I treat children for sexual abuse.

It is not so much a task of erasing memories, but of diffusing them; decreasing the impact and diminishing the power of the symptoms of trauma. Helping kids sort and put fragments into drawers and compartments and teaching them how to manage how the trauma; the triggers and hypervigilance are now a part of their life.

I often compare it to having to carry a bowling ball with you for the rest of your life. If you were to say, carry it in your right hand forever your back would likely develop scoliosis. Your shoulder, wrist and elbow joints would deteriorate and hurt and your balance would forever be compromised. Your body would have to adjust to live around the trauma. People would frequently walk up to you and say “Hey, what’s with that bowling ball?” because based on your crippled appearance everyone could see that it had taken over your life.  And every time you looked down, there it would be, right in front of you, dangling and pulling at you…a reminder. The worst part would be that only half of you, one arm, one hand would be free to touch and feel the world.

But if you were to get an ergonomic backpack and center the ball in the pack, your legs and back and body would be in balance and you would develop healthy muscles to carry it. As the days went by, the ball would seem lighter and lighter till you hardly noticed its heft any longer. No one could see it or really know it even existed unless they asked what was in the pack and you chose to tell them. Best of all, both arms would be free to embrace all the world has to offer.

The trauma, well it would have to take a backseat to your life.

That is the sweet spot I hunt for, that nesting of the ball in the pack. A purveyor of backpacks I am.

But it works. Yeah, we struggle sometimes to get it in there, and you will always have those few who insist they want to carry it out in front and sometimes hit others in the head with it for various reasons. But most folks, most want to find that place to put it and move on with their lives.

But the thing about trauma is that it is a developmental, organic process; it is ever changing as we move through the rest of our lives. We can’t just zip it away and never take it out again. At various points we must in fact stop and take it back out, re-examine it, see how it fits in our pack now and maybe make adjustments to the pack. Often, this happens when we are having trouble fitting through a new doorway; it seems our pack keeps getting us stuck or is preventing our passage. That is when we have to take the ball out and rearrange things.

When I see kids, I always tell the parents that their child will likely need therapy over the course of his or her life. This is not to be mistaken with “a lifetime of therapy.” Simply put, it means something different cognitively, to have a history of sexual abuse when you are 5, than when you are 12, than when you are starting to date, get married, or have kids of your own. The triggers change right along with life stage and distance from the event. As the train moves, we see new scenery, simple as that. Therefore our posture must change as one incorporates the trauma emotionally into each stage and we  must rearrange the pack.

Small doses of the therapy at stop-points long the way are the ticket to a healthy life, a life where the cancer lives around you, not you around it. Despite a parent pleading me to take my big eraser out of the drawer and make their child forget, bowling balls can’t be erased. But many, many things can be done to manage how they create havoc in your life and to make them less heavy. The first step is seeing what triggers it and managing that; the tricky part is that the triggers change and have many levels to them.

You gals know where I am going with this, so I will go ahead and preach to the cancer choir. The trauma (and PTSD symptoms) of breast cancer are something we will carry with us for the rest of our hopefully very, very long lives. When we are first handed our special edition awareness version of the pink bowling ball, we bitch about how damn heavy it is and protest that there must be a mistake, surely this big ugly cumbersome thing this doesn’t belong to us. We are dying (not literally of course) to finish treatment and put it down. And then, there is that moment when we realize this sucker is with us for life and that scares the crap out of us as we wonder how in the heck we will manage this huge thing from here on in.

Better learn how to understand it and manage it punkin, the rest of your long, long life will be a whole lot happier. And a whole lot less about cancer.

~~~~~

A few weeks ago, someone asked me about my triggers with PTSD and breast cancer. As my response meandered, I had the Aha! moment where I realized that the triggers that were the THE TRIGGERS were no longer THE TRIGGERS. New ones had come out of hiding of late and had taken their place. After five years, I think I suddenly had time to consider the other things I hadn’t noticed that were elements of the trauma. The deeper layers and textures, more elusive to recognize at first, that contributed equally to what scared me, what haunted me, again and again.

See, I used to get freaked out by the obvious; hospitals and thigh cancer and hearing about women who didn’t make it. Sure these things still bother me (but not as much any more) yet suddenly a secondary layer of triggers emerged; events from the shadows of that time.

One of the million elements of the original trigger stepped forward and said, “Notice me.”

~~~~~

A while back, I was torturing myself by watching the most Chock Full of Triggers for a Cancer Patient Movie of All Time, 50/50; a true horror movie for residents of Cancerland. As I watched, the panic internally mounted as the normal garden variety triggers poked their sharp sticks at me; the hair loss and buzz of the razor on your bald head, the chemo barcaloungers, and the days you arrived at treatment and your chemo buddy was quietly gone. But all of the sudden a scene popped up, startling me and shoving me into the abyss….the moment when the main character goes to chemo alone and afterward was standing outside alone, waiting for his ride that never showed.

I had many dark days after that movie; sorting the new muck out.

See, if I had watched this movie five years ago, this little snippet, this scene would have gone unnoticed but now, further along in my development/emotional life after cancer….it got me. This little part of cancer now had the time and space needed to demand the attention it deserved. This, was a new development.

Going through cancer solo had really traumatized me in ways I never knew until now. Yet at the time, I brushed it off to tend to the more pressing issues of dying and wigs and scared kids. Now, I suddenly began to realize that much of my current dread of rechecks and blood draws and mammograms and it coming back had more to do with the going to it alone part poking at and awakening a tender, unresolved place than with cancer. See, I’ve gotten relatively used to the “cancer” part, but am just now realizing how horrifying it was to not have a hand to hold during the cancer part and really to help me hold the ball, even now. Now, seeing others with supportive spouses and teams of people surrounding them when they are diagnosed triggers something deep and sad in me, and it is not pleasant.

~~~~~

Cancer has deep roots.

Cheesy yes, but allow me the metaphor of comparing trauma life to a flower growing. At first there is this tiny seed; neat and tidy, encapsulated and manageable. You feel very sure of its heft and potential as it appears. But you plant it and it begins to grow; green, fresh, tiny leaves emerge and you deal with those. At times it may start to wither but then a flood comes, maybe a little fertilizer (and we all know what that is) triggering a sudden growth spurt and new things appear quickly. Some parts get pruned away, some wither and find a natural death and some stay and grow strong. Then the flower blooms and suddenly, there is so much more to incorporate sensually; smells and colors and nuances you never knew were there when that tiny seed sat nestled in your palm. Lastly, it drops it’s seeds and it starts again.

The evolution of our emotional lives after cancer can be seen as a good and normal and cyclical thing if we accept it. PTSD can be managed. It doesn’t necessarily get bigger, it just changes and we must be open to that reality. As we progress along the developmental trajectory of cancer, we are not static. We only become static when we take the ball out and our fingers get stuck in it; the metaphorical equivalent of arrested development.

Emotional triggers will grow and die, grow and die. Cancer blooms and re-blooms through our triggers. We simply must take each new thing and find a place for it in our pack. Then we must heft it up, take a swig of water and a deep breath, and get on our way our way to the rest of our lives; arms outstretched and ready to embrace life, clearing that next doorway with room to spare.

It’s not the load that breaks you down, it’s the way you carry it.
— Lena Horne