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Sunday, November 22, 2015

After Paris, After Everything: Reflections on Death and Dying With Special Reference to Trauma

45e Convegno di Studio
“La Dimensione Umana del Morire e Il Sostegno alla Famiglia”
Accademia di Psicoterapia della Famiglia
Roma – 13-14 Novembre 2015

After Paris, After Everything:
Reflections on Death and Dying
With Special Reference to Trauma

Vincenzo Di Nicola


Psychiatrist-Psychotherapist-Philosopher Vincenzo Di Nicola attended the Convegno in Rome, “La Dimensione Umana del Morire/The Human Dimension of Dying,” 13-14 November 2015. This is his report.


Death and trauma as exceptions

Death and dying are eminently philosophical questions. Albert Camus famously asserted in The Myth of Sisyphus that suicide is the only serious philosophical problem.

The death of Socrates is a foundational myth for Western thought that heralds the mortal danger of critical inquiry. Accused of corrupting the youth of Athens, Socrates was condemned to death by hemlock for inviting them into his relational dialogues that led them to question received wisdom.

The earthquake that levelled the city of Lisbon in 1755, killing many of its citizens, was a seminal incident in European history that triggered critical reflection and theological questions such as the beneficence of God and divine providence. Gottfried Leibniz coined the term théodicée (teodicea, theodicy) to frame the question of how a good God could permit evil acts. Voltaire satirized Leibniz’s position in his provocative novella, Candide, whose protagonist Professor Pangloss pronounced, Tout est pour le mieux dans le meilleur des mondes possibles.”  (“All is the for the best in the best of all possible worlds.”)

The First World War in Europe destroyed not only countries and empires but a European culture of hope and progress. The 19th century positivism of August Comte had articulated this hopeful atmosphere, with its motto, Ordem e Progresso (“Order and Progress”) emblazoned in Portuguese on a banner on Brazil’s flag. Its undoing is reflected in the work of artists like Otto Dix who portrayed the war and its physically and spiritually traumatized soldiers and citizens. In this era, too, Freud began his research on war and death, memory and trauma. His use of the word invoked “trauma” as a breach, a rupture in the order of things, and thus an exception. His essay, Zeitgemäßes über Krieg und Tod (“Thoughts for the times on war and death,” 1915) is one of the most pained expressions of his humanistic concerns beyond the psychoanalytic couch.

Each generation since then has rediscovered and re-invented some new representation of horror and disaster that we call “trauma”:

·      * “Shell shock” (WWI combatants)
·      * “Combat fatigue” or “battle neurosis” (WWII combatants)
·      * “Concentration camp syndrome” (Nazi death camp survivors)
·      * “Post-traumatic Stress Disorder – PTSD” (Viet Nam war veterans)
·   * Genocide and post-genocidal societies (the Armenian Genocide, the Holocaust, the Rwandan and Bosnian Genocides)

Concerns about trauma are so prevalent today; they take up so much space in the collective imagination of sensitive and thoughtful people, that we may call our times the age of trauma. In invoking the age of trauma, I am not approving of this preoccupation but witnessing it.

The contemporary discourse of trauma implies that we are all at risk for trauma, if not actually traumatized. This creates a paradox whereby trauma, which is by definition an exception (a breach, a rupture in the order of things), becomes the norm, which by definition applies to all. This is precisely the contemporary predicament that Italian philosopher Giorgio Agamben has limned in his series of studies called Homo Sacer, notably in his historical-philosophical essay, Il stato di eccezione (The State of Exception). The state of exception, with its origins in the banishment of a Roman citizen who was legally neither inside nor outside Roman society, neither protected nor allowed to be killed, took its paradigmatic form with the Nazi death camps, justified by the legal philosophy of Carl Schmitt and sanctioned by German law. Do they exist today? Agamben asked in an interview:

Bisogna chiedersi se esistono dei “Campi” oggi in Europa …
Questi luoghi sono stati pensati come “spazi di eccezione” fin dall’inizio.
Sono zone pensate come zone d’eccezione in senso tecnico, come zone di sospensione della legge, così come zone di sospensione assoluta della legge erano i campi di concentramento, in cui – come dice Hannah Arendt – “tutto era possibile” perché appunto la legge era sospesa.
Giorgio Agamben, “Nei campi dei senza nomi,” Il Manifesto, 1998

We must ask ourselves if these “camps” exist today in Europe …
These places were imagined as “spaces of exception” from the beginning.
They are zones imaged as zones of exception in the technical sense, as zones where laws are suspended, just as concentration camps were zones of the absolute suspension of laws, where – as Hannah Arendt says – “everything was possible” precisely because law was suspended.
Giorgio Agamben, “In the camps of the nameless,” Il Manifesto, 1998

In this contemporary cultural logic, we are all in a traumatic situation, we are all living a kind of death, una muerta anunciada (“a death foretold”) to invoke the title of a novel by Gabriel García Márquez. The cultural-historical dynamic that brings us to this predicament is an exquisite sensitivity whereby we wish to acknowledge and witness kinds of suffering. Some decry this as a form of political correctness that becomes authoritarian and condescending. I will go further and call it nihilistic.  

