Helping Clients to Understand and Overcome Traumatic Reenactment

• Why Do People Reenact Trauma?
• The Reasons Why Clients Deny Having Been Abused
• Basic Grounding Exercise
• Exercise: Discovering Your Triggers

As a psychotherapist who has specialized in working with trauma victims for almost 40 years, I have experienced many clients who are suffering from traumatic reenactments—the phenomena that occurs when people expose themselves to situations reminiscent of an original trauma, placing themselves at emotional risk or in physical danger in a compulsive mimicking of the past. For example, a woman who was physically abused by her father may continually find herself being attracted to abusive men. A man whose mother emotionally abused him may continually become attracted to women who are overly critical toward him. Yet when I attempt to help these clients make the all-important connection between these current reenactments and past trauma I’m often faced with reactions like, “but I didn’t experience any trauma growing up” or “I’ve already dealt with my past abuse, it’s not still affecting me.” Clients tend to minimize, deny, or “forget” their past trauma experiences.   

Why Do People Reenact Trauma?

While reenactments are experienced by many people, those who were traumatized as children (including neglect, abandonment, and abuse) have a tendency to re-enact or relive past trauma more than the average person. Other types of traumas can also create the need to repeat what happened to us as a way of understanding it and bringing closure. This includes acts of nature such as floods, earthquakes, and tornadoes; the death of a loved one; as well as fatal accidents. Several theories have been suggested to explain the phenomenon of traumatic reenactments.

• Many experts understand reenactments as an attempt to achieving mastery. This means that a traumatized individual reenacts a trauma in order to remember, assimilate, integrate, understand, and heal from the traumatic experience. (1)
• Some experts perceive reenactments as spontaneous behavioral repetitions of past traumatic events that have never been verbalized or even remembered. For example, Freud noted that individuals who do not remember past traumatic events are “obliged to repeat the repressed material as a contemporary experience instead of … remembering it as something belonging in the past.” (2)
• Others suggest that reenactments result from the psychological vulnerabilities characteristic of trauma survivors. For example, as a result of a range of ego deficits and poor coping strategies, trauma survivors can become easy prey for victimizers. (3)   

Ongoing reenactments usually indicate that a former victim is emotionally stuck and can be interpreted as a “call for help.” They are attempting to work through some aspect of past trauma by repeating it with another person, hoping that this time the result will be different.

We don’t consciously and deliberately set out to repeat a parent’s behavior, get involved with a replica of an abusive or neglectful caregiver, or repeat a trauma over and over. These are unconscious actions on our part. Sigmund Freud stated that such unconscious processes may affect a person’s behavior even though he or she cannot report on them. For example, Freud and his followers believed that dreams and slips of the tongue were really concealed examples of unconscious content too threatening to be confronted directly. Reenactments can be seen as this type of unconscious behavior.

In addition to Freud’s concept of reenactments being a need to repeat the past in order to get a different result, I would add that reenactments are often an unconscious need for people to understand what happened to them and why. Those who are caught up in reenactments are often troubled (consciously and unconsciously) by events that occurred in their past. Some are confused about why people treated them the way they did. Others blame themselves. Still others are in denial about these events. They are overwhelmed by emotions such as shame, anger, fear, and pain, emotions that are often suppressed or repressed. All this confusion and denial work together on an unconscious level, causing them to reenact troubling events in an effort to gain understanding and closure. For example, a girl whose father abandoned her will likely be preoccupied with discovering why he did so and may blame herself in some way. As an adult, this will likely affect her relationships with men, causing her to both doubt her ability to keep a man interested in her and to be attracted to unavailable men.   

Reenactments often lead to re-victimization and with it, related feelings of shame, helplessness, and hopelessness. For example, it has been found that women who were sexually abused as children are more likely to be sexually or physically abused in their marriages. Therefore, gaining an understanding and control of reenactments is a primary way to avoid further re-victimization and shaming.

The Reasons Why Clients Deny Having Been Abused

Even though they may suffer from reenactments, some people insist they have not suffered from trauma or are not sure whether they have or not. The reasons for this are many.

