Tag Archives: trauma


How do you write about something that people are afraid to see? How do you expose an undermining, but insidious, practice? How do you change peoples’ minds? How does a civilization heal from the wounds of abuse?

It has been a few weeks since I posted about abuse.  I needed some time to refresh.  It is a tough topic to bring one’s attention to weekly.  It is challenging to discover new ways to talk about a very old topic that simply boils down to three words – it hurts badly.  As I type that, it occurs to me that perhaps the three words are – it impacts everyone.  And now I am thinking that if it hurts badly and impacts everyone, why is there so little discussion about it?  Why is the topic shameful?  Why are those speaking about it either vehemently reduced to blithering cry babies or met with silence, isolation?

Abuse is a taboo subject. Wikipedia defines taboo as “a vehement prohibition of an action based on the belief that such behavior is either too sacred or too accursed for ordinary individuals to undertake. Such prohibitions are present in virtually all societies. The word has been somewhat expanded in the social sciences to strong prohibitions relating to any area of human activity or custom that is sacred or forbidden based on moral judgment and religious beliefs. “Breaking a taboo” is usually considered objectionable by society in general, not merely a subset of a culture.”

If abuse is a taboo, then perhaps any discussion of abuse becomes an associated taboo.  Maybe it is time to consider that abuse is not a taboo in our society.  It is not vehemently prohibited, most offenders are not held accountable through the judicial system.  The statistics would support that abuse is not accursed as a practice.  And it seems that it is only objectionable in theory and not in practice.  The recent public abuse Malia Obama endured is a good example that abuse is not taboo in our culture.  Or how about the countless things Donald Trump feels free to express regarding the myriad of people he hates.  Maybe abuse is covertly hidden in our fascination with celebrities; it would seem that we love to hate them.

So what is the deal with abuse?  Is it possible we all shy away from the conversation because in our hearts we each know that our potential as humans contains the ability to abuse?  Is it possible that we each know unconsciously that we abuse daily?  Is it overwhelming to consider yourself as an abuser on the continuum of abuse?

It is for me, and I think that is why I needed a break.  Sometime to process my own resistance to my own abusive practices.  My instantaneous knee jerk reaction to a centipede, the illogical action of stomping on the poor creature.  My judgement of someone’s competence that leads me to behave inconsiderately.  My fear that I won’t be heard by another that causes me to lash out personally against them.

Abuse is a far too common practice, and the taming of it will require self-awareness and reflection.  It won’t be easy.  It will be hard.  It isn’t only about what someone else does.  It is about what we each do.

Tami Boehle-Satterfield, MSW, LCSW-C, NBBCH, HTP, a licensed psychotherapist in Boulder Colorado at has challenged herself in 2016 to post weekly about the unpopular topic of abuse. Learn more about Tami at



How do you write about something that people are afraid to see? How do you expose an undermining, but insidious, practice? How do you change peoples’ minds? How does a civilization heal from the wounds of abuse?

I cried when I read the letter.  The letter the courageous and intelligent woman wrote in response to a recent rape verdict in California.

I can’t even count the number of times I have been sexually harassed or violated. I never stopped to think about it. I never took the time to collect them up and consider their effect upon me. I didn’t want to. When I try now, I remember things I have forgotten, but surprisingly the forgetting of them hasn’t lessened their emotional response in my body. There was the time when I was 13 at a car dealership, there was the time I was 21 in my own apartment, there was the time I was 25 on a downtown street in Baltimore at 4 in the afternoon, when I was dressed in a suit to attend a meeting with the Mayor’s office. Then there is a splattering of random times; lewd remarks and gestures, condescending comments concerning my sexuality, unwelcome touch from people I didn’t know in public places. And still other times.  Times that I am still not comfortable enough with to strike the keys of my computer, to put the letters together to form the words that would make up the sentences of accounts as much as 0ver 40 years ago, but still too fresh to admit.

Yep, my chest is tight. I feel the emotion at my face and I steel myself against tears. It sucks to feel so vulnerable. It hurts to remember being violated simply because someone felt it was their privilege. Why does this happen? This question is most often answered with silence.

