trauma

November 18, 2017

A Unique Perspective on Traumatic Shock

It was just another late autumn Friday afternoon. A New England autumn. A lovely time to be in Boston. Warm enough, with a high in the 50s.

The greatest shocks never warn.

Matinee symphony concerts, such as those of the Boston Symphony, were then attended by more ladies than men. Surely, in the November audience, many from high society – the scions of colonial days – occupied the best seats. Old money, as they say.

The intermission concluded and Erich Leinsdorf, the orchestra’s Viennese-American Music Director, came on stage. His hands stilled the applause.

Leinsdorf had an announcement to make.

Relive the moment if you are courageous enough: the 53-word report of the November 22, 1963 assassination of President John F. Kennedy and, more remarkable, the audience’s reaction.

Countless TV and radio interruptions like this occurred, all with the same terrible news. None of the recordings of those broadcasts, however, carry the shock of Leinsdorf’s, because none allow us to hear a traumatized, horrified audience.

Some of the concert-goers knew Kennedy personally. Many had seen him close up. He was a son of their soil and their soul.

Before saying more, I will give you the opportunity to listen. Additional description, context, and analysis follow. Should you be afraid of the shock, however, you may want to read on first. One further word: I’ve included over a minute of the Boston Symphony broadcast before Leinsdorf speaks. I did this to put you in the mind of a Boston listener of the time, unprepared for the unimaginable. Leinsdorf begins to talk about a minute-and-a-half in:

Erich Leinsdorf gave two messages simultaneously, unwittingly. He was convinced Kennedy was dead, but conveyed uncertainty. The audience gasped. Then, before they could process the news – before they could admit to themselves that the President was gone – the orchestra began the Funeral March from Beethoven’s Eroica Symphony, a piece dedicated to the memory of a fallen hero. Music of consolation served, in this instance, to kill hope.

Perhaps those of you too young to remember the day cannot understand how Americans then felt, despite the more recent shocks you have known. No President had been murdered since William McKinley in 1901, 62-years before Kennedy. The closest previous U.S.A. horror was the Pearl Harbor invasion of December 7, 1941, 22-years before: before my generation, the Post WWII Baby Boomers, were born.

We were – we middle class white kids – yet untouched by national tragedy; a condition now lost in the wave of gun-related domestic massacres, the terrorist catastrophe of September 11, 2001; and subsequent (almost routine) calamities of so many kinds. By 1968, five years later, the murders of Martin Luther King, Jr. and Robert Kennedy had deflowered the virgin sensibilities of my age group. No wonder smoking marijuana became almost as common among us as saying hello.

On the other hand, if you grapple with Post Traumatic Stress Disorder from the inside, the audience reaction in Symphony Hall is within the range of your experience. And for those lucky enough not to have suffered such a blow, perhaps listening to this broadcast excerpt will bring you an inch closer to understanding what personal trauma is like.

At least, how it sounded 58-years ago.

June 12, 2016

A Remarkable Recovery From Unspeakable Grief and PTSD

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Some stories stick with you. The word “heartbreaking” is not enough to describe them; nor do “resilience,” “survival,” and “overcoming misery” say enough.” Yet all those words apply.

The therapist in the tale who helped enable a positive conclusion was Donald Meichenbaum, Ph.D. He related this account in a video focused on finding meaning in the aftermath of trauma: PTSD & Complex PTSD: Ways to Bolster Resilience. 

Don’t read further if you wish to avert your eyes from tragedy, but understand this: you cannot know of the treatment that allowed for a redemptive, healing story unless you face it.

The woman: a young, bright, intelligent mother. A good mother. Her husband was away on a business trip. Home held only her daughter and herself. An intruder could be heard downstairs. Mom entered Vicky’s room and they hid in her closet. The burglars left without going upstairs. The event upset both Vicky and the mother, worried such an episode might happen when the husband/father traveled once more to make his living. The adults installed a security system and alerted the police. They lived in a safe neighborhood. No reason to expect another forced entry. Still, the man insisted his wife get a gun, just in case. She did not like firearms, but relented. The night stand next to her bed harbored the weapon.

