CAT | Trauma
Fern Schumer Chapman
Okay, I can go along with that. We can make choices to contribute to human solidarity and resistance against the curtailment of human rights. But it is difficult to make choices about the reactive qualities of PTSD. I think we have established that important distinction in this blog.
Having said that, in the last decade, some exciting new treatments for PTSD – neurofeedback, Eye Movement Desensitization and Reprocessing (EMDR), light and sound therapy, to name a few – have emerged. They move memories to the proper storage place in the brain and reduce triggers.
Ernest Hemingway's "Analyst"
Interestingly, another way to gain power over trauma is through storytelling. The most famous American trauma artist is probably Ernest Hemingway. In a 1934 letter to F. Scott Fitzgerald, Hemingway advised, “We are all bitched from the start and you especially have to be hurt like hell before you can write seriously. But when you get the damned hurt use it.” When Hemingway was asked if he had ever had an analyst, he said, “Sure I have. Portable Corona number three. That’s been my analyst.”
“Stories are our mind’s attempt to make sense of our own and other’s rich inner worlds,” wrote Developmental psychologist Daniel Siegel in Parenting From the Inside Out. “Those who can’t tell a cohesive story have not fully integrated the experience.“
In fact, sometimes you can listen to someone tell a story and realize that they have not integrated the experience. Their perceptions are fragmented and they tell their story in a staccato style without much arc to the narrative.
Interestingly, Dr. Siegel says, if adults can create a coherent, emotionally rich narrative about their own childhoods, they are likely to form a secure relationship with their children.
If they can’t… well, that is one way trauma is transmitted to the next generation. In other words, emotional health wasn’t determined by what happened to a person as a child, but by how that person made sense of what happened. Ultimately, that would determine what kind of parents they would become.
Studies also have shown that when people write about emotionally difficult events for just 20 minutes a day for three or four days a week, the function of their immune system improves. In a 1998 study published in the journal Health Psychology, college freshmen who wrote about their feelings and problems and created coping strategies made fewer visits to the medical clinic than those who didn’t write. So the benefits of making sense of life through stories are both mental and physical.
Maybe Hemingway knew what he was talking about when he said his Portable Corona was his analyst.
Gert Krell
German psychiatrists rejected connection between concentrration camps and PTSD
We seem to be moving in each others’ directions. I have read a number of articles on trauma, which has become a serious and broad field of research in Germany, particularly since the 1980s, when the psychological and psychoanalytical professions also began to study their involvement in the Nazi era. (Shamefully, German psychiatrists had been instrumental in denying numerous Holocaust victims compensation in the 1950s and 60s; they rejected any plausible connection between the experience in the concentration camps and acute physical or psychological symptoms among claimants.)
Much of what I know from you about second generation victims of the Holocaust I found confirmed here: the child’s subconscious identification with the repressed trauma of her mother’s or father’s, the resulting symbiosis and loss of the sense of a separate self, the use or rather abuse of the child as a psychological container by the traumatized parents, and the risk of the child’s individuation and separation which the parents experience as retraumatization.
I also understand now why Gerda Schrage (see our blog on Holocaust Remembrance Day, part 1) suggested that her son, who was born after the war, might have been victimized more than herself. Survivors often had a normal childhood before the Nazis, including the experience of home and of nourishing parents. Their children, although born after the shoah and no direct victims of persecution, were nevertheless socialized into the Holocaust from the very beginning. Survivors have no chance not to confront their children with their own trauma, and children of survivors have no chance not to deal with it.
In one of the sad case studies, the daughter of a surviving father and mother who considers herself a “child of the Holocaust” (she is called Mika in the article) passes on a sentence to the therapist which her mother’s best friend had said to her the day before she was murdered: “Weißt de, Rivkale, wenn Du wirst sehen morgen a Roiech, das bin iach”. (You know, Rivkale, when you will see the smoke tomorrow, that’s me.) This sentence hangs like a curse over the family. (One of Mika’s aunts also died in Auschwitz, in her mother’s arms.) And although Mika was her father’s dearest daughter, he treated her with extreme violence when she brought home non-Jewish friends or established relations with non-Jewish men. Tragically, yet understandably they symbolically represented the murderers of their family to her parents. In the end, Mika committed suicide.