Denial and Minimization

Many people don’t label their experiences as traumatic, even when they are. Others minimize the damage an event or series of events had on them. In fact, the majority of trauma victims tend to deny or minimize traumatic experiences. As humans, we will do almost anything to avoid facing the feelings surrounding being traumatized, feelings such as fear, pain, shame, and anger. One of the best ways to avoid such emotions is to deny that the trauma ever happened. For example, even if a client is able to admit to himself that he was physically abused by his father, he may still be in denial about various aspects of the abuse. He may have convinced himself that “it wasn’t all that bad,” (minimization) or that his father didn’t mean to harm him (rationalization). In the case of a client having been sexually abused they may have even convinced themselves that it wasn’t actually abuse because they enjoyed it or because they believe they were the one who initiated it (denial). 

Denial is a powerful, unconscious defense mechanism intended to protect us from having to face intense pain and trauma. It can even allow us to block out or “forget” intense pain caused by emotional or physical trauma such as childhood abuse. The denial process is designed to prevent us from facing things that are too painful to face at the time. But it also defends us against the truth and can continue way past the time when it served a positive function.

Former victims of child abuse often deny that they were abused, deny that it caused them any harm, and deny that they need help. The following are the most common reasons why victims of child abuse tend to deny what happened to them and/or minimize the damage it caused them:  

• They don’t want to feel the pain, fear, betrayal, and shame that acknowledging the abuse would cause them to feel. The abuse is either walled off from conscious awareness and memory, so that it did not really happen; or it is minimized, rationalized, and excused, so that whatever did happen was not really abuse. Unable to escape or alter the unbearable reality that they were abused, some children alter it in their mind.
• They don’t want to admit that they were a helpless victim. It can be humiliating and degrading to acknowledge that another person can overpower you or have control over you. Instead of admitting either of these two things, victims often prefer to take responsibility for the abuse. This is especially true of male victims since males are raised to be tough and strong and to always defend themselves.
• They don’t want to admit that someone they cared about could harm them and cause them damage. For those who were abused by a family member, a close friend of the family, or an authority figure they respected such as a priest, a teacher, or a coach, to face the fact that they were abused is to experience the sometimes unbearable pain of admitting that someone they respected or loved could treat them in such horrendous ways. The most common way for children to explain behavior on an abuser’s part, especially if it is someone they respect or love, is for them to blame themselves.
• Another reason some former victims deny that they were ever abused is that they repeated the cycle of abuse by abusing other children. In this situation they may have an investment in believing that parents have a right to discipline their children, even if it causes physical harm. Those who were sexually abused often convince themselves that children are never really “forced or manipulated” into sex with an adult or older child, but they do so willingly and that they get pleasure from doing it. This kind of denial not only keeps former victims from admitting that they themselves were abused but that they became abusive.   

Repression vs Suppression

Repression (unconsciously blocking out traumatic events) and suppression (consciously choosing to “forget” traumatic events) are survival skills that help former victims of trauma to move on with their lives instead of being so completely overwhelmed with feelings of fear, shame, or guilt that they can’t function. Unfortunately, these defense mechanisms can make it difficult for clients to allow themselves to remember and process a trauma.

Painful feelings and memories can be very upsetting. Instead of facing them, clients often unconsciously hide them from themselves in hopes of forgetting about them. That does not mean that the memories disappear entirely. They can influence behaviors and can impact our relationships without us realizing it. Most important, repressed memories can show up in our lives in the form of reenactments.

It can be especially painful for clients to admit that someone they loved, and who they believe loved them, could traumatize them by being abusive or neglectful. Sometimes, instead of facing the truth they consciously suppress the memories of what happened. This was the case with my client Chloe:

“It’s not like I ever forgot about the sexual abuse. I just chose to lock it away and throw away the key. I couldn’t handle the fact that my own father, who I loved dearly and who was the only person in my childhood who was kind to me, could harm me in that way—could be so selfish to put his own needs ahead of mine like that.”

Dissociation

Another reason a client may have no memories or only vague memories of a trauma is the common practice of victims to dissociate. Some victims dissociated, while others were traumatized so severely that they lost all memory of the attack—much like car accident victims often experience amnesia after the crash (repression).

