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My trip to Athens: What I read, saw and listened to                                           Edited 8/12/2023

Have compassion for everyone you meet,  //  even if they don’t want it. What seems conceit,

bad manners, or cynicism is always a sign   //  of things no ears have heard, no eyes have seen.

You do not know what wars are going on  //  down there where the spirit meets the bone.

From The Ways We Touch: Poems  by Miller Williams

“Indeed, one reason for the idea of “liberated” HSPs [highly sensitive persons], was the seemingly odd mixture of traits emerging from study after study of gifted adults: impulsivity, curiosity, the strong need for independence, a high energy level, along with introversion, intuitiveness, emotional sensitivity, and nonconformity.” Elaine N. Aron

“Relationships shape health outcomes throughout the life course and have a cumulative impact on health over time…”  Debra Umberson and Jennifer Karas Montez

“We are the landscape of all we have seen”  Isamu Noguchi, Japanese-American artist

After almost two years on the island with no breaks I spent a few days in Athens. I visited family, had a medical check-up, and did some dental work. I also managed to squeeze in a visit to the new National Gallery, something I felt I wanted or needed to do for ages. So, today’s post is about some of what I managed to read, listen, see and observe amidst the busyness and the hours stuck in traffic…..

While packing I listened to the week’s Being Well episode that included several topics with Forrest and Dr Rick Hanson. The first theme involved communication habits and strategies in relationships and the need to talk about how we talk, Rick Hanson says “My rule of thumb personally is that significant relationships need to be able to talk about talking and they need to be able to repair. Both of those are absolute gold standard virtues,” They touch upon what might consist abuse, various power dynamics, the strategies of distancing and controlling what can be discussed, the function of communication behaviours, and the difference between being long-winded or chatty, which is just a tendency, and filibustering somebody else, which can be abusive and which Forrest Hanson says “is really problematic, because that’s the only one where there’s a power assertion being made inside of the relationship.”

Another topic discussed was the natural temperamental spectrum of humans, and how socialization, events in their lives and their current conditions, interact with their natural tendencies, for better or worse.  Their focus is mostly on competitiveness and sensitivity. Some people tend to be intensely competitive, which is sometimes connected with a certain amount of aggressiveness, and need to dominate. They also mention the biological rootedness of social comparing in our nature as social primates. Rick Hanson says that humans are designed to compare ourselves to others, and this is part of our capacity to feel shame, which also generates our feelings of inferiority and less than, but this is kind of a necessary basis for the co-evolution of our beautiful capacities for altruism,  generosity, and charity, because if we’re not able to feel shame or remorse, then there’s no basis for the development of healthy altruism.

They discuss (highly) sensitive people, which as they say can perform a useful function in cultural and social systems or in families and friend groups because sensitive people are that “canary in the coal mine” that recognizes toxic or unhealthy dynamics and practices,, but they need to recognize their sensitivity and act accordingly. Forrest Hanson  says “So, there’s this kind of dance between you’re doing something helpful for people, and you’re doing something valuable for yourself, but you’re also doing what you can to build up those resources so you feel less disrupted by it.” They briefly try to unpack the notion of identifying as a highly sensitive person [HSP], and the possible crossover with post traumatic stress, or attention deficits, dyslexia  or any other form of neurodiversity, and they acknowledge the high complexity of all this.

Rick Hanson says: “What’s going on here is a lot of complexity. There are a lot of chickens and a lot of eggs, which came first?…. So [trauma]… and life experiences landing on a sensitive person are going to tend to have more impact than on a more phlegmatic, just kind of “whatever, what, me worry?” kind of person. So, obviously, then sensitivity could tend to predispose somebody to PTSD, not letting the environment off the hook, just acknowledging that in the stress-diathesis model, it’s the combination of what is happening along with the vulnerability of the person, offset by resources which may or may not be present. So all that’s, to me, really, really normal….There’s been a growing appreciation for the individualization of care, and a broadening of what our friend Gabor Maté calls “The Myth of Normal.” What is normal anyway? I get it about normal molecules of water, you know, two atoms of hydrogen, one atom of oxygen, gotcha, but normal human being? Huh, you know, it’s a really broad range, and so it’s really important to acknowledge where you are, and normalize you, you are normally you, you are you whoever you are, are incredibly normal as you. And validating that, and appreciating that, and then constructing a world around you that’s a good fit for you is to me, really appropriate to do with a lot of nurturing and compassion for yourself.”

