Sometimes, poorly managed yet surmountable traumas leave needless drama and damage. All humans experience mini-injuries, misunderstandings, or hurt feelings. Bruno Bettelheim described “good enough” parents as consistently loving and caring for their children so they feel secure. A good enough parent is attentive enough to create an emotional haven regularly.
When they make mistakes, which are 100-percent guaranteed and inevitable, they make amends to the child by apologizing, physical holding, and emotional containment. These repairs allow the child to feel safe and secure, and they can recover from many of life’s wounds. So, the aftermath of the injury is important when we’re dealing with cumulative, repetitive hurts or a single injury.
“Not Good Enough” Trauma Aftermath
Here is my story of a “not good enough” trauma aftermath.
When I was four years old, my parents rushed me to the emergency room at midnight for the fourth time in two weeks because of a ruptured abscess on my belly caused by infected mosquito bites. They itched, and I scratched myself mercilessly until I drew blood.
Doctors drained, cleaned, and bandaged the wound, then recommended that my mother follow up with our pediatrician. My mother took me to the pediatrician’s office. No one bothered explaining that the infection was raging and that another procedure was necessary.
Although I was afraid, Dr. Roseman was a lovely man who always gave us a lollipop when we left his office. On that day, the doctor looked strangely masked and gloved. He approached me with a pair of long skinny scissors, and within seconds, he began piercing the giant zit and snipped away. Snip and squeeze. I screamed. The incident left a physical scar and an even deeper emotional ache from the shock of not knowing what was happening. Moreover, after that, I was on my own to process and metabolize big, scary, overwhelming feelings.
I hadn’t yet understood that my late parents were traumatized Holocaust survivors whose lives overflowed with expectations of loss and destruction. Overwhelmed with anxiety about impending calamity rendered them incapable of effective parenting when their child was physically ill or injured. How do you take care of anyone else when in survival mode? Frozen in trauma mode, they remained oblivious. They didn’t realize how traumatizing the mosquito treatment experience was for me, so in this instance, they failed me. They didn’t demonstrate the “good enough” parental behavior necessary to limit its harmful effects. They were just out of touch and not attuned.
I had an even worse experience when I was two years old, and the traumatic memory is seared in my mind. My whole family was on a rare vacation at a Borscht-belt Catskills bungalow colony. I remember entering the nurse’s infirmary “office” — a claustrophobic space. She told me to lie on the table face down. I remember the white paper crinkling beneath me. Despite recriminations and warnings, I had been drawing blood from the mosquito bite on my butt cheek that I couldn’t stop scratching. I knew that this visit to the infirmary had something to do with the area that began hurting.
I was alone. My parents’ unmarried friend, a Holocaust survivor without family whom we called “Uncle Leo,” waited outside. I’ll never forget the nurse approaching me with a steaming metal iron. She pulled my cotton underwear down with one hand. From the corner of my eye, through my streaming tears, I could see the iron approaching. I felt the tip of the hot iron sear my flesh. I was shocked beyond pain! Held down and immobilized, I howled and screamed into a deafening silence as the tip of the scorching iron landed on my tender baby ass. My heart pounded furiously as the sadistic nurse nonchalantly applied a gauze bandage.
I remember feeling both fear and disbelief. Uncle Leo asked no questions but gently took my hand as I left the small room. I suppose his silence confirmed the incident wasn’t something to mention. However, I was too young to self-regulate my emotions effectively. I must have experienced unmitigated terror alone and in silence. I may have been on high alert, vigilant, with cortisol and adrenaline pumping through my veins.
Physical And Emotional Healing
What makes an assault traumatic for a child? What differentiates physical and emotional healing?
The body heals a wound automatically out of awareness. When physically injured, as I was, electrical impulses travel through the nervous system to the brain, acknowledging the pain while sending signals to the body: “Hey, this needs attention.” In response, a battalion of leukocytes, clotting factors, and collagen fibers are summoned to the site and ordered to congregate around the injury to stop the bleeding, fend off intruders such as germs, and heal the wound. A temporary scab forms: a perfect, natural Band-Aid that protects the delicate, vulnerable underlying tissue until it’s strong enough to be a scar that undergoes years of continuous revision. Eventually, the mark may disappear altogether, leaving no physical trace of the injury.
Analogously, our brain defends us from emotional wounds to ensure that healing occurs with complete recovery. Usually, a responsive, good enough parent would help the child modulate their overwhelming feelings with tender loving care (TLC), mitigating the traumatic perception. Without modulation, the response to a painful incident could become embedded and sensitized to future triggers. Picking at the fledgling mental scab reminds us of the original traumatic event.
Automatic mental constructs (AMCs) form our deeply embedded principles and inform and define our patterns of behavior, our character, and our individuality. My AMC had a specific trigger, clothing irons — which explains my quirky ironing habits. This automatic response contained an irrational belief that irons are primarily weapons, and fabric, worsted wool, or gossamer silk, like my baby skin, requires a protective cover with a towel. But since I rarely iron, and I’m fully aware of the connections, this AMC is a non-issue in my life. More relevant is that it took time for me to contend with everyday dependency needs and feel comfortable relying on others.
In the aftermath of isolated traumas, especially in young children, optimal responsiveness from caretakers and support networks is important for the incident not to cause long-term damage. Generally, a healthy body’s systems work together harmoniously and can heal substantially outside our awareness. However, the healthy human mind, heart, and soul need a responsive environment, tenderness, touch, and loving-kindness. The trauma is in the foiled caretaker’s response, the aftermath, and not necessarily the event itself.
Imagine this ordinary good parent: Short of yanking me out of the infirmary and calling the police, suppose my mother comforted me by holding me closely as I sputtered and sobbed through my story until I felt safe and protected. Suppose she chewed on my toddler words and digested my experience, soothing me as she calmly stroked my brow. Then, once contained, and comfortable, my vital signs at their resting state, she feeds me a bite-size portion of repackaged emotion, using words I understand. My imagined mother is as attentive as I need, making this a bad incident from which I can recover fully.
Eventually, I understood my parents’ difficulty regulating intense emotions. With determination and time, their anguish abated, allowing them to reflect and develop greater insight. They apologized, took responsibility, and repaired the ruptures, which deepened our love and connection.
That is good enough!
Jacqueline Heller, MD, a psychoanalyst, is board certified in psychiatry and neurology. Her professional experience as a practicing clinician has allowed her extensive insight into the vast range of human experiences. Her new book, Yesterday Never Sleeps (Greenleaf Book Group Press, August 1, 2023), delves into her personal experience with family trauma and helping others work through their own. Learn more at jacquelineheller.com.