In my silence I have been complicit. I have been afraid to admit out loud the things that have happened.  Once at a slumber party, a brave girl told about how someone had hurt her.  A circle of 15 year old girls on sleeping bags stared silently at her until one girl said, “Oh that just happens,” and another echoed her and added, “Don’t make a big deal about it.”  Those girls, like me, perpetuated the silence.  All of us afraid of being judged, afraid of the shame of either what had happened or that we didn’t know how to make it not happen.

Some girls made sense of those experiences by playing them out and crafted their identities around them, some relinquished their senses of security in the world and drew themselves inward, and others, few and unfavored, found ways to speak out against such trespasses.  Honestly, I suppose I have done all three, but where I ended up feeling most whole was simply in the silence of it.   Best to forget about it, best not to make a big deal about it, best to believe it never really happened.  Even now writing this, I fear judgement and criticism.  And not because I have held my tongue, but because I dare suggest that I was hurt by someone’s forward or invasive advances.  Despite being a mandated reported and a trained mental health professional, I still feel doubt about the truth of what I am writing.  “Really?”  Some part of me challenges, “I think you are making this into more than it is.” But I am not.

I remember a discussion after work with a group of coworkers, that led to a particular revelations about the social worker who directed the children’s program at a domestic violence shelter. “You were raped,” we told her and she looked like she was only first learning it, even though a high percentage of the very children she helped had been assaulted themselves. Denial, at first an ally in trauma, but in time an obtuse, thick cloud that distorts our own perceptions about ourselves.

I want to say that while silence allows the perpetration of sexual violence, it is not the cause.  The cause lies in our deep rooted sense of entitlement.  Our percieved right to lord privilege of power over people, animals, and the planet completely destorts our understanding of love and respect.

I cried when I read the letter. I want to tell her that I am deeply sorry for what happen to her and for my small, but significant part in the silence that allowed her to be hurt. I want to say how brave she is, and that I am grateful for and respectful of her strength.  I admire her.

I was raised in a different generation. While the Women’s Movement provided me permission and modeling for speaking out about my right to dignity, I hadn’t been programmed that way. Sex was not a topic for discussion, even as it pertained to procreation.  Sex was alluded to as a woman’s duty.  It was a practical responsibility that straddled a razor-sharp distinction between pleasing a husband and falling into a gutter. Raised Catholic in a small midwestern town, normal feelings of sexual interest or pleasure were diminished to sinful perversions. A female body was either chaste or dirty.

But still, while that does inform my silence, I am over half a century old.  I saw Jodie Foster’s brilliant performance as Cheryl Araujoas in the 1983 gang rape movie called The Accused.  I watched the 1991 televised testimony of Anita Hill.  As a professional and as a woman, I have heard countless stories of sexual violence from woman, men, girls and boys.  I suppose what matters more than my silence now, is joining in with the many voices out there like the young woman who wrote the letter.  She was quoted saying, “This is a reason for all of us to speak even louder.”  And it is.

What is your story?  If you want, tell your story here in whatever way you like. Only this time, we won’t believe that, while the thing that happened is not normal, to talk about it is. It is normal to feel afraid, angry and sad when someone hurts you.  It is normal to tell other people when you are hurt.  It is normal to expose the person who hurt you.

Tami Boehle-Satterfield, MSW, LCSW-C, NBBCH, HTP, a licensed psychotherapist in Boulder Colorado at has challenged herself in 2016 to post weekly about the unpopular topic of abuse. Learn more about Tami at


How do you write about something that people are afraid to see? How to you expose an undermining, but insidious, practice? How do you change peoples’ minds? How does a civilization heal from the wounds of abuse?

The following is courtesy of David Baldwin , licensed Psychologist practicing in Eugene, Oregon.

“Traumatizing experiences shake the foundations of our beliefs about safety, and shatter our assumptions of trust. Because they are so far outside what we would expect, these events provoke reactions that feel strange and “crazy”. Perhaps the most helpful thing I can say here is that even though these reactions are unusual and disturbing, they are typical and expectable. By and large, these are normal responses to abnormal events.