They conclude that sensitivity is a broad category, and that 20 to 30 percent of people would qualify for being a HSP in some way, which is almost a third of the population. And Rick Hanson says: “if thirty percent of the population is highly something-where’s the center of the distribution?…….’ and that  “maybe we need to recalibrate our notion of being a human, particularly thinking about this, if you’re not being crushed daily by an intense workload, what would be the natural sensitivity that could develop in more benign circumstances? In other words, when people are not being numbed, and blunted, and squashed by their environments….”

They also refer to Elaine N. Aron’s work, which I came upon perhaps a decade ago. Maybe I’ve written about her work in an older post. .Anyway, below is a quote from her book: The Highly Sensitive Person

“HSPs tend to fill that advisor role. We are the writers, historians, philosophers, judges, artists, researchers, theologians, therapists, teachers, parents, and plain conscientious citizens. What we bring to any of these roles is a tendency to think about all the possible effects of an idea. …”

Forrest and Rick discuss more topics, which you can listen to or watch at: https://www.youtube.com/watch?v=MjGXsD9Xhb8

For the trip I only packed a few articles to keep my luggage light, and also, because I expected to buy a book or two in Athens. One of the articles I read on the boat was Social Relationships and Health: A Flashpoint for Health Policy by Dr Debra Umberson and Jennifer Karas Montez. I only recently came across Umberson’s research work as I’ve been looking for material on grief related to adult children losing one or both parents and the identity shifts that inevitably take place, I hope to write and post something after Christmas. Summarily, they discuss major findings in the study of social relationships and health, and how this knowledge could be translated into policies that promote population health. Key research findings include: (1) social relationships have significant effects on health; (2) social relationships affect health through behavioral, psychosocial, and physiological pathways; (3) relationships have both costs and benefits for health; (4) relationships shape health outcomes throughout the life course and have a cumulative impact on health over time; and (5) the costs and benefits of social relationships are not distributed equally in the population.

The article mentioned above focuses on how both the quantity and quality of our social relationships affect mental and physical health, health behaviour and mortality risk. Overburdened, strained, conflicted, abusive social ties can undermine health, and supportive social ties may have indirect effects on health through enhanced mental health, by reducing the impact of stress, or by fostering a sense of meaning and purpose in life. Social ties may trigger physiological sequelae that are beneficial to health and minimize unpleasant arousal that instigates risky behavior. They may enhance personal control, which is advantageous for health habits, and mental and physical health.  The article explores the link between social relationships and short-and long-term health outcomes. These effects often emerge in childhood and cascade throughout life to foster cumulative advantage or disadvantage in health. Various factors and explanations for this link are identified and social variation by gender and “race” at the population level are also discussed.

Umberson and Montez support that “a growing body of theoretical and empirical work illustrates how social conditions foster cumulative advantage and disadvantage for health over the life course.” They cite research that suggests that while social relationships are the central source of emotional support for most people, social relationships can often be extremely stressful, and that relationship stress undermines health through behavioral, psychosocial, and physiological pathways. Research findings support that stress in relationships contributes to poor health habits in childhood, adolescence, and adulthood, and to psychological distress and physiological arousal (e.g., increased heart rate and blood pressure, compromised immune and endocrine function) that can damage health through cumulative wear and tear on physiological systems, and by leading people to engage in unhealthy behaviors.

I also read Peter Singer’s 1971 essay: Famine, Affluence, and Morality. Singer is a philosopher, ethicist, writer, professor, and is considered by many the person who put animal rights on the map. In this essay he argues that we have a moral obligation to both those near us and those far away and we should do what we can to help people living in extreme poverty and prevent people dying from starvation.

An extract from the essay:

“I begin with the assumption that suffering and death from lack of food, shelter, and medical care are bad. I think most people will agree about this, although one may reach the same view by different routes. I shall not argue for this view. People can hold all sorts of eccentric positions, and perhaps from some of them it would not follow that death by starvation is in itself bad. It is difficult, perhaps impossible, to refute such positions, and so for brevity I will henceforth take this assumption as accepted. Those who disagree need read no further.”

