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Dr. Zafirides The Trauma Of Being Alive

Discussion in 'General Discussion Subforum' started by Peter Zafirides, Aug 17, 2013.

  1. Peter Zafirides

    Peter Zafirides Physician

    Hi Everyone.

    I have been meaning to post this article for about a week now. I thought this was a wonderful piece, written Dr. Mark Epstein (a psychiatrist). I hope you like it.

    Dr. Z

    The Trauma of Being Alive

    By: Mark Epstein, MD

    source: http://nyti.ms/19BaRI8

    Talking with my 88-year-old mother, four and a half years after my father died from a brain tumor, I was surprised to hear her questioning herself. “You’d think I would be over it by now,” she said, speaking of the pain of losing my father, her husband of almost 60 years. “It’s been more than four years, and I’m still upset.”

    I’m not sure if I became a psychiatrist because my mother liked to talk to me in this way when I was young or if she talks to me this way now because I became a psychiatrist, but I was pleased to have this conversation with her. Grief needs to be talked about. When it is held too privately it tends to eat away at its own support.

    “Trauma never goes away completely,” I responded. “It changes perhaps, softens some with time, but never completely goes away. What makes you think you should be completely over it? I don’t think it works that way.” There was a palpable sense of relief as my mother considered my opinion.

    “I don’t have to feel guilty that I’m not over it?” she asked. “It took 10 years after my first husband died,” she remembered suddenly, thinking back to her college sweetheart, to his sudden death from a heart condition when she was in her mid-20s, a few years before she met my father. “I guess I could give myself a break.”

    I never knew about my mother’s first husband until I was playing Scrabble one day when I was 10 or 11 and opened her weather-beaten copy of Webster’s Dictionary to look up a word. There, on the inside of the front cover, in her handwriting, was her name inscribed in black ink. Only it wasn’t her current name (and it wasn’t her maiden name). It was another, unfamiliar name, not Sherrie Epstein but Sherrie Steinbach: an alternative version of my mother at once entirely familiar (in her distinctive hand) and utterly alien.

    “What’s this?” I remember asking her, holding up the faded blue dictionary, and the story came tumbling out. It was rarely spoken of thereafter, at least until my father died half a century later, at which point my mother began to bring it up, this time of her own volition. I’m not sure that the trauma of her first husband’s death had ever completely disappeared; it seemed to be surfacing again in the context of my father’s death.

    Trauma is not just the result of major disasters. It does not happen to only some people. An undercurrent of trauma runs through ordinary life, shot through as it is with the poignancy of impermanence. I like to say that if we are not suffering from post-traumatic stress disorder, we are suffering from pre-traumatic stress disorder. There is no way to be alive without being conscious of the potential for disaster. One way or another, death (and its cousins: old age, illness, accidents, separation and loss) hangs over all of us. Nobody is immune. Our world is unstable and unpredictable, and operates, to a great degree and despite incredible scientific advancement, outside our ability to control it.

    My response to my mother — that trauma never goes away completely — points to something I have learned through my years as a psychiatrist. In resisting trauma and in defending ourselves from feeling its full impact, we deprive ourselves of its truth. As a therapist, I can testify to how difficult it can be to acknowledge one’s distress and to admit one’s vulnerability. My mother’s knee-jerk reaction, “Shouldn’t I be over this by now?” is very common. There is a rush to normal in many of us that closes us off, not only to the depth of our own suffering but also, as a consequence, to the suffering of others.

    When disasters strike we may have an immediate empathic response, but underneath we are often conditioned to believe that “normal” is where we all should be. The victims of the Boston Marathon bombings will take years to recover. Soldiers returning from war carry their battlefield experiences within. Can we, as a community, keep these people in our hearts for years? Or will we move on, expecting them to move on, the way the father of one of my friends expected his 4-year-old son — my friend — to move on after his mother killed herself, telling him one morning that she was gone and never mentioning her again?

    IN 1969, after working with terminally ill patients, the Swiss psychiatrist Elisabeth Kübler-Ross brought the trauma of death out of the closet with the publication of her groundbreaking work, “On Death and Dying.” She outlined a five-stage model of grief: denial, anger, bargaining, depression, acceptance. Her work was radical at the time. It made death a normal topic of conversation, but had the inadvertent effect of making people feel, as my mother did, that grief was something to do right.

    Mourning, however, has no timetable. Grief is not the same for everyone. And it does not always go away. The closest one can find to a consensus about it among today’s therapists is the conviction that the healthiest way to deal with trauma is to lean into it, rather than try to keep it at bay. The reflexive rush to normal is counterproductive. In the attempt to fit in, to be normal, the traumatized person (and this is most of us) feels estranged.

    While we are accustomed to thinking of trauma as the inevitable result of a major cataclysm, daily life is filled with endless little traumas. Things break. People hurt our feelings. Ticks carry Lyme disease. Pets die. Friends get sick and even die.

