. WW Norton. 2006.416 pp. $32.00 (hb). ISBN 0393704017. The British Journal of Psychiatry, 191(6), 571-572.