Sometimes poorly managed yet surmountable traumas leave behind unnecessary drama and damage. All people experience mini-injuries, misunderstandings, or hurt feelings. Bruno Bettelheim described “good enough” parents as consistently loving and caring for their children so that they feel safe. A good enough parent is thoughtful enough to create an emotional refuge on a regular basis.
When they make mistakes, which are 100 percent guaranteed and unavoidable, they make it up to the child by apologizing, physically holding them, and emotionally restraining them. These repairs ensure that the child feels safe and secure, and can recover from many life wounds. The aftermath of the injury is therefore important when we are dealing with cumulative, repetitive pain or a single injury.
Trauma aftermath of ‘Not good enough’
Here is my story of a “not good enough” trauma aftermath.
When I was four years old, my parents took me to the emergency room at midnight for the fourth time in two weeks because of a ruptured abscess on my abdomen caused by infected mosquito bites. They itched and I scratched myself mercilessly until I drew blood.
The doctors drained, cleaned and bandaged the wound, and then advised my mother to contact our pediatrician. My mother took me to the pediatrician. No one bothered to explain that the infection was raging and a new procedure was necessary.
Although I was scared, Dr. Roseman was a nice man who always gave us a lollipop when we left his office. That day the doctor looked strange, masked and gloved. He approached me with a pair of long, skinny scissors, and within seconds he began piercing and snipping away at the giant pimple. Cut and squeeze. I screamed. The incident left a physical scar and an even deeper emotional pain from the shock of not knowing what happened. Plus, afterward, I was on my own to process and metabolize big, scary, overwhelming feelings.
I had not yet understood that my late parents were traumatized Holocaust survivors whose lives were filled with expectations of loss and destruction. Because they were overwhelmed by fear of impending doom, they were incapable of effective parenting when their child was physically ill or injured. How do you care for someone else in survival mode? They were frozen in trauma mode and remained oblivious. They didn’t realize how traumatizing the mosquito treatment experience was for me, so in this case they abandoned me. They did not exhibit the “good enough” parental behavior necessary to limit its harmful effects. They simply had no contact anymore and were not attuned to each other.
I had an even worse experience when I was two years old, and the traumatic memory is seared into my memory. My entire family was on a rare vacation at a bungalow colony in the Borscht-belt Catskills. I remember going into the nurse’s “office” – a claustrophobic space. She told me to lie face down on the table. I remember the white paper groaning beneath me. Despite accusations and warnings, I had drawn blood from the mosquito bite on my cheek, which I couldn’t stop scratching. I knew this visit to the infirmary had something to do with the area that was starting to hurt.
I was alone. My parents’ unmarried friend, a Holocaust survivor with no family, whom we called “Uncle Leo,” was waiting outside. I’ll never forget the nurse approaching me with a steaming metal iron. With one hand she pulled down my cotton underwear. Out of the corner of my eye, through my streaming tears, I could see the iron approaching. I felt the tip of the hot iron searing my flesh. I was shocked beyond pain! Restrained and immobilized, I cried and screamed in a deafening silence as the tip of the searing iron landed on my sensitive baby bottom. My heart pounded wildly as the sadistic nurse nonchalantly applied a gauze bandage.
I remember feeling both fear and disbelief. Uncle Leo didn’t ask any questions, but gently took my hand as I left the small room. I suppose his silence confirmed that the incident wasn’t something to talk about. However, I was too young to regulate my emotions effectively. I must have experienced absolute terror alone and in silence. I may have been on high alert and watchful, with cortisol and adrenaline coursing through my veins.
Physical and emotional healing
What makes abuse traumatic for a child? What distinguishes physical and emotional healing?
The body heals a wound automatically, outside of consciousness. When I’m physically injured, electrical impulses travel through the nervous system to the brain, recognizing the pain and sending signals to the body: “Hey, this needs attention.” In response, a battalion of leukocytes, clotting factors, and collagen fibers is called to the site and ordered to gather around the injury to stop bleeding, repel invaders such as germs, and heal the wound. A temporary scab forms: a perfect, natural band-aid that protects the delicate, fragile underlying tissue until it is strong enough to form a scar that undergoes years of constant revision. Eventually, the mark may disappear altogether, leaving no physical trace of the injury.
Analogously, our brains defend against emotional wounds to ensure healing occurs upon full recovery. Normally, a responsive, well-enough parent would help the child modulate his overwhelming feelings with loving care (TLC), thus soothing the traumatic perception. Without modulation, the response to a painful incident could become entrenched and more sensitive to future triggers. Picking at the young mental scab reminds us of the original traumatic event.
Automatic mental constructs (AMCs) form our deeply held principles and inform and define our behavior patterns, character and individuality. My AMC had a specific trigger, irons – which explains my idiosyncratic ironing habits. This automatic response included the irrational belief that irons are primarily weapons, and that cloth, worsted or gossamer silk, like my baby’s skin, needs a protective cover with a towel. But since I rarely iron and am fully aware of the connections, this AMC is a non-issue in my life. More pertinently, it took time for me to deal with the daily dependency needs and feel comfortable relying on others.
In the aftermath of isolated trauma, especially in young children, optimal responsiveness of caregivers and support networks is important to prevent the incident from causing long-term damage. In general, the systems of a healthy body work harmoniously and can heal largely outside of our awareness. However, the healthy human mind, heart and soul require a responsive environment, tenderness, touch and loving kindness. The trauma is in the thwarted caregiver’s response, in its aftermath, and not necessarily in the event itself.
Imagine this normal, good parent: instead of dragging me out of the infirmary and calling the police, what if my mother comforted me by holding me tight as I spluttered and sobbed through my story until I felt safe and felt protected. What if she chewed on my toddler’s words and processed my experience, soothing me as she calmly stroked my forehead. Then, once she’s settled my vitals and put her at ease, she gives me a bite-sized portion of repackaged emotions, in words I understand. My imaginary mother is as attentive as I need it to be, making this a serious incident from which I can fully recover.
Ultimately, I understood that my parents had difficulty regulating intense emotions. With determination and time, their fear subsided, allowing them to reflect and develop greater insight. They apologized, took responsibility, and repaired the rifts, deepening our love and connection.
That’s good enough!
Author biography
Jacqueline Heller, MD, a psychoanalyst, is board-certified in psychiatry and neurology. Her professional experience as a practicing physician has given her a comprehensive understanding of the vast range of human experiences. Her new book, Yesterday never sleeps (Greenleaf Book Group Press, August 1, 2023), delves into her personal experiences with family trauma and helping others process their own trauma. More information at jacquelineheller.com.
