WARNING: This article contains descriptions of traumatic events, therefore some of the content may cause distress.
What constitutes trauma? Do you have to experience a terrifying event to have been traumatized?

As a psychologist I am privileged enough to be a witness to stories of trauma and survival that demonstrate the power of the human spirit and the ability for people to be resilient and courageous even in the face of incredible vulnerability. It never ceases to amaze me what my clients have been able to survive.

The stories range from childhood trauma to complicated grief, sexual assault and birth trauma to the impact of suicide or domestic violence. Others talk to me about life changing car accidents, sudden injury, chronic illness, workplace bullying, natural disasters or being victims of crime.

As psychologists, what we define as trauma has broadened greatly over the years to any experience that is life threatening or where there is a significant threat to one’s physical or psychological wellbeing. What we know is that the same event may have little impact on one person but cause severe distress in another individual.

The degree of impact that an experience has may be related to the person’s mental and physical health, the nature and severity of the event, the level of available support at the time of the event, past experiences and coping skills.

The reaction to trauma varies greatly – some people recover from trauma without additional support and experience symptoms for a period of weeks to months, but many develop more significant changes in feelings, physiological responses, behaviour and relationships that need professional support to be able to move forward with their lives.

With the 12th anniversary of the London bombings on my radar recently, I felt the need to share a story of an Australian woman who I have been lucky enough to meet and interview (NB Gill is not a client) and who has moved and inspired me greatly. Her story has reminded me of the impact of trauma, the strength and courage of people and the role we can have as psychologists in supporting people through change, as they adapt to a different life in the face of great pain.

Sometimes real stories allow us to learn and to see a little bit of ourselves or someone we know in them, allowing us to be inspired or to reflect in a way that leads to a shift in perspective and behaviour change.

In this two part series I share Dr Gill Hick’s story (with her permission) and explore what her experience of trauma has meant for her life. In the second blog I move on to explore the full range of symptoms of Post Traumatic Stress Disorder and how we help clients as psychologists to address this impact.

Gill Hick’s story – Living out the “new normal” after trauma

12 years ago on July 7th in London, 52 people lost their lives and over 700 were permanently injured due to the actions of a suicide bomber. Sadly terrorism has been added to the list defined above as one of those traumatic events that people may endure either directly or witness vicariously in the media.

Tragically the frequency of these events is increasing and disturbing all of us, changing the way we see the world in terms of our sense of safety and our view of humanity.

The blast and the descension into darkness – never to be forgotten

Imagine just for this moment what it would have been like if it was you sitting in that carriage on July 7th heading to work. On that day several train carriages of people from all walks of life went about their daily morning routine, many catching the Tube to work, dutifully following the rules of no talking on the Tube and no eye contact. None of these commuters including Australian Gill Hicks were to predict what would happen next.

That day Gill Hicks experienced a blast from a bomb beyond her comprehension and a descension into darkness that was terrifying, leaving her without her legs, damage to her hearing, her lungs and vocal cords and nearly losing her life. Sadly this terrifying attack that changed the way we saw the world ended the lives in the most horrific way for 52 people that day and injured hundreds.

Gill’s adaptive response – to talk or not to talk, a question of survival

The compassion, skill and dedication of the rescuers gave Gill Hicks a second chance on life – she was just 30 seconds shy of losing her life as they allowed 3.5 minutes for her to come back after her heart had stopped for 28 minutes. Gill has shared that she came back talking even when pronounced dead.

I wonder whether this was the start of her adaptive response to trauma – she seemed to know when to use her voice and to speak up to let the others know she was alive “ I’m Gill – I’m here… I’m alive”.

In that carriage, Gill knew instinctively when to stop talking when she had little breath and had to conserve her energy, but found her voice when she could talk again and it was necessary for survival.

On feeling the touch of her rescuer she surrendered to their care and conserved her energy. She could no longer speak. Gill experienced a feeling of unconditional love and safety, and experienced the start of many connections from professionals and loved ones that she believes saved her life.

Gill was close to being pronounced dead but at the last minute in that ambulance her voice and her determination to survive saved her.  What an incredible example of adaptive functioning and survival.

To appreciate the power that comes with our ability to speak is something that many people who have been traumatized deeply understand as not being able to speak leaves us feeling out of control and powerless, even if it is the body’s primitive way of protecting us.

The brain has a clever way of protecting us when faced with trauma and sometimes shuts down the speech centre or disconnects from physical pain and feelings when our survival is threatened.

I sense that Gill will never stop talking when it is needed now as her values won’t make it easy to do so. More importantly she has learned to appreciate her ability to speak and share her story while also acknowledging the grief of losing her capacity to sing in the way she once did and all the other aspects of her previous life she lost that day.

Trauma is rarely one sided … a moment of elation and change is sometimes contrasted with the grief attached to all the suffering that went before that moment and a recognition of those things that will never be the same.

The anniversary experience – an emotional roller coaster made manageable by the strength of a community

July 7, 2005 will never be forgotten by those who survived and the loved ones left behind. From that day forward July 7th every year is likely to bring up so many memories and emotions for the survivors and the loved ones of those who lost their lives. The list of emotions is likely to be long and the feelings intense – anger, sadness, gratitude, determination, anxiety, survivor guilt… the list goes on.

What helps get Gill and her friends through a day like this is the support of a community that was created out of a tragedy – survivors, family members, ambulance officers and police come together each year to pay tribute to those who lost their lives and to remind each other that there is life after trauma, children that have been born and recovery that has happened both physically and psychologically.