So we need to be careful when we use the term “trauma”. One expert calls trauma “a prototype of an elastic term”. Others make a clear distinction between “catastrophic trauma” and situations “approaching trauma”. Much seems to depend on the intensity and duration of the “traumatic” experience. Some factors mitigate the consequences, but serious or catastrophic trauma may remain essentially incurable.
For me, the Nazi era and the Holocaust are “merely” a burden and a challenge (with a possible, yet comparatively mild exception of consequences from the war). I have had brief moments (very rare) when I felt so overwhelmed by the unfathomable violence of the 20th century, particularly the two World Wars and the Holocaust (also the Vietnam war which haunted me as a young student), that I thought there was only one way of coping with it and of showing solidarity with the millions of people who died prematurely and brutally: just disappear.
Iris Chang
I remember that you once warned me not to identify with the victims too much. You told me of an American author who had written about the “rape” of Nanking, where the Japanese butchered 300.000 people in 1937. She became drowned in the sadness of what she had written about and committed suicide. Fortunately for me, when I imagine I talk to some of these people I hear that this is the last thing they wanted us to do. They want us to remember them and to honor the legitimate rights of the living.
And there we come back in a way to the choice which Albert Aghazarian is talking about. For all of us who can still make choices, human solidarity and prudent resistance against the curtailment of human rights, wherever it occurs, is one way of recovering from burdens, wounds, and even trauma. With some of those who experienced catastrophic trauma in the camps, small signs of human empathy and solidarity, inasmuch as they were still possible, helped them not to give up and survive.
Fern Schumer Chapman
I took a strong stance in my first response to this blog. Now I’m going to back pedal a little. I want to address how trauma is alleviated. Part of what happens with PTSD is that an individual has a strong reaction to a situation. Though the individual may not realize it, he or she may be reacting to something that happened in the past rather than what is occurring in the present moment.
”Traumatized people find themselves re-enacting some aspect of the trauma scene in disguised form without realizing what they’re doing (e.g., putting themselves in dangerous situations this time to make the end come out differently (a version of the repetition compulsion.” says Judith Herman, who wrote what’s considered the bible on PTSD, a book called Trauma and Recovery. Often a PTSD experience is accompanied by a loss of feeling or numbness. With that numbness comes depression. You raise the issue of redirecting or reframing thinking and that is certainly a valuable strategy to cope with the depression.
Stress and Norwegian parachuters
But an individual who wants to manage PTSD must control stress levels and learn to recognize triggers before he or she reacts. That requires great awareness and vigilance. If the triggers surround one traumatic experience, it is easier to recognize PTSD. But if the trauma occurred early in life and is the result of prolonged abuse or neglect, the triggers are much more difficult to identify, which can be more disruptive.
A discussion on controlling stress levels and anxiety is a book in itself. There all kinds of ways of reducing stress, from breathing techniques to safe exposure to the original trauma. For example, the stress levels of Norwegian soldiers learning to parachute were examined over the course of months of training. At the time of their first jump, they were all terrified, and their stress hormones were elevated. But as they repeated the experience and mastered it, they were no longer terrified and their hormone secretion patterns changed.
One of the points that interested me in your first entry is that you identified that “people who in spite of traumatic historical and current experiences in their families are still working for peace and reconciliation between Israel and the Palestinians, some of them jointly in bi-national groups.” This is clearly productive, and it is also another technique for addressing PTSD.
Dr. Judith Herman, author of "Trauma and Recovery"
Herman claims that it’s important for those who suffer with PTSD to find a survivor mission. This may take the form of social action and a willingness to speak the unspeakable.
“I don’t think patients, survivors victimized people can recover in isolation,” Herman says. “They need other people and they need to take action in affiliation with others…Ultimately, if you’re talking about horrible abuses of power, you’re talking about atrocious things that one person does to another…You’re dealing with profound questions of human evil, human cruelty, human sadism. The abuse of power and authority.
“The antidote is the solidarity of resistance. Nobody can do that alone. It means testifying before the legislature. Or taking part in some kind of public education campaign or going to court or accompanying someone else to court, or demonstrating in favor of the assertion of victim’s rights, human rights.”
