Phases of Healing

Tanya Ruckstuhl LICSW

Back in the late 60’s, Swiss psychiatrist and kick ass trail blazer Elisabeth Kubler Ross developed the five stages of grief through her work with terminally ill patients coming to terms with their own death. Those phases have since been applied to everything from death to divorce to disappointment. The five phases are: denial, anger, bargaining, depression and acceptance. This framework for sorrow helps normalize and make some sense of the pain of loss.

In my work with trauma survivors, I’ve also noticed recurring patterns of healing.  The first phase is Rigidity and Anger. These are folks who need things just exactly so in their lives. They are often highly productive but not personable. Trauma survivors in this phase usually have more projects than friendships. They are usually workaholics because they don’t trust anyone else’s contributions. They often drop out of therapy because they are not ready for the vulnerability of being seen or having any part of their thinking or behavior challenged.

When the strategy of avoiding feeling by staying busy no longer works due to exhaustion or becoming healthy enough to start feeling the pain left by childhood trauma, trauma survivors enter the Anxiety Free Fall phase. In Anxiety Free Fall there is tremendous fear about future events, personal safety, loved ones, medical and economic vulnerability. They are downright creative in coming up with things to worry about!  They face a constant feeling of looming and inescapable disaster. People in anxiety free fall often seek therapy to relieve the discomfort from finally feeling.

Then comes the hardest phase: Shame and Self-Hatred. Just as rigidity/anger functions as an armor protecting survivors from the anxiety free fall, anxiety is a distraction (ironically a protection) against the underlying pattern of shame and self-hatred.

Why do abused or neglected children learn to hate themselves? First, let’s look at the world at large. Unlike an American courtroom where you are innocent until proven guilty, in the world at large you (and me, and everyone) are irrelevant until proven useful, or interesting, or attractive in some way. Strangers might care about others from of the goodness of their hearts, out of general care for the welfare of our fellow wo(man), but these strangers don’t actually know you enough to care about you personally. The focus of our caring starts with those we know the best, and moves out in concentric circles of distance. We feel the most investment in the wellbeing of those who we personally feel connected to.

This pattern of tribalism is okay as long as everyone is born into a household where they are flat out adored just for showing up on the planet. In a reasonably healthy family, each and every baby is the best thing that ever existed. Every child is a source of delight and wonder. This experience of being precious, worthy, special, smart and beautiful in one’s family is the counterbalance to the world at large, which says “you don’t matter until you prove your value.”

In families that are deeply unhealthy, babies are not adored. Children are a burden. And they are told this in a number of ways: rough handling, resentful or bored facial expressions, lack of touch, ignoring, screaming, pinching, hitting, etc.

An un-adored baby in a world of prove-your-worth is filled with a sense of emptiness and insecurity. There’s no tap root of knowing “I’m special” inside that person to counterbalance the world’s apathy.

That’s the bad news. The good news is that we can all move towards the phase of Healing. Just as the deepest wounds are inflicted relationally–by the very people who are supposed to take care of us–the deepest healing also comes this way. In a healthy love relationship, people develop a sense of personal value. They discover that they matter to another person, and that allows them to matter to themselves. This is a slow process because it’s a total change in personal identity.  Evidence of healing is both internal and behavioral:  they take less dangerous risks but more emotional risks. They take breaks from work, protect time to sleep, eat vegetables.  As they discover that they are lovable even while being imperfect, they stop hyper focusing on their own and other people’s flaws. (Which reminds me of the perfect bumper sticker I saw this week: “Proud parent of a great kid who can occasionally be an asshole and that’s okay”)

In a healthy relationship—which can be love, friendship, therapy or any combination of the three–we can reprogram our sense of value from “nothing” to “special.” Not everyone will feel this way about us. In fact, most of them won’t give us a second thought. Because they don’t know us well enough to have an opinion.  Pop culture aside, we cannot and do not need to impress everyone. We just need to *adore* ourselves, and hopefully, have a few other folks in our lives who join our fan club, as we also join theirs.