Time passed. The man traveled again. Late and stormy darkness. Noises downstairs. Was the mother dreaming, reliving an imaginary or remembered version of the home invasion?

No. No. No. Not again.

Yes, again.

The mother urgently reached for the gun and moved toward her bedroom door to go to Vicky’s room, just as she had the first time. Vicky came running and pushed the mom’s door open. It struck the mother’s hand and the firearm discharged. Vicky died immediately. The mother sat with her dead daughter for 24-hours until the husband returned.

No words are possible. The parents’ lives were forever changed. Guilt, horror, marital separation, grief, depression. Even loving friends became unavailable, unable to bear the story. Alienation and isolation. As the mother saw it, a life not worth living. She deserved to die.

What is a therapist to do? He can never undo the tragedy, but perhaps he can help the survivor to find a reason to live, a meaning for the rest of her life. Here is what Meichenbaum did:

The psychologist knew his job was first to establish a therapeutic alliance, to show compassion, and accept, not judge. He needed to allow the patient to tell her story as she was able, permit its unfolding, not push. A plan to prevent the woman’s self-harm was created. The therapist allowed his emotions to be touched. His own tears came as he listened.

The psychologist asked a question to understand more about the loss. The client had said that Vicky was “special.”

In what way?

She was wise beyond her years.

The first session ended and the doctor arranged a second appointment in two days’ time. Meichenbaum made a request. He said he would be “honored and privileged” if mom brought in a photo album of Vicky, but only if she wanted to: no pressure. He wished to get a further sense of who the child was.

Reviewing the pictures together was painful in the extreme. Yet this marked the beginning of the doctor’s effort to embed the only moment the mother focused on (the accident and death) within a broader narrative of Vicky’s life and her own life: to pull his client out of the single instant of horror into the stream of her ongoing existence — perhaps to create a potential redemptive story projected into the future.

This is not to suggest any kind of treatment would ever erase the pain or guilt completely. Yet, it might still be possible to help the mother give Vicky’s memory meaning. And perhaps to transform the patient’s life in the process.

The therapist asked his client another question. Two, actually. He wanted to know what this child (who was “wise beyond her years”) might say to the parent’s wish for oblivion:

What advice would Vicky give and what would happen to the memory of her if you kill yourself?

The mother affirmed the obvious answers which had escaped her: Vicky would not want her to die. Moreover, the memory of Vicky would also die with the death of the one who knew her best. Meichenbaum’s questions led her to realize she might do some good in the world, something to perpetuate Vicky’s memory and give meaning to the child’s short life. Treatment continued. Mom became a public advocate for gun locks and gun safety, thus transforming her loss and honoring Vicky.

In part, Donald Meichenbaum assisted the patient to fashion a new story of her own life different from one ending with two deaths. She became aware her time on earth was not yet completed. And that Vicky’s impact on the world offered a potential future, if only the parent gave her daughter a metaphorical life — gave voice to what her daughter’s death could still achieve.

This is not at all to suggest the mother wouldn’t have traded anything — anything — to get Vicky back. Yet, the mom might yet continue her existence with a constructive narrative of redeeming value in spite of complicity in the child’s loss.

Meichenbaum is famous for asking questions — for creating a Socratic Dialogue with his patients. He did not give his patient advice, but led the conversation so she might grasp the next rung on the ladder of recovery, not simply be handed it. Therapists should know “directions” from the counselor don’t produce as much “ownership” of the treatment process, nor as much motivation to change, as occurs when he helps the client uncover her own way, not just follow advice.

Might you also find your own way? Might the rest of your story be one of value?

What do YOU say?

—

The photo is titled Pedra do Baú — Compos do Jordáo. The author is Izabel Tartari and it was sourced from Wikimedia Commons.

