This blog started by posting research threads for my doctorate in philosophy at the European Graduate School, "Trauma and Event" (2012). Now, I am focusing on the crisis in psychiatry which is the subject of a forthcoming volume co-written with fellow psychiatrist and philosopher Drozdstoj Stoyanov - "Psychiatry in Crisis: At the Crossroads of Social Science, the Humanities and Neuroscience" to be published by Springer Medical in 2018.
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Friday, December 16, 2011
What We Talk About When We Talk About Trauma
This essay was written in the spring of 2011 as my inaugural column for the alumni newsletter of the Harvard Program in Refugee Mental Health with the overall epigraph from American anthropologist Clifford Geertz, a plea against received wisdom in favour of critical thinking.
GLOBAL MENTAL HEALTH
ALUMNI SOCIETY NEWSLETTER
Column: Critical Thinking About Trauma
If we wanted home truths, we should have stayed home.
What We Talk About When We Talk About Trauma
Vincenzo Di Nicola
What wound was I seeking to heal, what thorn was I seeking to draw from the flesh of existence when I became what is called “a philosopher”? —Alain Badiou1
ANNUNZIATA, my maternal grandmother, was born in 1910 in a quarter of Pescina, L’Aquila, Italy, called Fontamara.2 In her lifetime, she lived through the Spanish Influenza, an earthquake that fairly levelled her town, two world wars fought in our backyard, the deaths of two young children and the early death of her husband just after the Second World War which he had spent in Libya fighting and as a prisoner, leaving her as a widow with four young children and an estate to manage.
While she would cry retelling the stories of her children’s death, I would not say she was traumatized in any way, nor would I describe her as resilient. She simply lived through those dramatic experiences—natural and man-made disasters and the fullness of the lifecycle in a world where everything happened at home. I was born in the same bed that my grandfather died in!
It is possible that my grandmother, preoccupied with the vicissitudes of life, did not have the leisure or the capacity to find “the words to say it,” to express her suffering. Her mother kept her home to work and she never spent a day in school. But a distant cousin born in the same town did find the words and the man who took the name of Ignazio Silone from the high road above that same quarter and made Fontamara famous in world literature wrote that he was marked for life by the earthquake in Pescina.3
So Much Trauma So Close To Home
The American writer Raymond Carver wrote well-wrought short stories (we could say he was well-named as his stories feel sculpted, mostly by the art of excision, removing all superfluities) about the disappointments and ruptures of daily life and family relationships. He is our portraitist of trauma, alerting us to the vicissitudes of everyday life, or to adapt the title of one of his more disturbing stories—“So much trauma so close to home.”4
A popular trope in contemporary Western cultures holds that people experience traumatic experiences that must be transformed. There are several elements wrapped together in this notion: that bad things happen, that they have traumatic impacts which may be nonetheless mitigated by resilience and which may in any case be transformed into triumphal experiences. Clearly, I wish to challenge this trope.