I have been searching for explanations of the differences in our reactions. One of the reasons may be that I have no experience with trauma therapy. My first therapy was based on TA (transactional analysis), which says that we do make decisions (subconsciously) as children about ourselves and the world. They determine or at least strongly colour our “life scripts”. Such “decisions” can be: I am not really lovable; it was my fault that father left the family; only if I work hard will I be accepted. TA also says that these “decisions” can be changed, even late in life. (See the wonderful book by Mary McClure Goulding/Robert L. Goulding, Changing Lives Through Redecision Therapy, New York 1997)
Well, even in TA theory you cannot just move from one stage to the other at liberty, and certainly not if you have been seriously traumatized. So I agree that the statement by Mr. Aghazarian may look naïve and perhaps even frivolous. A lot depends on how we conceptualize trauma and whether we talk about individuals or whole societies, though. Maybe we should distinguish between genuine trauma, wounds (of course, trauma also means wound originally), or burdens. (This is my personal, not scholarly language.)
A couple of months ago I read Tilman Moser’s recent psychological autobiography. (Moser is one of Germany’s most famous psychotherapists.) In this book with the title Bekenntnisse einer halb-geheilten Seele (confessions from a half-cured soul) he analyzes his own long journey through half a dozen therapies, until he finally adjusted to the fact that his situation had improved but that he will never fully recover from a series of traumatic events, beginning with his turbulent birth.
Currently I am reading the second volume of Ulla Hahn’s large autobiographical novel Aufbruch (departure or awakening). (Ulla
Hahn is one of Germany’s foremost poets and writers.) She was raped when she was 17, and she at length describes the terrible distortions which this experience created in her life. It is a deeply disturbing story which I would recommend to anybody who wanted to read something about post-traumatic stress syndrome in non-scientific literary language.
I am not sure I ever experienced an event or a phase which I could call traumatic. My recurring somatoform depressions, which I only feel in my body (apart from the physical pain I am almost perfectly normal), may or may not go back to the time in my mother’s womb and to the strains of her pregnancy in 1944/1945. She would always tell herself: “I mustn’t get excited, I am expecting a baby”– an impossible injunction at a time of real threats to her life.
I have learned to live with my symptoms and to enjoy myself nevertheless. I cannot do much about them anyway. I have had much more control (or could do more “redecision-making”) about the “wounds” in my life, such as my parents’ divorce or my first child’s birth and death.
Sonja’s birth was indeed traumatic (for her). As a result of medical maltreatment almost all of her brain was destroyed, and she died when she was 18 months old. I made the “decision” at the time that I would not show my sadness and desperation, because I wanted to protect my wife, who was desperate enough herself. Later we found out that this had been the wrong decision. Irene was deeply irritated about my outward calmness and for some time even thought of leaving me.
28 years after Sonja’s death, when I was in a psychosomatic clinic after my “burn-out”, I had an unexpected flashback in the first go-around and the tears came again. I joined a “mourning group”, and after a couple of sessions, a symbolical stoning of the doctor who had ruined Sonja’s life, and a long fictitious letter to my first daughter, which I read out in the group and later dropped into the local river to let it flow, I could finally say good-by to her. She is deep in my heart, but there is no wound left, only a major scar. (There are some connections to the Nazi past here, which I will address some other time.)
Fern Schumer Chapman
“Every traumatizing experience, if you survive it, can lead to one of three results,” Aghazarian writes. “Either you turn numb, without sensation; or you insist you have a monopoly on the suffering and no other suffering compares to yours. Or you become hypersensitive and hyperactive against anything that shows the slightest similarity to what you have experienced yourself. You must make up your mind.”
Aghazarian’s assumption is that there is some free will in choosing one of these options. Maybe a traumatized individual has some control over how much he or she talks about the experience, but the individual does not choose to be numb or hypersensitive or hyperactive to the experience. In fact, regardless of whether a traumatized individual is silent or speaks incessantly of the experiences, he or she will likely be hypersensitive and hyperactive to similar experiences. They are likely to be emotionally numb, too.