February 27, 2010

Experience and Memory

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The last Canadian World War I veteran, John Babcock, is dead. He passed away at age 109 in Spokane, Washington on February 18, 2009. Frank Buckles, also 109, remains the sole surviving American veteran of the “War to End All Wars,” according to The New York Times.

With Mr. Buckles inevitable departure, we will all lose contact with what happened in Europe between 1914 and 1918 within what is called “living memory;” the contact that can only come from the direct experience of the world-changing event that shaped the lives of many of our grandparents or great grandparents. Our only available sources of information will then be in the form of books, stories that the survivors told to those still alive, old silent movie film of some of the battle action, recorded reminiscences, journals a few of the combatants kept, accounts from war correspondents, and the like.

All of which leads me to think about memory and experience. And why understanding them is important.

Experience takes a number of forms and, when the experience is past, it becomes a memory. Simple enough on the surface, but not simple at all.

First, there is the “living” of the thing, actually participating in an event. In the case of Frank Buckles, that meant driving an American Army ambulance in France during the conflict itself, witnessing the carnage, hearing wounded men cry for their mothers, making and losing friends, feeling the “pee-in-your-pants” terror of it, getting shot at, carrying a gas mask or perhaps being exposed to poison gas, ministering to the wounded, jumping into fox holes—eating, drinking, and sleeping it all. But once Mr. Buckles returned home from the front, his time there had become a memory and was now different from the actual, in-the-moment intensity of the lived-experience, an intensity that nothing in his long life after the war could match.

At another level, more removed, there are the spectators to events. We all achieve the status of “watchers” when we attend a sporting competition. We see and hear a good deal of what is happening, even if we don’t ourselves play in the game.

At even more distance from the event are those who watch at home. They will miss some of the “atmosphere” of “being there” unlike those of us independent of TV cameras, who will see the event naturally, in the way it unfolds in real-life (without the mediation of a cameraman or the interruption of commercials). And the “at-home” audience will not experience the same roar of the crowd, the heat of sun on skin, the faces of the beer vendors, and the thousands of movements and sounds of the athletes and spectators that the cameras and microphones do not record.

More distant still from the actual experience is a radio broadcast, where one’s imagination and memory of events like the one being reported tend to fill in the blanks where no visual representation of the event is present. At a further remove might be a newspaper account of the game or a friend’s description of what happened from his memory of being there himself.

Experience is one thing, memory another. Memory can only approximate the event itself and can alter or fade with the passage of time. Remember your first kiss—all the thousands of sensations happening all at once—the rush of being alive, the smell of perfume or aftershave or the person’s natural scent, the touch and texture of skin, the moistness and softness of lips, your own heartbeat, body against body—firmness, roundness—the moment before and after, the placement of your hands, the color of your partner’s eyes and their expression in those same moments? Now, as you think about it, however good your memory, I think you will admit that remembering is not the same as living it.

At least in the case of memories of things like your first kiss, you have an advantage over others’ understanding of that experience because it was yours and not theirs. It becomes a good deal harder to relate to the experience of others, especially if they have lived through something wholly unlike what has happened in your own life. The most dramatic examples I can think of come from those who have experienced severe trauma. Take the testimony of a Holocaust survivor, Magda F., from the Fortunoff Video Archive of Holocaust Testimonies quoted by Lawrence Langer in Holocaust Testimonies: the Ruins of Memory, as relatives implored her to talk about her experience:

And I looked at them and I said: “I’m gonna tell you something. I’m gonna tell you something now. If somebody would tell me this story, I would say ‘She’s lying, or he’s lying.’ Because this can’t be true. And maybe you’re gonna feel the same way. That your sister’s lying here, because this could not happen. Because to understand us, somebody has to go through with it. Because nobody, but nobody fully understands us. You can’t. No (matter) how much sympathy you give me when I’m talking here, or you understand…you’re trying to understand me, I know, but I don’t think you could, I don’t think so.”