    “They’re shooting at our regiment now,” a 60-year-old friend said the other day as he recounted the various illnesses of his closest acquaintances. “We’re the ones coming over the hill.” He was right, but the traumatic underpinnings of life are not specific to any generation. The first day of school and the first day in an assisted-living facility are remarkably similar. Separation and loss touch everyone.

    I was surprised when my mother mentioned that it had taken her 10 years to recover from her first husband’s death. That would have made me 6 or 7, I thought to myself, by the time she began to feel better. My father, while a compassionate physician, had not wanted to deal with that aspect of my mother’s history. When she married him, she gave her previous wedding’s photographs to her sister to hold for her. I never knew about them or thought to ask about them, but after my father died, my mother was suddenly very open about this hidden period in her life. It had been lying in wait, rarely spoken of, for 60 years.

    My mother was putting herself under the same pressure in dealing with my father’s death as she had when her first husband died. The earlier trauma was conditioning the later one, and the difficulties were only getting compounded. I was glad to be a psychiatrist and grateful for my Buddhist inclinations when speaking with her. I could offer her something beyond the blandishments of the rush to normal.

    The willingness to face traumas — be they large, small, primitive or fresh — is the key to healing from them. They may never disappear in the way we think they should, but maybe they don’t need to. Trauma is an ineradicable aspect of life. We are human as a result of it, not in spite of it.

    Mark Epstein is a psychiatrist and the author, most recently, of the forthcoming book “The Trauma of Everyday Life.”

    Cheryl and plum like this.
  2. plum

    plum Beloved Grand Eagle

    Thanks for posting this. There is always comfort in learning we are more human and not less for the hurting. It's silly but hard to shake the notion that one day we will grow up, out, beyond these feelings. Maybe the measure of maturity (and meaning?) resolves in deeply experiencing them. While being wrung out is awful, the next stage of cleansing is to be hung out to dry in the warm sun and gentle breeze. Time to reflect on the passage, time to decide whether to shed a skin or add another layer of varnish to the persona.
  3. Gigi

    Gigi Well known member

    What a blessing this article is. Life comes with pain--emotional and physical. For most of my life I've dealt with chronic physical pain , and tried never to let it stop me from achieving my goals. But I think there's a freedom in not only acknowledging but discussing our hurts.
    I remember doing a project in high school about Kubler-Ross's work on death. I found the stages comforting, knowing that others had these same responses to crises.
    For me, it comes down to balance. Life is pain, but it's also about unbridled JOY. I try to acknowledge the former to be healthy, but to focus on the latter, which makes me happy.
  4. Walt Oleksy (RIP 2021)

    Walt Oleksy (RIP 2021) Beloved Grand Eagle

    Hi, everyone. A real interesting article and postings. Yes, Gigi, life is balance. I look at my dog napping right now after a nice long walk, and
    know she's got it right. She got exercise, now she's resting.

    I hope Mark Epstein's mother has been able to finally find peace by giving up her feeling of loss after her husband's death and think about the
    happy life they had together.

    Yes, Gigi, life is pain, but it also is joy, and we need to focus more on the joy. Things that have happened to us over the years that made us especially happy, an event such as a marriage, birth of child, being with our best friends.

    Today 's homily at Mass was especially good relating to the subject of "The trauma of being alive." The priest said:
    "No one can start today and make a new beginning, but anyone can start today to make a new ending."

    Actually, I thijk he was wrong. I believe we can do both. We can make a new beginning and a new ending.
  5. Walt Oleksy (RIP 2021)

    Walt Oleksy (RIP 2021) Beloved Grand Eagle

    Annie is a 70 pound, 11 year old lap dog.
    She shows her love to me every day in her eyes. annie on couch.jpg
    plum and Eric "Herbie" Watson like this.
  6. Gigi

    Gigi Well known member

    Walt I'm so glad you have Annie!
    My daughter volunteered at an animal shelter before starting college and adopted a kitten, Aura (see photo). The poor creature did not do well in an apartment with 4 noisy college students, and one of them became allergic to her, so we took Aura. She drives us crazy in some ways, but she's a gentle, loving creature. She makes it easier for me to have an empty nest.
  7. Walt Oleksy (RIP 2021)

    Walt Oleksy (RIP 2021) Beloved Grand Eagle

    I've been blessed with having dogs (three black Labs, one at a time, first two for 16 years each, and Annie is 11 now).

    I love cats too but like your daughter I'm allergic to them. Dogs and cats are supposed to be enemies.
    I don't think so. (see photo below)

    plum likes this.
  8. Forest

    Forest Beloved Grand Eagle

    This reminds me of how common TMS is. It is something that effects every person at some point in their lives. TMS is not caused simply as a result of experiencing a major event. As Steve O mentions TMS is caused by both the abandonment and the fear of abandonment. The stress of what may happen is just as significant as the stress from events that have already happened. The anxiety we have about not being able to control our lives and the world we live in creates an immense amount of stress that drives these symptoms.

    Great article. Thanks for posting it!

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