There are a number of barriers to recovery, even under the best of circumstances. A number of these barriers are directly related to the psychobiology of the traumatic experiences – dissociation, fragmentation, amnesia, emotional number, intrusive re-experiencing, and avoidance.
Neither children nor adults usually make a connection between their symptoms and previous experiences and they are unlikely to want to talk about these experiences, even if they have the words for such painful feelings. Many times they cannot remember the worst parts of the experiences as a result of what happens to the brain’s information processing system under conditions of extreme stress and they would prefer to stay emotionally numb rather than feel the pain that is attached to their traumatic memories. They are likely to remain loyal to their families, even when the family is the source of the trauma, and in many cases, unbeknownst to those who are trying to help, the violence or dysfunction in the family is still going to – and no one wants to talk about it.
But there are other barriers too. As mental health, health and social service providers, we haven’t wanted to talk about the traumatic lives that so many of the people we treat have actually experienced. Certainly most mental health systems have not thus far incorporated knowledge about trauma, nor have other social service systems or school systems. In fact, our helping systems themselves are often fragmented, lacking a common set of basic assumptions, a shared language, clear goals, and a positive vision of the outcomes for the children, adults and families who have been exposed to interpersonal violence. There are complex interactions that occur between traumatized clients, stressed staff, pressured organizations, and social and economic environment that resist positive, trauma-informed change. As a result our helping systems frequently recapitulate the very experiences that have proven to be so toxic for the people we are supposed to treat.