“Losing our parent is like losing part of oneself.” Debra Umberson

While in Athens and amidst the things I had to do, I found the time to walk in the city, visit a book shop, where I bought a translated version of Debra Umberson’s book The Death of a Parent  (Ο Θάνατος ενός Γονιού – Εκδόσεις ΜΑΚΡΗ), and The National Gallery, which exhibits Greek and European art from the 14th century to the 20th century. The newly renovated building reopened after an 8 year refurbishment in 2021. This visit was a totally different experience from my past visits, and also, seeing the actual paintings of many well known Greek artists, of the 20th century, many of which I had only seen in art books or slides, felt like small awakenings.

“As I am, so are others; as others are, so am I.
Having thus identified self and others,
harm no one nor have them harmed.”  Sutta Nipāta 3.710

Finally, I will end this post with something I don’t often do, with quotes from Buddhist texts related to cultivating a kinder and healthier way of living from Rick Hanson’s weekly meditation sessions page.  I don’t know them by heart, but during my recent trip, as I observed people and interactions and listened to stories, I found myself bringing to mind the essence of the quotes I have included in this piece today.

May all beings be happy and secure.  //   May all beings be happy at heart!

Omitting none, whether they are weak or strong,  //  seen or unseen, near or distant, born or to-be-born:

May all beings be happy.

Let none deceive another,   //   or despise anyone anywhere,
or through anger or ill will wish for another to suffer.

Just as a mother would protect her child, her only child,   //   with her own life,
even so you should cultivate a boundless heart toward all beings.

You should cultivate kindness  //  toward the whole world with a boundless heart:
above, below, and all around,  //  unobstructed, without enmity or hate.

Whether standing, walking, sitting, or lying down,  //  as long as you are alert,
you should be resolved upon this mindfulness.

This is called a sublime abiding here and now.

Adapted from the Metta Sutta

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Resisting dehumanization, dignity conserving health care and art

PART TWO

“Dehumanizing beliefs are theoretical rather than perceptual beliefs. We get them from outside of ourselves—from propaganda and ideology, and from the testimony of those who are supposed to be authorities. When we accept the view that some group of people are less than human, we have to overrule the evidence of our senses.” David Livingstone Smith

“Because so many time-worn systems of power have placed certain people outside the realm of what we see as human, much of our work now is more a matter of “rehumanizing.” That starts in the same place dehumanizing starts—with words and images. Today we are edging closer and closer to a world where political and ideological discourse has become an exercise in dehumanization. And social media are the primary platforms for our dehumanizing behavior.” Brené Brown

This is the second part of the essay posted on November 8th, and it mostly focuses on the concept and theory of race, the difference between racism and dehumanization, how dehumanization helps dissolve our natural human inhibitions to harm or kill another human being, understanding dehumanizing beliefs as ideological beliefs, and what we need to do to resist dehumanization. As I’ve recently been engaging with watercolour painting I have also included some new artwork. I’ve also included a link to an article on dignity in health care by Harvey max Chochinov, a topic that Ι will probably return to in future posts. The article is about dignity conserving care, which consists of the caring for, as well as, caring about patients by health practitioners.

Smith unpacks the concept of race to some length. Here I will try to only summarize the multiple threads of the discussion. First, the overwhelming majority of serious scientists deny the biological reality of race, and the idea that Black and White people are separate species with no common evolutionary ancestors. Smith discusses how we need to let go of the tendency to equate race with skin colour, which he says is a marker for race only for historical reasons involving colonialism and slavery. He says that once the concept of race gets unpacked, we notice that “people use words like “ethnicity,” “culture,”  “religion” and “nationality” to talk about race without even realizing that’s what they’re doing.” He tells us that  people think that a person’s race is something that’s objectively true of them, rather than being merely a matter of how other people categorize them, or that a person’s race is something that’s deep and unalterable, and which gets passed down, biologically, from parents to their children. Scholars who study race call this the idea of racial essentialism.