As psychologists we know what a difference social and professional support does for people recovering from trauma. Trauma is very isolating. Connecting with others breaks down that isolation and buffers the stress that comes with this experience. It allows people to share aspects of this experience and to have their pain and fear validated.

How does life change? The opportunity for growth and transformation

For Gill Hicks, like all those who are affected by trauma, her life distinctly changed forever in that second. Her “new normal” as she has called it is now a life as a double amputee and her prostheses and constant pain are a constant reminder of the impact of this act of hate, fear and division.

So many things are much harder now. Gill had to learn how to balance and walk all over again with prostheses but this time with no ability to feel the ground, no anchor to ground herself and establish safety. She learned that the only way to keep upright was to consciously think about every movement that was once automatic.

Think about it for a second … what would life be like if you had to do that and have a conversation with someone at the same time? This was just one of her many challenges.

Her new life has required her to develop the flexibility to respond to difficult situations, intense emotions, and thinking that is constant. On top of adjusting to living with a disability and constant pain, this psychological impact has been significant and her sense of safety has been rocked.

Gill has had to find a way of redefining her identity within the framework of trauma (her legs gone are a constant reminder) while finding a way of detaching from it enough to get on with her life in a meaningful way.

“It stops here” – The moment of choice – choosing life and making sure it counts

Gill Hicks is one of those survivors who has found a way of viewing her own survival as a defining moment in time that she will never forget or ignore…. A sliding door moment when her life as a Publishing Director of an architecture and design magazine at the Design Council in London where she lived to work ceased and her new life in addressing violent extremism started.

She was certainly not ready for that change, nor expecting it, but that is the nature of trauma. It takes us by surprise and therefore shakes up what we take for granted, our sense of safety and our sense of having control in our environment.

Gill could have died …she had a moment of making a conscious choice between life and death. In that carriage she heard what she describes as the gentle voice of death beckoning her to come with her but the voice of life was stronger and angry about the prospect of her leaving the world.

In that moment she made a decision that she was choosing life and if she was lucky enough to survive (and she was determined to) she would make the rest of her life really count, for all those who did not survive that day and were injured.

With that determination she tied her scarf around her legs in a tornique to attempt to stop the bleeding. She felt determined to do all she could to survive until help came. That hour in the carriage before she was rescued was a longest hour of intense reflection and focus as she was surrounded by the horror of the impact and in a body that was fighting to survive.

Guided by instinct Gill describes in her TED talk  shutting everyone out to focus, lowering her breathing rate, elevating her thighs and fighting the urge to close her eyes. In that hour she contemplated her entire life – “perhaps I could have done more, danced or run more” but she had dedicated her life to her work, her biggest passion, never predicting that this moment would change everything.

This conscious choice to live was the start of a vow to ensure she never wasted another moment, determined to stop this from happening to others and using her gratitude for life and her anger to channel constructively to combat violent extremism and work towards world peace. Gill continues to spread the message that love and compassion rather than hatred and fear is the key to a better, safer and more tolerant world.

The birth of her daughter – a symbol of the immense possibilities beyond trauma

Gill went on to give birth to daughter, a risky and complicated birth requiring a team of doctors to ensure a safe outcome for her and the baby. The miracle of the birth of her daughter made her forever grateful for the rescuers, her family and for all those who have showed her compassion and supported her in this journey of recovery and transformation to allow her to be able to do that.

Gill has proven that you can do anything even in the face of incredible anxiety and pain if it is important to you, even abseil the tallest building in Adelaide with prostheses and sing again with severe hearing damage and severe damage to the lungs (Gill was previously an accomplished professional jazz singer).

As she watches her 4 year old daughter now take simple pleasure in simple things like the growth of her own carrots in the garden, Gill teaches her daughter a valuable lesson in life ….there is always the opportunity to shape growth and to marvel in transformation.

Furthermore she teaches her the skill of mindfulness… engaging in something fully with curiosity, openness, awareness, a skill that has become essential in managing her own trauma, her emotions and living her life with greater enjoyment in spite of all the challenges.

Life beyond trauma… what is it like?

Post trauma recovery, the ability to turn a traumatic experience into some positive is considered a constructive and adaptive response to trauma but for many people suffering with Post Traumatic Stress Disorder (PTSD) this is challenging. Life may be severely affected on a day to day basis and these symptoms often greatly affect their identity and prove challenging to manage alone.

It is possible that both are true – a person may see positives and use the experience as a motivator like Gill has, gaining clarity about what is important and meaningful in that process. However, despite all of the positives for Gill Hicks described above, it doesn’t mean to say that anxiety, anger, negative thoughts, distrust and a different perception of safety are not true for her also as they are for many victims of trauma. The physical injuries were only part of what Gill and all those survivors have faced… 12 years on we can only imagine what still comes up for Gill and the other survivors.

Gill Hick’s story is inspirational as it not only demonstrates the broad impact of trauma, but it teaches us about adapting to change that is out of our control and helps us see that transformation is possible even out of the most traumatic events if we can then learn what is truly meaningful, understand the power of empathy and humanity in healing, and most importantly see the power of choice.

We may not be able to control what happens to us but we can certainly learn to influence our response to events.

If you would like to read more about Gill and hear her inspirational TED talk go to http://www.gilltalks.com/gill-hicks.html

Watch out for my next blog where I will explore the main symptoms of PTSD and discuss how we as psychologists may work with trauma in different ways to assist with adapting to a life beyond trauma. If you or a loved one are struggling with the impact of trauma, at Attuned Psychology we have psychologists who will provide support and strategies to assist in rebuilding a meaningful life.

Image Photographic Portrait of Gill Hicks – Photographer – Tony Kearney

Author: Alexandra Frost

Clinical Psychologist