The second dart* : Psychological injury explained

A story of two injuries

I will attempt to explain something of my understanding of psychological suffering using a personal story of physical suffering as a metaphor that is, perhaps, more easily accessible.

As an older teenager, due to a genetic deformity, I dislocated both my shoulders multiple times, initially playing sport but as the ligaments became increasingly slack when undertaking more mundane activities like backing a car, even when sleeping. With the help of two operations and because of the fear of a repeat of this trauma I began, without thinking about it, holding my shoulders “high and tight”.

Years later in my early forties I ruptured a disc in my lower back. I went to various, doctors, surgeons, physios and yoga instructors attempting to alleviate the symptoms of the life-constricting pain in my back. Eventually a Pilates teacher identified the way in which I unconsciously “held” my shoulders affected my posture so as to stress the lower part of my back, enough over time to cause serious injury.

Understanding present and past

The Pilates teacher also helped me to begin to relax my shoulders, slowly at first… it was terrifying. I felt incredibly vulnerable, somewhat surprised my shoulders didn’t ‘fall out’ as I became conscious that this was what I was still afraid of after all these years. My back symptoms still required treatment, the pain and damage were real, but it was an injury sustained by the ongoing and not conscious reaction to the initial, unavoidable but now distant past trauma of my shoulders.

Holding tightly

So much psychological suffering such as depression, anxiety, anger issues, avoidant behaviour and compulsive behaviour can be symptoms of the “2nd injury” akin to my injured back, the first pain long since buried and often forgotten deep in our past. It's like playing-on with an injured mind.

It is human nature to want to put our pain away, to repress and suppress, but there are inevitably real and painful and often unnecessary ongoing secondary symptoms from what we do to cope with and defend against, our sometimes old and often now redundant primal suffering.

We can remain "tightly held" against something that has already happened and is no longer a threat. These psychological symptoms can cause us heartache, frustration and despair as we don’t understand their origin and struggle with their repetition.

How I can help

It took someone knowledgeable, kind and keenly aware to see the source of my pain and help me to realise the unconscious and suppressed fear of a repeated trauma was resulting in such tension to cause another injury; the symptoms of which came to severely detract from my life; as per psychotherapy the relief of awareness and self-compassion, once known, cannot be un-known.

As well as my general psychotherapy practice I have a particular interest in gaining an understanding of how the current social and cultural setting interacts with the personal background of depressed and anxious young males (18-35) and working with this group to throw off these shackles in order to survive and thrive.