According to the Diagnostic and Statistical Manual of Mental Disorders 5th edition, dissociation is a “disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, perception, body representation, motor control and behavior.” Dissociation is a normal phenomenon that everyone has experienced. Examples of mild dissociation include daydreaming, “highway hypnosis,” or “getting lost” in a book or movie, all of which involve “losing touch” with an awareness of one’s immediate surroundings. 

During traumatic experience such as crime victimization, abuse, accidents, or other disasters, dissociation can help a person tolerate what might otherwise be too difficult to bear. In situations like these the person may dissociate (detach or disconnect) from the memory of the places, circumstances, and feelings surrounding the overwhelming event, thus mentally escaping from the fear, pain, shame and horror.

When faced with an overwhelming situation from which there is no physical escape, a child may learn to “go away” in their mind. Children typically use this ability as a defense against physical and emotional pain or fear of that pain. By the process of dissociation, thoughts, feelings, memories and perceptions of the trauma can be separated off in the mind. This allows the child to function normally.   

For example, when a child is being sexually abused, in order to protect themselves from the repeated invasion of their deepest inner self they may turn off the connection between their mind and body creating the sensation of “leaving one’s body.” This common defense mechanism helps the victim to survive the assault by numbing themselves or otherwise separating themselves from the trauma occurring to the body. In this way, although the child’s body is being violated, the child does not have to actually “feel” what is happening. Many victims have described this situation as “being up on the ceiling, looking down on my own body” as the abuse occurred. It is as though the abuse is not happening to them but just to their body.

While dissociation helps the victim to survive the violation, it can make it difficult to later remember the details of the experience. And it can make it difficult for a victim to come to terms with whether or not they were actually abused. If someone was not in their body when the abuse occurred, it will naturally affect their memory. For example, in the case of sexual abuse, if the person doesn’t “remember” the physical sensations of what the abuser did to their body or what they made to do to the abuser’s body, it can cause them to doubt their memory and add to their tendency to deny what occurred.

Tragically, ongoing traumatic events such as abuse are often not one-time events. For those who are repeatedly exposed to abuse or neglect, especially in childhood, dissociation is an extremely effective coping mechanism or skill. However, it can become a double-edged sword. While it can protect clients from awareness of pain in the short-run, a person who dissociates often may find that in the long-run his or her sense of personal history and identity is affected.

Grounding is a very effective practice to teach clients to help them come out of this dissociative state.

Basic Grounding Exercise

• Find a quiet place where you will not be disturbed or distracted.
• Sit up in a chair or on the couch. Put your feet flat on the ground. If you are wearing shoes with heels you will need to take your shoes off so that you can have your feet flat on the ground.
• With your eyes open, take a few deep breaths. Turn your attention once again to feeling the ground under your feet. Continue your breathing and feeling your feet flat on the ground throughout the exercise.
• Now, as you continue breathing, clear your eyes and take a look around the room. As you slowly scan the room, notice the colors, shapes, and textures of the objects in the room. If you’d like, scan your eyes around the room moving your neck so you can see a wider view.
• Bring your focus back to feeling the ground under your feet as you continue to breathe and to notice the different colors, textures and shape of the objects in the room.
• This grounding exercise will serve several purposes:
• It brings awareness back to the body, which in turn can prevent being triggered or dissociating.
• It brings us back to the present, to the here and now; again, a good thing when being catapulted back into the past by a memory or a trigger.
• Deliberately focusing the attention outside yourself by being visually involved in the world helps bring a person out of a dissociative state and into reality where they can get in touch with their emotions and their memory.  

Dissociative Amnesia  

Dissociative amnesia is the inability to recall autobiographical information. For example, Betrayal Trauma Theory holds that for incest survivors, dissociative amnesia serves to maintain connection with an attachment figure by excluding knowledge of the abuse (betrayal blindness). This, in turn, reduces or eliminates anxiety about the abuse, at least in the short run.

