Tips and Cautions for Recovering from the Boston Marathon Bombing

I was recently a guest expert on trauma for Arise News, an international news channel for New York, London, and Johannesburg. I was asked to provide tips on how the nation can recover from this recent tragedy during the Boston Marathon.

Below is an elaboration of my thoughts from this appearance.

The nature of our stress response

On a more cognitive level, our belief in the world may be challenged or shaken. I overhear people saying, "What is this world coming to?" r "We're going to hell in a hand basket!" On the most basic level, we all need to feel that the world is generally more safe than dangerous and that people are more helpful than hurtful. Without this assumption, our capacity to love and grow becomes significantly hampered, and we become more vulnerable to mental illnesses like depression, anxiety, PTSD, and even anger. Any traumatic event challenges these fundamental assumptions we need to make about the world. It is our job to remember that the world is generally a safe place, particularly for those of us fortunate enough to live in these great United States. Like I said on the news program, this tragedy was but one moment in our lives. We are supposed to respond with horror and grief. But, when that moment passes, we have to allow it to pass and realize that there have been and will be millions of moments when nothing bad happens and in fact "pockets of beauty" quoting Nietzsche emerge.

Right now, we are all mostly responding like we should. We are all a little more hyper-vigilant, ore alert, more jittery and tense. Our sleep may be disrupted and we may feel less hungry or queasy. This is our body's natural way of keeping us protected from perceived threat. We need to thank our bodies for keeping us alert for danger, but when the danger has passed, we need to help our body expend that energy (through physical exercise, crying, relaxation practices, etc) and remind our bodies that we are safe again.

A word of caution: be careful of "othering"

One other thing that our stress response does when it is on high alert, is that it looks to identify the source of threat. It needs to find the enemy. Simultaneously, this state of alarm narrows our thinking, making us think in simplified, black-and-white erms. In another parallel process, we feel horrified by exposure to evil and want to move ourselves as far away from that as possible. We all hold within us a mix of good and evil parts. But, when something extremely evil happens, we want to simplify the world, distance ourselves from such evil, and compensate by thinking of ourselves as more good. This is what I think of when I hear interviews of people who knew this young men and can't make sense of these evil acts and the good kids they used to know.

These processes leaves us highly vulnerable for wanting to find a singular source of danger and label that danger as purely evil. In this moment, particularly when commingled with grief, which leaves us wanting retaliation as a safer, less vulnerable and helpless, state of being, we are at great risk of planting seeds of hatred, discrimination, racism, and oppression. We want to say that all Chechen or all Muslims are bad people because it makes us feel safer to just assume so and leave it at that or know who to blame and hurt for what has happened.

The key to protecting ourselves from such an outcome is to stand naked in our inability to comprehend how such evil acts exists, allow these events to wash through us in waves of fear, anger, despair, and grief, then allow them to pass, realizing that the moment is temporary and soon enough new moments will arise free from this one.

How Therapy Works (Sometimes)

(Originally posted on drjacobham.com)

herapy is such an interesting, magical thing and there are so many ways that it can help and for such a variety of issues. It's honestly hard to describe what makes it work, and I think most therapists would struggle to summarize an answer. I’ll give my favorite answer to how therapy works, recognizing that it’s definitely not the only answer.

Therapy helps people heal interpersonal wounds and build trust and love with other people and more importantly with themselves

Most people who seek therapy struggle in their relationships with others and this struggle often reveals struggles in people’s relationships to themselves, which in turn is often reciprocally due to earlier problems in their relationships to primary caretakers. It’s as if all relationships at every interpersonal and intrapsychic level are literally fractal--that is, they echo each other at different scales of experience. Even a person’s relationship to their therapist echoes this core, fractal pattern of relating. I personally enjoy working in this way and pay careful attention to my experience in the room with another person and the moment-to-moment nuances in our interactions. I trust that what happens in the moment is a fractal of the core issue, so exploring and healing the moment will heal relationships that expand out into the real world and pierce inwards towards one’s relationship to the imagined “Others” in one’s heart and to one’s relationship to oneself.

I find that this careful, attentive listening works really well when working to heal all types of family relationships too. This approach seems to help people get out of the rut of having the same fights over and over again. Most family fights happen because people are too afraid to speak from the true place of vulnerability and hurt. Instead, they lash out and attack back when they feel they’ve been attacked. People also have a hard time acknowledging and listening to each other, desperate to make sure their own voices don’t become diminished or drowned. At other times, ghosts of relationships past, self-hate and self-criticism haunt us and distort everything we hear into the messages we most fear hearing. For instance, we hear “I wish you wouldn’t do that” as “I think you’re stupid and disgusting.” Or, more commonly, we hear  “I’m tired of fighting with you” as “I hate you and I’m leaving you,” which scares the heck out of all of us!

If my approach doesn’t fit with you, that’s okay. I think the fractal nature of  experience means that many kinds of therapy can heal because the healing has a ripple effect across the levels of experience. For example, a cognitive therapist might focus on uncovering and challenging destructive core beliefs about oneself or others; a behaviorist might focus on coaching specific ways to change one’s behaviors in real relationships outside the therapy room; or a psychoanalyst might explore childhood history and/or its impact on the here and now of the therapeutic relationship.

So, the most important thing to consider when finding a therapist is not what type of therapy they practice, but how they make you feel when you talk to them. All consumers of therapy know this implicitly and act on this knowing by either showing up every week or missing appointments and avoiding therapy (I wish that more of clients would express their dissatisfaction with verbal feedback, instead, so therapists can learn and become better therapists).

There is such an incredible amount of hurt that flows like a deluge across the world. It crashes through us one interaction at a time as we are hurt and then hurt the next in return. The only way to stem the tide is to actively and defiantly say “I will no longer allow this hurt to pass through me and poison me.” Then, this commitment needs to be made again and again, because the tide of hurt is big and deep. It wells around us and springs from us. But, someday, the momentum can change, such that being light becomes a little more easy, less work. I promise. Be patient. In fact, that patience is one of the first and most important acts of love and light that stems the tide.