And I said this to them. Hoping (they) should never be able to understand, because to understand, you have to go through with it, and I hope nobody in the world comes to this again, (so) they should understand us. And this was the honest truth, because nobody, nobody, nobody…

Those of us who are the children of Americans who survived the Great Depression got a little bit of this kind of understanding, I think, in late 2008, when the economy fell off a cliff and looked like it was going to continue falling and possibly repeat the Great Depression. We’d heard the stories our parents or grandparents told, we’d read the history books describing the period between the Stock Market crash of 1929 and the beginning of World War II, but we hadn’t lived in a period anything like that. Now, we were getting a taste of it, even if, for most of us, it was only a taste and not the whole meal. Now we know more, and better, what it was like for our elders (and what it is like for our fellow Americans who are losing their homes along with their livelihoods right now).

Sergiu Celibidache, the Roumanian symphony conductor, put very well the difference between direct experience and some form of pale attempt to duplicate that experience in a different time and place. Celibidache believed that it was impossible to accurately render the transcendant impact of musical performance except in a concert hall. He thought that recordings were a fraud, because they attenuated this experience and altered it, didn’t duplicate the physical and aural sensations present sitting in the hall, listening to the full dynamic range of sound as that sound was being made in the same acoustical environment as the musicians themselves. Therefore, Celibidache refused to make recordings for most of his career. And, in the days before anyone ever considered the possibility of experiments in virtual reality, he said that “listening to a recording is like making love to a picture of Bridget Bardot,” the gorgeous French model and actress of the 1950s and 1960s.

Adlai Stevenson II, as I’ve quoted elsewhere, captured the impossibility of fully communicating an experience he’d had to those who had not yet had that experience in a 1954 speech (made when he was 54) to the senior class of his alma mater, Princeton University:

“…What a man knows at fifty that he did not know at twenty is, for the most part, incommunicable. The laws, the aphorisms, the generalizations, the universal truths, the parables and the old saws—all of the observations about life which can be communicated handily in ready, verbal packages—are as well known to a man at twenty who has been attentive as to a man at fifty. He has been told them all, he has read them all, and he has probably repeated them all before he graduates from college; but he has not lived them all.

What he knows at fifty that he did not know at twenty boils down to something like this: The knowledge he has acquired with age is not the knowledge of formulas, or forms of words, but of people, places, actions—a knowledge not gained by words but by touch, sight, sound, victories, failures, sleeplessness, devotion, love—the human experiences and emotions of this earth and of oneself and other men…”

So, put another way, for example, no one who hasn’t been in love can know what love is; no one who hasn’t experienced discrimination or fought against it can really understand it fully; no one who has only watched a travelogue about the countryside really knows what it is like to be in the country; just as those who observe from the sidelines and never have played the game cannot completely grasp the clichéd expression about “the thrill of victory and the agony of defeat.”

No, life is about the living of it, not the reading about it or the watching  of it. And, so too, it is about knowing that you don’t know fully about the experiences you haven’t had. It is about knowing that you can only approximate a real and complete appreciation of another’s life; knowing that some of those things the other has witnessed or lived through are frankly unknowable without their experience; knowing that the depths of human personality, emotion, and incident are infinitely great and that one can only approach the deepest point in knowledge and understanding even as we reflect on our own live’s through the lens of memory; and knowing that the death of the last veteran of World War I robs us all of some element of connection to history and, therefore, to the forces that shaped us, our parents, and their parents.

Life is infinitely humbling, fascinating, terrifying, and touching. I imagine one could live a dozen lives, some in one gender, some another; some straight, some gay; some black, some white, some yellow; some married, some single; some in this time, some in the future and the past; some here, some there; and still not achieve the richness that is possible.

But, of course, we only get one, so far as anyone knows. That means we must get on with things.

The day is short and there is much to do.

—

The photo above is of Frank Buckles with Secretary of Defense Robert M. Gates on March 6, 2008 by Cherie A. Thurlby of soldiersmediacenter, sourced from Wikimedia Commons.