Daniel A. Bochner, Ph.D.

Psychologists are always talking about "inner conflicts." Why is that? Well, certainly "inner conflicts" can't have anything to do with a disorder that arises due to trauma. Right?... Nooooo, wrooonng!!! Post-traumatic stress disorder (also known as PTSD) is, believe it or not, also caused by an inner conflict. The inner conflict of PTSD, however, is not borne from a troubled past or conflicted feelings about right and wrong. Those kinds of issues can exacerbate PTSD, sure, but they are not what causes it. PTSD is actually caused by a conflict between two essential biological imperatives. These imperatives are at the core of health and development. The first is the avoidance of pain. The second is the integration of experience.

It should come as no surprise that we avoid pain. It is obvious that we humans, just like all animals, survive largely because we do avoid pain. Most organisms move away from physical pain instinctively. The instinctual first cry of birth is an impulse to have some kind of tension or discomfort soothed, whether it be the actual pain of being born, the first pangs of hunger, or the first experience of terror. We then move on to cry for comfort of all kinds, which is not just avoiding pain, but is also deeply involved in connecting to others. And of course, from the earliest ages, although we might reach out to touch the glowing embers of the fire or the red hot burner on the stove, our first burn teaches us a clear respect for anything with a yellow, red, or orange glow.

Trauma is, by definition, out of the ordinary, extremely painful, experience. Sometimes severe physical pain is involved, but often the most horrendously damaging aspects of a traumatic experience involve the impact it has on others whom we love or for whom we feel responsible, or our feeling that we might be to blame for the trauma. Emotional pain is somewhat different than physical pain. Nevertheless, the impact of emotional pain is every bit as powerful as physical pain in traumatic experiences. Just like any other kinds of pain, it is natural that we avoid all the different kinds of pain involved in trauma, including both the physical and the emotional aspects. Avoiding emotional pain is at the core of PTSD.

The second primary factor involved in PTSD, the integration of our ongoing experience, is just as essential for living as the avoidance of pain. Life has little meaning without the ability to remember what we've been through, or who we know, or where we've been. Our earliest experiences, perhaps by design, are especially difficult to integrate. Maybe that is one of the reasons that being born is not especially traumatic (from the viewpoint that it is not recalled repeatedly with horror). At that point we have not yet integrated any of our experiences. As we develop, however, our ability to recognize our closest caregivers, to know how best to get their attention, and to steer clear of physically painful objects grows in importance. Soon, our understanding of everything we perceive gets organized for the specific purpose of helping us manage our ongoing functioning in the most efficient manner possible.

Trauma is especially chaotic experience that defies logical understanding and thus is especially difficult to integrate. Although we typically expect to be able to avoid disasters, traumatic experience brings into question our ability to avoid accidents or painful experience. Thus, we don't want to integrate traumatic experience because doing so requires us to admit that we might be in danger that is unavoidable. Not only are many accidents unavoidable, but we also would like to remain in denial about how true it is that we are taking chances on a daily basis. Our desire to deny the possibility of danger, even when it might be avoidable, makes it difficult to integrate trauma in that doing so requires us to realize how dangerous things are. When we're making ourselves vulnerable in some way, we're typically in denial of the danger we're in. For example, we operate motor vehicles so frequently that we forget how ludicrous it is to believe that it's safe to hurtle ourselves at 60 mph in a metal box on wheels, and to expect our vehicle will never malfunction, and to expect that we ourselves will never malfunction, and to expect that all the other drivers will follow all the rules...

For the complete article, please buy The Emotional Toolbox book.