Those who suffer with PTSD relive the past in the present
These reactions of numbness or hypersensitivity are defense mechanisms and a symptom of Post Traumatic Stress Disorder. Those who suffer from PTSD attempt to mobilize coping responses to protect and insulate themselves from repeating the trauma. They have
the distorted belief, as professor of biology and neurology at Stanford University Dr. Robert M. Sapolsky writes in Why Zebras Don’t Get Ulcers, “that stressors are everywhere and perpetual, and that the only hope for safety is constant mobilization of coping responses.” Consequently, someone who suffers with PTSD can be unaware that he or she is in a constant state of vigilance.
In addition, Dr. Sapolsky reports in his book that research shows that “people with PTSD from repeated trauma (as opposed to a single trauma) – soldiers exposed to severe and repeated carnage in combat, individuals repeatedly abused as children — have smaller hippocampus, and in at least one of these studies, the more severe the history of trauma, the more extreme the volume loss.” He concludes that there is decent but not definitive evidence that this kind of stress can cause structural changes to the hippocampus.
What does the hippocampus do? It helps form conscious memory. Those people who suffer with a damaged hippocampus can remember the distant past but can’t form new memories. That is consistent with the symptoms of those who suffer with PTSD. For healthy people, memories are recalled as stories that change over time and do not evoke intense emotions and sensations. But those who suffer with PTSD relive the experience in the present and feel as if the trauma is happening all over again.
So I don’t believe that there are options and that an individual has a choice. The brain structure of those who suffer with PTSD is altered by this disorder. That’s why I take issue with Aghazarian’s assumption.
Gert Krell
I have written a review of two books by German authors who both grew up after the war and gained part of their personal and political identity by working through the silence of their en¬vironment about the crimes of and during the Nazi regime. Both later became involved in the Middle East, and they both describe the biographical backgrounds of a number of Jews and Arabs and their political activities; of people who in spite of traumatic historical and current experiences in their families are still working for peace and reconciliation between Israel and the Palestinians, some of them jointly in bi-national groups.
One book focuses on meetings between Israelis and Palestinians (and a few Germans who remained in the background) who – in spite of a number of very practical difficulties – jointly visited the Yad Vashem Memorial and ruined Palestinian villages which had been destroyed and deserted during the 1948 war. This is what Shlomo Shpiro, one of the participants, has to say: “If you don’t talk, there will be no hope for understanding. Understanding does not arise from textbooks or nice thoughts about peace in the world (…). Understanding grows from everyday communication, from communication which touches everything (Henning Niederhoff, Trialog in Yad Vashem: Palästinenser, Israelis und Deutsche im Gespräch).”
Shpiro also feels that the politicians in the area do not address the core questions of the conflict adequately: the fear of annihilation which the Holocaust has instilled in the Jewish side, and on the Palestinian side the feeling that they were thrown out of their own country in 1948. He does not compare the two traumas, because they are not comparable. But he adds that he was just as moved by visiting the ruined and deserted Palestinian villages as he was by his visit in Yad Vashem. It makes a big difference when you see the manifestations of traumatic experience with your own eyes. Nothing can remain as black and white as it may have been for you.
One of the Palestinians, Albert Aghazarian, comes from an Armenian family whose father survived the Turkish genocide as a child, went to Syria first and later to Jerusalem. This is what he says about trauma: “Every traumatizing experience, if you survive it, can lead to one of three results: Either you turn numb, without sensation; or you insist you have a monopoly on the suffering and no other suffering compares to yours. Or you become hypersensitive and hyperactive against anything that shows the slightest similarity to what you have experienced yourself. You must make up your mind. I have decided to act and to react instead of castigating myself or claiming the zenith of all suffering”
I think we may have to split the third reaction into a more destructive and a more constructive variant. Trauma may lead to an amplifier in your brain and your soul which enlarges or even distorts much of your everyday normal experience (neutral, mildly negative or even positive), pushing it close to the traumatizing event. Or it may make you sensitive in a more positive sense, increasing your awareness of humiliating behavior, e.g., and your ability to feel and act in solidarity with those suffering from it. (As when you say that you suffered from your mother’s traumatizing experience but also learned intensively how to empathize.)
I have tried to translate this into collective and my personal experience, but I would like to first give you a chance to react to what I have written so far. You know a lot about trauma. What do you think and how would you translate the options developed by the Armenian-Palestinian?