I contest this way of thinking and propose precisely the contrary: trauma is and remains an exception. Trauma is neither the condition of all of us nor should this be an accepted way of living. Most of us, most of the time, cannot identify with the exception that is trauma because it is not a shared experience.


The possibility of witnessing death

In the middle of the conference, between the two conference days, the Paris terrorist attacks occurred in which 129 people were murdered. As if to make my point, at a meeting of several hundred sensitive and thoughtful people, no one could find the words, a way to address what had happened in Paris until the very last minutes of the conference when it fell to a younger man, a therapist-in-training to ask how we could close the conference with no mention of what had occurred. As it turned out, there was a sizeable group attending the conference from Palermo, Sicily that was in mourning over the loss of one of their members. Instigated by the student’s courage, Maurizio Andolfi, the Director of the Accademia di Psicoterapia della Famiglia, spoke to these two kinds of losses and asked the Palermo group to stand as we observed a moment of silence.

As an exception, trauma is like death: we do not have easy access to it. Vittorino Andreoli, an Italian psychiatrist-neurologist, novelist and playwright, asserted in his keynote address to the conference that, “morte e dolore sono le espressione più umane,” that bring out in us, “la voglia di auitare.” (“Death and pain are the most human expressions,” that bring out in us, “the wish to help.”)

I do not know what it means to say that pain and death are the most human of experiences. Is it a description of the human condition? Does it mean that they are universal, unavoidable and hence define our very existence? Is it rather a prescription for how to be more humane, if not human? Does it mean, as Andreoli suggested, that it brings out in us the need to be understood and the wish to help others in their pain? Many of us healers identify with that. But callous indifference and sadism are also the lot of humanity.

I would like to comment first as a philosopher, then as a psychiatrist-psychotherapist. The issue is whether we can witness the exception without living it ourselves. To make this come alive for you, I recommend a reading of Maurice Blanchot’s brief story-memoir, L’Instant de ma mort (“L’Istante della mia morte”), where he asserts, “Solo io posso testimoniare alla mia morte.” Condemned to death, the author-protagonist of the memoir awaits his death but does not die. In this context, he was able to testify to the possibility of death, as he says, “at the instant of my death.”

How are we to read – to understand, to signify, to grasp – this text? Philosopher Jacques Derrida in a companion piece called Demeure (Dimora), marks the distinction in German between Dichtung (fizione, fiction) and Warheit (verità, truth). Is the text a fiction or is it the truth? Is it a short story or a memoir? Is death then an understanding (that is, a construction) or an experience? This creates these antinomies:

Dichtung                    vs.                    Warheit
Construction              vs.                    Truth
Culture                       vs.                    Nature 


Is this “most human of experiences,” in the words of physician-novelist Andreoli, face to face with the finitude of our mortal existence, a construction or a truth, a shared cultural experience or a natural one? Spared of dying by another’s death, Blanchot’s protagonist feels a légèreté, a “lightness” which Derrida claims is neither a relief nor a salvation. In the end, Blanchot writes about the impossibility of testifying to one’s own death and asks who has the right to declare the instant of my death?

Now, the community of healers – psychiatrists, psychologists and psychotherapists – may well ask why does a philosopher offer this reflection? Of what use is it to us? Blanchot’s writing both closes and opens perspectives on dying. In problematizing the question of testifying to death – problematizing is a kind of enclosure, giving form to a question – Blanchot opens for us the possibility of a relational understanding of dying. Not the journalistic truth of what can be documented, nor the phenomenological truth of what is experienced, but of what can be communicated and witnessed interpersonally. A shared human experience of our finitude.

In his profound reading of Primo Levi’s writings about Auschwitz, Quel che resta di Auschwitz: l’archivio e il testimone/What Remains of Auschwitz: The Archive and the Testimony, Giorgio Agamben says that all we can do is to read Levi as a witness who was there. A witness not of his own death but of the lives and deaths of others in the spazio di eccezione, the space of exception where a new forma-di-vita, form-of-life took hold – la vita nuda, bare life. Even when the inmates living a bare life could not witness their own deaths and testify to them, the survivors have the imperative to bear witness and to testify. This is a relational understanding of the truth of existence, of life and of death. It is not easy, it is not common, it cannot be taken for granted, but the effort to do so – to witness and to testify – makes us more human, even as the state of exception makes it everyday more arduous and more tenuous.

When the conference ended, I waited to say goodbye to my friend Maurizio Andolfi as we were both travelling to other places while the Palermo group sat silently, huddled together for comfort, wordlessly reaching out to Maurizio, and indeed, as everyone else left, Maurizio stayed there to bear witness.  And I write this to testify.

This is now the task before us, as psychotherapists, after Paris, after everything.

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