Trauma symptoms are probably adaptive, and originally evolved to help us recognize and avoid other dangerous situations quickly — before it was too late. Sometimes these symptoms resolve within a few days or weeks of a disturbing experience: Not everyone who experiences a traumatic event will develop PTSD. It is when many symptoms persist for weeks or months, or when they are extreme, that professional help may be indicated. On the other hand, if symptoms persist for several months without treatment, then avoidance can become the best available method to cope with the trauma — and this strategy interferes with seeking professional help. Postponing needed intervention for a year or more, and allowing avoidance defenses to develop, could make this work much more difficult.

We create meaning out of the context in which events occur. Consequently, there is always a strong subjective component in people’s responses to traumatic events. This can be seen most clearly in disasters, where a broad cross-section of the population is exposed to objectively the same traumatic experience. Some of the individual differences in susceptibility to PTSD following trauma probably stem from temperament, others from prior history and its effect on this subjectivity.

In the “purest” sense, trauma involves exposure to a life-threatening experience. This fits with its phylogenetic roots in life-or-death issues of survival, and with the involvement of older brain structures (e.g., reptilian or limbic system) in responses to stress and terror. Yet, many individuals exposed to violations by people or institutions they must depend on or trust also show PTSD-like symptoms — even if their abuse was not directly life-threatening. Although the mechanisms of this connection to traumatic symptoms are not well understood, it appears that betrayal by someone on whom you depend for survival (as a child on a parent) may produce consequences similar to those from more obviously life-threatening traumas. Examples include some physically or sexually abused children as well as Vietnam veterans, but monkeys also show a sense of fairness, so our sensitivity to betrayal may not be limited to humans. Experience of betrayal trauma may increase the likelihood of psychogenic amnesia, as compared to fear-based trauma. Forgetting may help maintain necessary attachments (e.g., during childhood), improving chances for survival; if so, this has far-reaching theoretical implications for psychological research. Of course, some traumas include elements of betrayal and fear; perhaps all involve feelings of helplessness.”

Tami Boehle-Satterfield, MSW, LCSW-C, NBBCH, HTP, a licensed psychotherapist in Boulder Colorado at has challenged herself in 2016 to post weekly about the unpopular topic of abuse. Learn more about Tami at


artwork by Natalii Rak

How do you write about something that people are afraid to see? How to you expose an undermining, but insidious, practice? How do you change peoples’ minds? How does a civilization heal from the wounds of abuse?

It might be helpful to understand what a therapist would do to help an adult who is struggling with childhood or adolescent abuse. It might help you understand how you can help or support that person in their healing. And if you are that person who is struggling, sometimes it can be helpful to see a map of the journey you are on.

Treatment for adult survivors of childhood/adolescent sexual abuse first focuses on building a trusting relationship between the therapist and the survivor. In the beginning, the survivor is encouraged to tell their story, which is cathartic, as well as provides the therapist good information for determining the course of treatment and which therapeutic techniques may be the most beneficial.

Telling the “story” can be very difficult. Memories are often fragmented and confusing to the survivor. Telling the story can trigger the experience of the abuse, making it hard for the survivor to begin the telling. Often times, the abuse is so pervasive it can feel like it highjacked the survivor’s whole sense of childhood or adolescence. The therapist can be helpful to provide the survivor parameters and tools in which the survivor can piece their childhood or adolescence together in a way that makes more sense, and can become useful as a foundation for building a new life with structure for intentional living.

With this foundation in place, the therapist can help the survivor safely process the trauma. First by acknowledging that it happened and that it impacted their life in some significant ways. Re-experiencing the trauma with the safety of the therapist allows old feelings associated with the trauma to be expressed and released. This is critical in changing dysfunctional patterns that likely developed as a result of the trauma. Discovering distortions in thinking regarding what happened and who is responsible, is crucial to changing irrational beliefs that may have developed. Irrational beliefs like “I am a bad person,” or “I deserve bad things to happen,”  often lead to expressed or latent anger.