He explains that chemistry is one of the few domains where essentialism earns its keep. For instance, hydrogen is made out of atoms that have only one proton. That’s why hydrogen is assigned the atomic number 1. All hydrogen atoms have the atomic number 1, and nothing that’s not hydrogen has that atomic number. But the theory of essences doesn’t make any scientific sense when it’s applied to races. As a matter of biological fact, he claims, “there just isn’t a racial equivalent of an atomic number. Races don’t really have essences. We just imagine that they do. But despite its falsity, racial essentialism maintains a fierce grip on the human imagination.”

The common conception of race is actually a theory of race, a “folk theory” rather than a scientific or philosophical one. He describes how we use the idea of hidden racial essences to explain the observable diversity because people come in different physical packages and behave in a wealth of different ways. He does clarify that beliefs about race may not always be destructive because in a racist society, the idea of race and racial pride can provide a sense of strength and solidarity for the oppressed, but this comes with the price of the perpetuation of the circumstances that make such solidarity necessary. Furthermore, he reminds us that the idea of race also provides a sense of strength and solidarity to Nazis or White supremacists.

As I mentioned above, Smith distinguishes racism from dehumanization. He claims that racism is the belief that some races consist of lesser human beings, but dehumanization is the belief that members of some races are less than human beings. He writes: “Grasping this difference is crucial, because it throws light on why groups are almost always racialized before they’re dehumanized, and why it is that racist attitudes so readily morph into dehumanizing ones. Dehumanization is racism on steroids.” He asserts that false ideas about race need to be combated because conceiving of people as racially other easily morphs into dehumanizing them. He writes:  “although we can see diversity, we can’t see race. Dividing human beings into races—into “our kind” and “their kind”—is the first step on the road to dehumanizing them. We first set them apart as a fundamentally different kind of human being—we treat them as a separate race—and only later transmute them into subhuman creatures fit to be exterminated or enslaved.”

Part of the book focuses on how processes of dehumanization dissolve our natural human inhibitions to enslave, torture or kill another human being.  Smith describes how humans inhibit severe forms of violence against members of their own community. This resistance to performing these acts of violence, he says, is an inhibition, not a prohibition. It isn’t merely grounded in morality. He describes how our survival depends on being members of cooperative communities and our social way of life demands that we be exquisitely attuned to one another. Our violence-avoidance isn’t only restricted to the local community, but extends to every human because we cannot help but recognize them as fellow human beings. This, he writes, “is a gut-level response to seeing others as human. It’s not something that we can turn on or off at will.” But, if human beings have inhibitions against killing, he asks, how do they manage to regularly prosecute wars and genocides?

Firstly, he claims that it’s our desire to harm others that leads to their dehumanization, rather than the other way around. Dehumanization, he writes, happens when one group of people sees benefits and advantages in doing violence to another. Morally disengaging from the second group through thinking of them as less than human solves the problem, because it makes their actions ethically allowable. Moreover, the violence that dehumanization unleashes often has an intensely moralistic tone, that’s why Smith believes that focusing on what’s morally right is not enough to end dehumanization, Instead, he writes: “we must block the processes—both psychological and political—that subvert our automatic perception of the humanness of others.” Other ways that our clever brains have been able to selectively disable our inhibitions against performing acts of atrocity on our own kind is through material technology. We now have created weapons that make it possible for us to kill at a distance, Alcohol and drugs, and war rituals, are also used to disable inhibitions.

Dehumanizing beliefs are ideological beliefs

Dehumanization is, according to the writer, a psychological response to political forces that mesh with our propensity for psychological essentialism and hierarchical thinking. Simply put, powerful social forces interact with equally powerful psychological ones to produce altered states of consciousness in those affected by them that cause them to see other human beings as less than human. And then once they’ve taken root, people are liable to perform acts of atrocity that they would never have imagined they could perform. More specifically, dehumanizing beliefs are ideological beliefs. So, Smith says, in order to understand how dehumanization works, and to resist it effectively, we’ve got to have a clear conception of ideology. He finds the notion of ideologies as beliefs that have the function of fostering oppression useful.