Betrayal Trauma Theory is based on attachment theory and is consistent with the view that it is adaptive to block from awareness most or all information about abuse (particularly incest) committed by a caregiver. Otherwise, awareness of the abuse would acknowledge the fact that a betrayal occurred, and this acknowledgement would likely endanger the attachment relationship. Betrayal blindness can be viewed as an adaptive reaction to a threat to the attachment relationship with the abuser and thus explains the underlying dissociative amnesia in survivors of incest. Under these circumstances, survivors often are unaware that they were abused, or will justify, or even blame themselves for the abuse. In severe cases, victims often have little or no memory of the abuse or complete betrayal blindness. Under such conditions, dissociation is functional for the victim, at least for a time. (4)  

Due to dissociation, dissociative amnesia or betrayal blindness, someone experiencing reenactments may have to trust the fact that they wouldn’t have the symptoms they have and wouldn’t have the deep sense that “something happened” unless they actually experienced a trauma. Other times some education can help clients to come out of denial:

The Lack of Specific Memories  

The lack of specific memories can cause former victims to question their sense that something happened to them and even the flashes of memory that they do experience. Let’s compare this lack of specific memories with what often happens when someone has been in a traumatic car accident. Let’s say that you wake up to find yourself in the hospital. You notice that one of your arms is in a sling and that one of your legs is in a cast and that you have cuts and bruises all over your body. There’s no one around and you feel panicked, thinking, “what happened to me?”

Then someone you know comes into your hospital room and tells you that you were in a horrible car accident. You feel shocked because you have absolutely no memory of it. Not only that, but you can’t remember anything just before the accident. Just because you have no memory of the accident doesn’t mean that it didn’t happen, right? You have the broken bones and the bruises to prove it.

The same is true of childhood abuse. A client may not have any memories, but they have the results of the abuse as proof that it actually did happen. They have nightmares, flashbacks, and triggers, and they have self-destructive behaviors. If they were neglected or emotionally abused they may have low self-esteem, a tendency to be self-critical, or a tendency to push people away or, conversely, a fear of abandonment. If they were physically abused, they may have a tendency to be defensive or have rigid posture and a startled reaction when someone comes up behind them. They may have the habit of gritting their teeth, or tension in their jaw from all the repressed anger they are holding. In the case of child sexual abuse, they may have the unexplained pain in their vagina or anus, a negative reaction to being touched on certain parts of their body, powerful reactions when they see a movie about someone being raped or about a child being molested. Certain types of sexual acts or positions, or certain kinds of touches may repulse them, or they may dissociate when they are around certain people, places and things. These are, in essence, their “memories.”

The bottom line is that a client may never have actual “memories” in the sense of being able to “remember” or “recall” actual events. But that doesn’t mean they weren’t abused. Many of the clients I have worked with who do not have tangible memories have other indicators that they were abused. Some have flashbacks, others have what are called “body memories.” Those who were physically abused often have pain in the places where they were beaten, such as their back and buttocks. They often have a “startle reaction” when someone raises their hand in front of them due to the fact that they were slapped or hit in the head so often.

Those who were sexually abused can have pain in their genitals, anus, or breasts for no apparent (or medical) reasons and vaginismus (involuntary contractions of the vaginal muscles preventing penetration or making penetration extremely painful). Still others have such tell-tale symptoms as being repulsed by thoughts of sex, a fear of sex, an inability or repulsion to being touched, obsessive rape fantasies (either of someone forcing sex on you or you forcing yourself on someone else), or sexual addictions.

A Real Compulsion

It is important to understand that traumatized people experience a true compulsion to repeat repressed experiences. Even if the person attempts to keep the memory repressed, there is an opposing need on the part of the psyche to force the repressed material into consciousness. Thus, the repressed and dissociated events emerge to be re-experienced, often in dreams and nightmares (during sleep when conscious control must be let go), and then in waking hours as well. Clinical experience suggests that the compulsion to repeat takes on an almost biologic urgency, such as our need to urinate. We can hold our urine for only so long.

Examples of the Emergence of Repressed and Dissociated Experiences

Flashbacks are the most striking examples of repressed and dissociated trauma, and are frequently observed in clients with posttraumatic disorder, and some dissociative disorders. Flashbacks are involuntary recurrent memories in which an individual has a sudden, usually powerful, re-experiencing of part of a trauma or elements of a past trauma. These experiences are often frightening, catapulting the person back in time.   