New beliefs, like “I am not a bad person,” or “Things happen that are hard to understand,” allow the anger to be processed and provide feelings of security which allow the survivor to live in the present and not feel confined by the past. These new beliefs coupled with the release of old emotions, allow the survivor to consider self-trust and trusting others. With self-trust, the survivor can embrace the harmed child that resides within them and unify with that child for healing, instead of fighting each other. At this point the therapist can help the survivor clearly distinguish the past from the present, allowing them greater opportunity to create a future-oriented outlook that does not include the experience of the trauma. As the survivor moves forward in their newly created life that includes a new sense of autonomy, the therapist can help the survivor navigate the new experience of actively and intentionally living their current life experience while continuing to discard any remaining distortions that cloud the survivors self-esteem.

That is what a therapist would do. And then, the therapist would celebrate the survivor’s success, deem them as graduated from surviver to thriver, and encourage the thriver to keep living the life they want to live. Now that you know that, you might know better how you could help or support someone who is struggling with childhood or adolescent abuse. And if you are the person who is struggling with childhood or adolescent abuse you might take a look at this map and consider finding a guide to help you in this journey.

Tami Boehle-Satterfield, MSW, LCSW-C, NBBCH, HTP, a licensed psychotherapist at has challenged herself in 2016 to post weekly about the unpopular topic of abuse. Learn more about Tami at


brain facts

How do you write about something that people are afraid to see? How to you expose an undermining, but insidious practice? How do you change peoples’ minds? How does a civilization heal from the wounds of abuse?

Those that suffer abuse are traumatized. Trauma causes a person to reside in the past where the abuse occurred. It is as if time stops, and their minds and bodies are stuck in the pain of the shocking event. In order to attend to the present while still in shock from the past, the traumatized dissociate from their bodies and numb their sensitivity to the physical world about them. For some the disassociation comes as a psychological state, for others it is self-induced through drugs, alcohol, food, sex, and self-injurious behaviors like cutting and burning. Trauma causes people to feel “unreal,” like they are experiencing their life through observation instead of participation. Trauma is a crisis state that can come and go with the onset of fear and pain that may not necessarily seem rational. These raw sensations can cause the traumatized to lash out aggressively, retreat into depression, or remain in a confused state of shock. The experience of trauma is stored in the body. Until the body has processed the painful experience, the traumatized will behave consistently or intermittently, chronically or acutely, as if their very existence is threatened. And for good reason, abuse does terrorize the abused and everybody around the abused.

Do you know someone whose behavior is erratic, irrational, self-destructive? Is it possible that they are struggling to survive the terror of a past or current abuse?

Tami Boehle-Satterfield, MSW, LCSW-C, NBBCH, HTP, a licensed psychotherapist at has challenged herself in 2016 to post weekly about the unpopular topic of abuse. Learn more about Tami at


How do you write about something that people are afraid to see? How to you expose an undermining, but insidious practice? How do you change peoples’ minds? How does a civilization heal from the wounds of abuse?

Every 107 seconds, another sexual assault occurs.

The causality of sexual abuse ripples through our culture. It touches every one of our lives in ways that you may not have noticed. Do you know what your neighbor has endured? Or more importantly how he/she has transubstantiated his/her suffering for a greater purpose? Suppose the sufferings of abuse have not been easy? Suppose the opportunities to transform his/her experience into something greater for his/herself and for other’s has been elusive? What might that mean for your neighbor? What might that mean for you?

Tami Boehle-Satterfield has challenged herself in 2016 to post week about the unpopular topic of abuse. Learn more about Tami at


Although certainly just one of many things contributing to weight gain, I suspect that childhood sexual and emotional abuse can also play a significant role.

Having worked with thousands of seriously ill patients over the last 3 decades, including many women who went through childhood sexual abuse, I’ve seen how many women are left with long-term consequences. For example, I have been left with the impression that some (though of course not all) women who suffered sexual abuse as a child would put on a large amount of weight. This seemed to serve as a form of protection, by making themselves unattractive to whoever was abusing them.

New research suggests a physical mechanism that may be contributing to the weight gain. The study looked at women who have fibromyalgia or osteoarthritis pain. It found that the ones with a history of sexual or emotional abuse as a child had significantly higher levels of the stress hormone cortisol ― despite the abuse having happened in the distant past. One side effect of cortisol levels that are too high is weight gain. Interestingly, the elevated cortisol was not found in women who suffered emotional trauma as a child from being neglected.

