Save Me From Pegah Rah

Last night, I was on a panel of skilled mental health professionals discussing the nature of trauma. Much discussion and writing are devoted to that topic these days and I was an invited scholar at a convention focused on the effects of trauma on human development. What was unique about this particular conference is that those attending were victims of trauma, and are [still] part of the Orthodox community.

The moderator, distinguished for his contributions to the field of traumatology, presented a range of questions posed by audience members on trying to reconcile their faith with their struggles, their values with their beliefs, as well as clinical matters. The final question to the panel was one that could pertain to each one of us as human beings. Every one of us, at times, has encountered an unwanted or horrifying event, situation, challenge, or individual who poses a threat. And that ordeal can leave us feeling depleted, frightened, shocked, betrayed, and confused. In that sense, each one of us has known trauma to a certain extent. Despite the fact that the media at times hypes the term “trauma,” and at times we’re tempted to dismiss the gravity of it, trauma is indeed traumatizing. And intensely terrifying experiences can create real and discernible wounds in those who survive those experiences.

The final question that was posed to the panel was regarding how a person can know if or when they have healed from their wounds. Each of us offered insights based on our clinical experiences in treating people who have suffered, and some based on our own perspectives on what the research has taught us. One expert suggested that we can perceive healing in an individual when they can function effectively in the aftermath of a traumatic experience. Another one opined that when a person can feel proud of himself and accept that he is, once again, comfortable in the presence of others, that’s when he knows the trauma has been healed. And yet another one offered that when one remains mindful and focused in the present most of the time, then he or she has most likely gotten over much of trauma’s imprint from the past. Someone else suggested that trauma is healed when a person no longer views himself with the critical, insulting, and vile terms that their offenders once called them, and their own internal voice is no longer demeaning and guilt-invoking.

My own response was somewhat more structured and possibly blunter. Those who have been hurt by traumatizing experiences will always have an imprint within their brain and body which is the “scar tissue” of the past wounds they have endured. I do not believe that in that sense, one heals from trauma in the same manner that one heals from the measles or from a sunburn or a toothache. Trauma does impact the thoughts, emotions, body, behavior, and even the spirit of a person. Effective treatment promotes adaptation, a return to functional living, and a reorganizing of the position which trauma serves in the mental life and behavior of a trauma survivor. Effective treatment allows a person to spend more time in their healthy flow, able to maintain a life rhythm that is relatively unfettered by the gloomy darkness and dread that once occupied their mental life. Treatment assists a patient in relocating the trauma so that its effects are not as prominent in their present mental life.

Adaptation, or what some might consider healing, includes greater self-awareness of one’s internal processes, allowing them to access and identify what thoughts are present in their conscious mind, what feelings and what physical sensations they are conscious of, and healthy adaptation includes non-critical self-acceptance of the contents and processes of one’s internal life. Healthy adaptation also includes being able to like oneself, and being comfortable with one’s image, role, reputation, and relationships.

But there is another facet of life with trauma: each morning in the daily prayers, we ask that Hashem protect us from a range of negative persons and situations. There is a phrase in that prayer, “pegah rah,” which can be translated as a negative encounter, a negative confrontation, or a negative entity. I look at pegah rah as the things that trigger a person. Sometimes a particular individual seems to bring out in us an uncharacteristic change of mood, demeanor, or behavioral reaction. Sometimes, it is an auspicious date on the calendar which we associate with a sad or negative event. Sometimes it might be some other entity which somehow sparks inside of us a reaction which we did not anticipate. And in the aftermath of trauma, even trauma which has been effectively treated, there are always going to be those “pegah rah” triggers that can evoke a flashback, a shift of energy, an urge to run and escape, or a rapid regression into the frightened or frozen state that was once an overwhelming symptom of trauma. Persons who have worked through their trauma can adjust, adapt, and return to a better level of functioning, yet a chance encounter, a whiff of some scent, a tone of voice, a particular word or phrase, or the return of a forgotten memory can trigger an avalanche of reactions that can pull a person back into a traumatized state. This is why, I suggested, that those who have done well in treatment are not only self-aware, but are also aware of what their triggers are. Forewarned is forearmed, the saying goes, and being aware of what types of encounters might be one’s “pegah rah” triggers is a necessary aspect of the healing process for trauma which is more about how to deal than how to heal. n

Rabbi Dr. Dovid Fox is a forensic and clinical psychologist, and director of Chai Lifeline Crisis Services. To contact Chai Lifeline’s 24-hour crisis helpline, call 855-3-CRISIS or email [email protected]. Learn more at ChaiLifeline.org/crisis.