One of the reasons to read literature and philosophy is precisely to prepare us to bear these stories and to understand them. Philosopher Hannah Arendt said we cannot master a traumatic past but we can try to know it and endure it before we reach for transformation.5 To do this, Richard Mollica offers us the simplest yet deepest of empathic tools: the trauma story. I call it the story that must be told. Telling stories is necessarily dialogic and relational. The story that must be told must be told to another in what I call the relational dialogue.6
And we, who think of ascending joy, would feel the emotion that almost dismays us, when a joyful thing falls. —Rainer Maria Rilke, Duino Elegies7
Paul Celan is the modern European poet of trauma. His most accessible and successful poem, “Death Fugue” was criticized in some quarters for aestheticizing the Nazi death camps.8 Even he distanced himself from his own creation, refusing to have his most celebrated work anthologized. But this has many layers. First, let us recognize that Celan was able to create his art out of suffering. Against Theodor Adorno’s notorious pronouncement that after Auschwitz there can be no more poetry, Celan was able to do just that: to write poetry almost literally with the ashes left in the ground and rising in the air of Auschwitz. He was able to wrest a terrible beauty from the limit experiences there.9 Yes, there are objections to shaping beauty out of terror (remember Milton’s “Paradise Lost” and “Paradise Regained”) but consider the alternative: that horror is unspeakable, its execution unthinkable, the experience incommunicable and the consequences unbearable. And yet Primo Levi, who was suspicious of the notion of incommunicability, proved to be a sober, stable witness of the unthinkable and found ways to speak it in a measured voice with calm tones.10
Can we imagine what Rilke challenges us to imagine? Instead of transforming trauma, can we imagine that suffering is an experience, what Rilke calls a joyful thing falling? Let’s not be too concrete about the word joyful. Think of Dylan Thomas’ wartime poem, “A Refusal to Mourn the Death, by Fire, of a Child in London.”11 Here, the joyful thing falling is a child and the refusal to mourn is a statement about how the experience is to be construed. Is it to be traumatic? Will it occlude or open experience? Thomas suggests an occlusion, but as a choice, a kind of mourning without mourning in a nuanced final line that asserts
After the first death, there can be no other
As Adorno said elsewhere, “all expression is the trace left by suffering.”12 Let me connect this now to what Mollica says. By creating the conditions that allow the trauma story to be told, we can follow the trace left by suffering. It is the ideology of our day that such suffering is traumatizing and hence needs to be transformed. In order to be borne and tolerated, it must be changed.
A popular American movie was based on a memoir called Girl, Interrupted. This resonant title perfectly captures Susanna Kaysen’s fragmented experience.13 I think of trauma this way: it interrupts life, becoming “a nodal point” in someone’s lifeworld, marking a before and an after, as in Leftover Life To Kill, Caitlin Thomas’ account of her life after the death of her husband, the celebrated and hard drinking poet Dylan Thomas.14 Whether that point is a rupture or an event depends on all the things that this community holds dear—those positive characteristics and qualities that allow for an experience to open up new possibilities—or close down them down in a rigid and hurtful way.
Alain Badiou has given us a new philosophy of the event defined as an experience that heralds change by introducing novelty.15 This is in stark contrast to the literature on stress (including posttraumatic stress disorder) where no matter how we perceive it, stress is stress, accumulating and multiplying inexorably towards illness. In Badiou’s philosophy, one can live an entire lifetime and not experience an event. We can live through something that is an event for others and not for ourselves. An experience that closes the possibilities of a life is the opposite of an event; it is a rupture, occluding change. It is traumatic.
We can even apply this insight to ourselves as therapists, philosophers or whatever practice we follow, as Badiou explained the epigraph to this column:
It may be that, as Bergson maintained, a philosopher only ever develops one idea. In any case, there is no doubt that the philosopher is born of a single question, the question which arises at the intersection of thought and life at a given moment in the philosopher’s youth; the question which one must at all costs find a way to answer.
This is deeply compatible with Alice Miller’s view of how we become therapists in her classic, The Drama of the Gifted Child.16 Early in life, we are taken by certain family dramas which those of us who become therapists work to resolve “at all costs,” as Badiou so poignantly puts it.
Waiting and Seeing
Who can tell from the sound of the word ‘parting’ What kind of bereavements await us —Osip Mandelstam, Tristia17
We need to clarify our language and thinking about trauma. The poet Mandelstam lamented the impoverished language of our emotions. We have conflated vicissitudes, vulnerability, suffering and trauma. Currently, one word, trauma, refers to the context, the triggering incident, object or agent (vicissitudes), the individual disposition before, during and after the incident, as well as the lifeworld of the individual in a web of relationships (vulnerability vs. resilience), not to mention the complex responses (suffering) to all of the above. Like the difference between illness and disease, we need a more nuanced vocabulary of suffering.18 Such a lexicon will not come from any one group and nobody can own trauma. Neither psychiatry nor psychoanalysis, neither medicine nor psychology, and neither those who document and catalogue suffering nor the sufferers themselves can exhaust what we wish to capture with the notion of trauma.