Those who are experiencing flashbacks are thrust back into the traumatic events both in their dreams and while awake. The reliving of the trauma is experienced as a real and current event. The traumatized person does not feel as if they are remembering the experience but instead, they feel the experience in the present. When someone is experiencing a flashback, they often lose awareness of their surroundings and are thrust back into the trauma, visualizing previous surroundings and people, and feeling they are the same age as when the trauma originally occurred. This points to the ability of the psych to repress and dissociate overwhelming experiences, as well as to bring them back into consciousness with full force.  

Implicit Memories 
Trauma “memories” often manifest in intense physical, perceptual, and emotional reactions to everyday occurrences and objects (triggers). These emotional and physical responses, called “implicit memories,” keep bringing the trauma alive in a former victim’s body and emotions again and again, often many times a day. Their bodies tense up, their hearts pound, they see horrifying images, and they feel fear, pain or rage. They freeze in fear or feel a sudden wave of painful shame and lose the capacity to speak. They feel an intense impulse to run away and hide from others.

Decades of research on the effects of trauma confirm that overwhelming experiences are less likely to be recalled as a series of images that we can describe or in a clear coherent narrative. Trauma is more likely to be remembered in the form of sensory elements without words—emotions, body sensations, changes in breathing or heart rate, tensing, bracing, collapsing, or just feeling overwhelmed. (5) When implicit memories are evoked by triggers, we re-experience the sense of threat, danger, humiliation or impulses to flee that we experienced at the moment of threat—even if we have no conscious verbal memory of what happened.   

Those who insist that they do not remember any trauma often don’t realize that they are, in fact, remembering when they suddenly feel startled or afraid, when they feel shame or self-hatred, or when they start to tremble or shake. Because trauma is remembered emotionally and somatically more than it is remembered in a narrative form that can be expressed verbally, former victims often feel confused, overwhelmed or crazy. Without a memory of words or pictures, they do not recognize that what they are feeling is memory.

Most people also do not realize that we remember in different ways. With the thinking brain we can remember the story of what happened but without a lot of emotion connected to it. With our sensory systems we can remember how something felt. Our bodies might remember the impulses and movements and the physical sensations (tightening, trembling, sinking feelings) experienced at the time.

For example, many former victims feel uncomfortable stating that they were sexually abused because they do not remember whole events. Their memories are fragmented or unclear or consist of a few images, rather than an entire mental video of the events. They doubt themselves and think, “it can’t be true because I don’t remember exactly what happened” or “I must be making this up or I would remember more clearly.” But it is important to explain to clients that trauma cannot be remembered the same way other events are recalled because of the effects trauma has on the brain. When clients feel the impulse to doubt their memory or intuition that something happened to them, remind them that recalling events as a story or narrative is not the only way to remember. They may be remembering a lot more than they think.

Triggers

Your clients may feel surprised to learn how much they remember when they include the feelings, thoughts and physical reactions they experienced when triggered. Generally, a trigger can be defined as any stimulus that causes a reaction, often an emotional response such as anxiety, sadness, panic, feeling overwhelmed, flashbacks, nightmares, or severe emotional distress. A trigger is sufficiently reminiscent of a past event or process that it activates implicit (feelings, sensations, and nonverbal thoughts) or explicit (the what, when, and where of remembered events) memories in the present.   

Types of triggers 
There are various types of triggers, including:

• Sensory: sounds, smells, textures, or physical sensations
• Time-related: certain times of day or seasons
• People or places: people or places that remind them of a negative experience
• Bodily sensations: pain or touch that reminds them of a negative experience
• Substance-related: cravings or urges to use substances

Clients may also feel surprised to learn that there is an explanation for their seeming “overreaction” to certain things. For example, maybe they aren’t an “angry person,” but are simply experiencing feeling memories of anger that have been triggered when someone is selfish, controlling, or domineering.   

Exercise: Discovering Your Triggers

My aim, in part, of writing this article is to help those of you fellow therapists who have clients who can’t make the connection between their past trauma and their current negative patterns of behavior either due to lack of memory, denial or minimization.

The following exercises and lists can help your clients discover their triggers:  

• Begin by asking your clients to notice the events, sensory experiences, or people that tend to trigger them (catapult them into the past, remind them of an abuse experience or some aspect of an abuse experience). For example: those who were traumatized by parental abandonment may become triggered every time a friend doesn’t respond to a phone call or text or every time their partner goes away on a business trip.
• Next, ask them to begin making a list of these triggers.
• As time goes by ask your clients if they see patterns regarding the things that trigger them.  