Although I need to stress that the study did not report on (or even really significantly discuss) weight gain, the findings of a persistently high cortisol in women who suffered abuse has several important implications:

It may be an important physical contributor to excessive weight gain.
It can explain why it would be physically very difficult to lose weight in these cases.
It opens the possibility that physical and emotional treatments may allow the woman to finally lose the extra weight.

Possible New Treatments

As in most medical conditions, I find that people do best by combining both mind-body and physical support. There is a rather amazing yet very simple treatment called the “Emotional Freedom Technique” which can be very helpful at releasing old emotional traumas. In this simple process, the practitioner guides you through tapping certain acupressure points while you remember the trauma. While doing it, people usually feel the emotional trauma quickly drain away. As a physician, I initially considered it absurd that this technique could work ― until I tried it. The results are nothing short of astounding, and I highly recommend this technique for anyone suffering from phobias or emotional traumas (including abuse or post traumatic stress disorder). As a physician, it has been very humbling to see how many people can be helped by treatments that fall outside of traditional medicine.

The physical treatments that can lower an elevated cortisol include the supplements Phosphatidyl Serine and Ashwaganda. These can be especially helpful if taken before bedtime when insomnia is also present. Otherwise, they can be taken in the morning. Before using this, it makes sense to do so salivary cortisols to see if they are elevated, and if so at what times of day. (Consider seeing a holistic physician to guide you.)

Many of you have suffered severe traumas in your lives. There is cause for hope. It may be time to for you to reach out for help, so you can finally leave the past in the past ― where it belongs.


ShameWorking with shame is one of the most important emotions to process in therapy. So many presenting problems have an additional underlying layer of shame and this is often why clients still struggle with issues even after they seem to be reconciled. As we address the issue, it’s important to differentiate between guilt and shame. When clients feel guilt, they grapple with something they have done and feel remorse about it. They can often work through this by taking responsibility or doing something proactive. They can apologize or make amends in a variety of ways, and this allows them to achieve a satisfying degree of self-forgiveness and healing. However, feeling shame is not about what you’ve done, it’s about who you believe you are as a person. As you can imagine, this is much harder to reconcile when you feel fundamentally damaged, broken, incompetent or bad. This shame-based mindset profoundly influences all of our thoughts, feelings and behavioral choices. All human beings are vulnerable to feeling shame, but this may be even more complicated for men.

Much has been written about the acculturation of boys and the powerful messages they get about what it means to be “a successful man.” Some of these messages include: always be emotionally strong; handle challenges alone and don’t ask for help; avoid being vulnerable; always exude confidence; be clever and know how to solve problems; be responsible for everything; and self-worth is contingent upon your job and how much money you make. Although these messages are inherently unfair to boys and men, when they “fall short” in any of these arenas, it can be very shame inducing. Part of the challenge is rooted in the fact that the messages that create anxiety, self-doubt, depression, anger, grief and shame are the very same messages that evoke bravado and prevent boys and men from seeking the support and help they need in therapy.

When men live with shame, it breaks the bond that makes attachment, intimacy, and closeness in relationships possible. Shame may be masked by grief or anger, and as those emotional layers are peeled away, there is an opportunity to address the deeper shame dynamic that prevents true healing. The problem is really a systemic one. We must move in the direction of normalizing vulnerability in boys, including the right to cry, ask for help, feel fear, seek and give appropriate physical affection, and not have all the answers. Boys need to be supported in pursuing the things they love, letting go of gender-biases about what’s “appropriate” for them to enjoy doing. As adolescents and adults, they need to be encouraged to seek out therapy when they grapple with trauma, abuse, neglect or other painful experiences. Boys and men need to be given the communication skills that will enable them to freely express themselves, strengthening their emotional IQ’s. If we, as a society, can commit to providing these skills and supports throughout childhood, it would go a long way in ending the seeds of shame that get planted in childhood and then take root in adulthood.