Another conflation and category mistake is the almost automatic coupling of trauma and transformation. Like the poet’s refusal to mourn, let us refuse to demand of those who suffer that they transform their experience. While I wish to acknowledge strength and celebrate survival, I suggest another way to imagine these positive experiences. Trauma may be contrasted with Badiou’s notion of the event. An event opens possibilities of experience; trauma closes them. This philosophy creates a dialectic, opposing rupture against continuity, trauma against event.19
What do we talk about when we talk about trauma? Many things, but too little about trauma itself. The wellness and flow of positive psychology, the resilience and transformation of the clinical professions belong to a different set of experiences that we may call, following Badiou, events, opening possibilities.20 It is not clear how we can yoke trauma to transformation without doing violence to the notion of trauma, either through a psychological negation or a philosophical reduction.
I am talking about trauma: a rupture in the lifeworld of those affected by vicissitudes, interrupting their lives. In his phenomenological philosophy, Edmund Husserl called for an epoché: a pause before action, “bracketing away” lived experience to create a reflective distance.21 Faced with trauma, I am asking anthropologists and journalists, historians and jurists, philosophers and filmmakers simply to witness and to bear the trauma story. And those of us who put broken lives back together must first cure ourselves of the need to do “emotional alchemy” as a way of validating our work. Against the automatic interpretation, the demanded change and the imposed meaning, I am asking all of us in the global community of mental health face to face with trauma to heed what Hannah Arendt said about the traumatic past:
The best thing that can be achieved is to know precisely what it was, and to endure this knowledge, and then to wait and see what comes from knowing and enduring.22
1 Alain Badiou, Preface, After Finitude: An Essay on the Necessity of Contingency by Quentin Meillassoux, trans. by Ray Brassier (London: Continuum, 2008), pp. 3-4.
2 This column is dedicated to my grandmother, Annunziata Cipriani (1910-2005), who taught me the love of words through words of love. I am grateful to many thoughtful first readers who have helped me clarify my thoughts: Jan Jorgensen, Carlo Di Nicola, Armando Favazza, Eliot Sorel, Raymond Reed, Patrick Reed, Paul Francis, Emmanuel Stip, Laurence Kirmayer, Jacques Bernier, Ryan Smith and Paul Boshears.
3 Fontamara is part of Ignazio Silone’s The Abruzzo Trilogy (Zoland Books, 2000). Marie Cardinal, The Words to Say It, trans. by Pat Goodheart; Preface and Afterword by Bruno Bettelheim (Cambridge, MA: Van Vactor & Goodheart, 1983).
4 Raymond Carver’s collection of short stories, What We Talk About When We Talk About Love (New York: Vintage Books, 1982), includes “So Much Water So Close To Home” (pp. 79-88) in which four men on a fishing trip discover the naked body of a dead girl floating in a river. These stories and others inspired Robert Altman’s movie, Short Cuts (1993, available in the Criterion Collection, 2004). Altman described them as “terrific because he made stories out of small incidents. None of them were extraordinary, but mundane events could have important emotional consequences” (p. 163) in Altman on Altman, ed. by David Thompson, Foreword by Paul Thomas Anderson (London: Faber and Faber, 2006). Readers of philosophy will hear other resonances in my title, notably the influence of Wittgenstein through Stanley Cavell’s Must We Mean What We Say?2nd ed. (London: Cambridge University Press, 2002).
5 Hannah Arendt, “On humanity in dark times” in Men in Dark Times (San Diego: Harcourt, Brace, Jovanovich, 1968), pp.20-22.
6 Richard F. Mollica, Healing Invisible Wounds: Paths to Hope and Recovery in a Violent World (Vanderbilt University Press, 2008).All therapeutic approaches to narrative owe a debt to Bakhtin’s dialogism; see Mikhail M. Bakhtin, The Dialogic Imagination: Four Essays by M.M. Bakhtin, ed. by Michael Holquist, trans. byCaryl Emerson and Michael Holquist (Austin, TX: University of Texas Press, 1981). For an application of Bakhtin's dialogism in creating relational dialogues, see my Letters to a Young Therapist: Relational Practices for the Coming Community (New York & Dresden: Atropos Press, 2011).