He writes:  “Oppression” is a word for situations in which one group of people gets some real or imagined benefit by subjugating another group of people. It’s an intrinsically political concept, because it pertains to the distribution and deployment of power among whole groups of people rather than between individuals.” He states that ideological beliefs are reproduced culturally because they promote the oppression of some group of people while benefiting another group. He further notes that the people who might benefit from oppression need not intend to oppress others and they may not even be aware they are cogs in an oppressive sociopolitical or economic machine.

The last chapter of the book, with the title Resist, is a summary of key points about what we need to know and do so that we may resist dehumanization. Smith writes that resisting dehumanization is complicated and it’s not something that can be expressed in a list of bullet points or rules. He assumes from the outset that resisting dehumanization has to be based on an understanding of how it works. He claims that first we need to understand that it is both political and psychological. It’s both about the distribution of power in the public sphere and about the beliefs that we form about ourselves and others, and therefore, we need to consider both the political forces that push us to think of others as less than human and the psychological forces within us that make it possible for us to do so.

Thus, resisting dehumanization requires both political action and knowing yourself. The least we can do, the writer says, is to combat it in small ways in our daily life, calling it out where we see it, objecting to it as a dangerous rhetoric, opposing it in the voting booth, and also, opposing any dehumanizing impulses in us. He writes that we are all capable of dehumanizing others, and so we need to be vigilant about our own fears, biases, blind spots, and ideas we may have assimilated from society, as well as, our tendencies to essentialize others and to fall prey to dehumanizing propagandists, who play with our insecurities and grievances, demonize others, and then offer the illusion of salvation from them.

Moreover, because we can all, at times, fall prey to dehumanizing narratives we should avoid dehumanizing those that we witness dehumanizing others. He writes: “Instead of putting the process of dehumanization under a magnifying glass, there’s a tendency to castigate those who dehumanize others as evil monsters—to dehumanize the dehumanizers—and thus to indulge in the very form of thinking that one ostensibly seeks to combat. Describing other human beings as monsters is an obstacle to seriously addressing the problem. It doesn’t matter how repugnant or destructive their beliefs and actions are. Monsters are fictional, but dehumanizers are real, and they are mostly ordinary people like you and me.”

Smith also tells us that we should not confuse dehumanization with other kinds of bias because he explains it is not the same as racism, anti-Semitism, sexism, objectification, religious bigotry, or prejudice against other minorities, for dehumanization is potentially much more dangerous. He suggests that since understanding what it is and how it works is important in resisting it, it’s necessary to study history to learn about dehumanization. Learning about genocide, colonialism, racial oppression, and the darker pages of our national and international history, standing up for the truth and for humanity are important aspects of resisting.

As mentioned above, as human beings we naturally tend to see others as human beings, and Smith explains that dehumanization comes from outside of us. He writes: “The tendency to see them as subhuman creatures is foisted on us by people who have an investment in getting us to harm others.” He tells us that an important component of human nature is on our side in the struggle to resist dehumanization and that we should be wary of those that suggest that that the urge to dehumanize others is in our genes, He explains that although human beings have an inherent disposition to be biased against outgroups, this type of bias is a far cry from dehumanization, and also, where the line gets drawn between ingroup and outgroup is a political matter, not something coded in our DNA.

At this point I might need to add something that Smith discusses in the book, the fact that we also need to be aware of our propensity, as humans, to frequently hold conflicting beliefs. There are many reasons that we may hold contradictory beliefs, and ideally, we would be able to notice them and either hold both or see what they might be serving or where they might be stemming from. He writes of the contradictions often inherent in dehumanization and that it is common for people who denigrate others as animals  or monsters to reveal that they also recognize them as human beings. At some point he asks: But in the realm of real life, not horror movies, how do our minds manage to think that a single entity can be at the same time human and subhuman?

Another key point he emphasizes is the need to support a free press and freedom of speech because dehumanizing ideas are often spread and reproduced through media. This is the reason that totalitarians destroy freedom of the press.  It is also asserted that dehumanizing propaganda is usually not about hate and that it trades mostly on desperation, fear, and the longing for salvation. Smith describes how the masses are manipulated and how groups pave their way to power. In order to resist dehumanization it is helpful to know the warning signs. We need to listen closely for language that describes the despised group of people as parasites, lazy, dirty, diseased and criminal or prolific breeders that will overtake and replace the majority. We also need to be alert to animalistic slurs. Finally, it is important to resist both being desensitized to suffering and blaming the victims for their plight.