Triggers List 

The following is an extensive list of triggers common for those who were traumatized by child abuse, abandonment, and/or neglect. Sharing this list with your clients and asking them to put a check mark next to the items that trigger them will help them become familiar with their triggers and in turn help them make the connection between their past trauma and their present reenactments.
 

• Feeling abandoned or rejected
• The sound of someone crying
• Criticism
• Someone being very angry
• Someone saying mean or abusive things to you
• Someone yelling at you
• Someone raising their hand or fist near you
• Someone threatening to hurt you
• Mean or dirty looks
• Seeing violence on TV, at the movies, or on the Internet
• People in authority
• Competition
• Being lied to
• Someone acting like they are better than you
• Someone who reminds you of your mother
• Someone who reminds you of your father
• Being let down by someone
• Being laughed at
• Being accused of something you didn’t do
• Being ignored
• Feeling alone  

Remind your clients that their symptoms and triggers are their memories. This is what my client Briana figured out after reading the triggers list from above: 

 “I was shocked to realize how many triggers I experience, almost daily. In some cases, I had been aware that some situations were upsetting for me, but in other cases I was completely surprised when I realized I was being triggered. For example, I’d been aware for a long time that I had abandonment issues due to my mother leaving me all alone with our father. I hated to be alone, and I always reacted strongly when my Dad went somewhere for any period of time. But I had blocked out the memory of what it was like before my mother left me.

When I read “the sound of someone crying,” on the trigger list, I became really upset. I suddenly realized it had always been a trigger for me, and I understood why. I suddenly remembered my mother crying for hours, almost every night. I’d completely blocked that out. Suddenly I not only remembered her crying but the reason she was crying. I remembered hearing my father yelling at her, accusing her of being unfaithful, of being a horrible mother, telling her I would be better off without her. That simple realization and the memory of how often I am triggered by hearing someone cry made it all so clear. My mother left me because she believed what my father had told her. Suddenly it all made sense.

“For years I’ve been reenacting the fact that my mother abandoned me. I always chose men who ended up leaving me or I would push men away who loved me, out of fear that they would abandon me. I knew on some level that it had to do with my mother’s abandoning me. But even knowing that didn’t stop me from behaving the same way. I’d always questioned how my mother could have done such a horrible thing. And I always blamed myself in some way. I assumed that I wasn’t loveable—that my mother couldn’t love me because I was such a bad kid. I acted out a lot as a kid, missing school, getting into trouble at school, that kind of thing. I assumed she left to get away from me, away from all the trouble I was causing.

“But remembering my parents’ constant fighting, and the horrible accusations my father threw at my mother explained it all to me. I knew how it felt to have him throw out accusations like that—he did the same to me all the time. And I knew how hard it was not to believe what he said. I could see how my mother had taken it all in and had come to believe that in fact, I would be better off without her. It wasn’t my fault at all. And it some ways it wasn’t hers’ either. It was my Dad’s emotional abuse that caused her to leave.”   

Often, as it was in Briana’s case, what triggers your clients the most could be pointing towards what needs healing. Flashbacks can be messengers reminding us of what happened to us. In that way they should be considered our friends. They help us become aware of memories and feelings we have buried. In Briana’s situation, her reenactments had been due to her mother’s abandonment but more specifically her need to understand why her mother had abandoned her. Once she remembered why her mother left her, she no longer blamed herself and no longer needed to punish herself. She no longer needed to reenact the trauma of abandonment.

***

Hopefully, the information and exercises offered in this article can assist you in helping your clients determine whether they were, indeed, traumatized as a child or adolescent due to the abuse, abandonment or neglect they experienced and why they may be reenacting that trauma.

References

(1) Miller, A. (1984). Thou Shalt Not Be Aware. Meridian.

(2) Freud, S. (1961). Beyond the Pleasure Principle. Norton.

(3) Herman, J.L. (1992). Trauma and Recovery. Basic Books.

(4) Freyd, J. (1998). Betrayal Trauma: The Logic of Forgetting Childhood Abuse. Harvard University Press.

(5) Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the Body: A Sensorimotor Approach to Psychotherapy. W.W. Norton.   

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