7 Rainer Maria Rilke,“The Tenth Elegy” in The Duino Elegies, trans. by A.S. Kline.
8 Paul Celan: Selected Poems, trans. by Michael Hamburger and Christopher Middleton, Introduction by Michael Hamburger (Harmondsworth: Penguin, 1972).
9 Michael Hamburger in Paul Celan, op.cit., pp. 9-20.
10 Primo Levi, The Drowned and the Saved, trans. by Raymond Rosenthal (New York: Summit, 1989). Philosopher Giorgio Agamben reads Levi as a witness in Remnants of Auschwitz: The Witnessand the Archive. Homo Sacer III, trans. by Daniel Heller-Roazen (New York: Zone, 1999).
11 Dylan Thomas, “A Refusal to Mourn the Death, by Fire, of a Child in London” in Collected Poems (London: Dent, 1952), p. 101.
12 Theodor Adorno, “Heine the Wound,” in Can We Live After Auschwitz? A Philosophical Reader, ed. by Rolf Tiedemann, trans. by Rodney Livingstone, et al. (Stanford, CA: Stanford University Press, 2003).
13 I am struck by the fragmented quality in these two women’s memoirs: Susanna Kaysen, Girl, Interrupted (New York: Vintage Books, 1994) and Caitlin Thomas, Leftover Life to Kill (London: Putnam, 1957).
14 Family therapist Maurizio Andolfi proposed the notion of a “nodal point” which gives structure and meaning to family narratives (Maurizio Andolfi, Claudio Angelo, and Marcella de Nichilo, The Myth of Atlas: Families and the TherapeuticStory, trans. and ed. by Vincenzo F. Di Nicola; New York: Brunner/Mazel, 1989) while phenomenological philosopher Edmund Husserl proposed the notion of “lifeworld” as the canvas of such narratives (Edmund Husserl, The Crisis of European Sciences and Transcendental Philosophy, trans. by D. Carr; Evanston,IL: Northwestern University Press, 1970).
15 Alain Badiou, Being and Event, transl. by Oliver Feltham (New York: Continuum, 2005). For an accessible introduction to Badiou’s work see Ed Pluth, Alain Badiou: A Philosophy of the New (Cambridge, UK: Polity, 2010). For our purposes, the key feature of an event is its radical contingency, which means that it is situated between nothing and itself, introducing novelty (novation in French). A perfect illustration of radical contingency creating an event is the poem “Could Have” by Wislawa Szymborska, View From a Grain of Sand: Selected Poems (Boston: Houghton Mifflin Harcourt, 2001), pp. 65-66.
16 The similarities between philosophers Henri Bergson and Alain Badiou and Swiss psychoanalyst Alice Miller are striking in this regard. See Alice Miller, The Drama of the Gifted Child: The Search for the True Self, 3rd ed. (New York: Basic, 1996).
17 Osip Mandelstam, “Tristia” in Osip Mandelstam: Selected Poems, translated by Clarence Brown and W.S. Merwin (London: Oxford University Press, 1973), p. 23.
18 Arthur Kleinman, The Illness Narratives: Suffering, Healing, and the Human Condition (New York: Basic, 1989).
19 I am grateful to Alain Badiou for edifying conversations on my thesis, which he calls “ce couple traumatisme-événement—this pairing of trauma and event,”at the European Graduate School, 2009-2010.
20 Many things have their place in our work, but I am expressing what I perceive on a broad canvas as a denial of suffering and more narrowly as a denial of mental illness in contemporary professional discourses. In the guise of “positive psychology,” I discern much negation in these narratives. Both philosophy and psychoanalysis have much to say about negation and reduction, which I will take up in another essay.
21 Edmund Husserl, op. cit.
22 For a more detailed deconstruction of what we mean by change and how we limit therapy by yoking it to change, see my Letters to a Young Therapist, op.cit. Quote from Hannah Arendt, op. cit., p. 20.