Additionally, as discussed above, it is important to remember that that biological race is a social invention for justifying oppression. He claims that resisting race is crucial for resisting dehumanization, because as long as racial categorizing persists, dehumanization is just around the corner. He writes: “Washing your hands of the concept of race is an act of resistance and defiance. It doesn’t mean that you are betraying your family, your culture, or your history, or the work of securing justice for racialized people, because it does not deny that people have been treated as though race is real, and they have suffered from it.” He acknowledges that people will try to put people back into the racial box, because you become a threat to the whole hierarchical racial system. He admits this is easier for white people because in most circumstances they have not been racialized, but this he adds, only confirms the fact that race is by its very nature an oppressive ideology.

Finally, if Smith was writing the book this year there would sadly be new current atrocities to discuss and analyze.  The current wars in the Middle East and between Russia and Ukraine, for instance, bring to the foreground an additional factor that fewer journalists, reporters and commentators on these events discuss, with the exception of some more courageous or truthful maybe individuals, the fact that there is a lot of profit to be made from surveillance, conflict and disaster. The more powerful states that have industries that produce weapons and other types of technology, which facilitate oppressive regimes, need both testing grounds and an ever expanding market. Many governments of countries that have these types of industries inevitably become complicit in many oppressive regimes, dictatorships, wars and processes of genocide, and the inevitable environmental destruction. There are countless historical examples in the 20th and 21st centuries, which I will not go into here, but if, peace, the environment, whatever levels of privacy are available, and the future of our children, were to become serious concerns for the human species we should start engaging in more difficult and courageous conversations, especially those in leadership roles, who have the knowledge, the resources and the power to make a difference.

A link to an article on dignity in health care by Harvey max Chochinov (2007 Jul 28; 335(7612): 184–187)  at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1934489/

“In his 1927 landmark paper “The care of the patient” Francis Peabody wrote: “One of the essential qualities of the clinician is interest in humanity, for the secret of the care of the patient is in caring for the patient.”  The A, B, C, and D** of dignity conserving care may provide clinicians with a framework to operationalise Peabody’s sage insight and relocate humanity and kindness to their proper place in the culture of patient care.” Harvey Max Chochinov

** A is for attitude, B is for behaviour, C is for compassion and D is for dialogue

Some helpful suggestions and questions, proposed in the article for physicians and other health providers to engage with, in order to provide this kind of health care:

Attitudes

  • How would I be feeling in this patient’s situation?
  • What is leading me to draw those conclusions?
  • Have I checked whether my assumptions are accurate?
  • Am I aware how my attitude towards the patient may be affecting him or her?
  • Could my attitude towards the patient be based on something to do with my own experiences, anxieties, or fears?
  • Does my attitude towards being a healthcare provider enable or disenable me to establish open and empathic professional relationships with my patients?

Behaviours

  • Treat contact with patients as you would any important clinical intervention
  • Behaviours towards patients must always include respect and kindness
  • Lack of curative options should never rationalise or justify a lack of ongoing patient contact

Compassion

Getting in touch with one’s own feelings requires the consideration of human life and experience.  Some ways to do this:

  • Reading stories and novels and observing films, theatre, art that portray the pathos of the human condition
  • Discussions of narratives, paintings, and positive role models
  • Considering the personal stories that accompany illness
  • Experiencing some degree of identification with those who are ill or suffering

Dialogue

Acknowledging the patient’s personhood       &

Questions to increase  knowing the patient

  • “What should I know about you as a person to help me take the best care of you that I can?”
  • “What are the things at this time in your life that are most important to you or that concern you most?”
  • “Who else (or what else) will be affected by what’s happening with your health?”
  • “Who should be here to help support you?” (friends, family, spiritual or religious support network, etc)
  • “Who else should we get involved at this point, to help support you through this difficult time?” (psychosocial services; group support; chaplaincy; complementary care specialists, etc)

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What is trauma?

“Trauma is perhaps the most avoided, ignored, belittled, denied, misunderstood, and untreated cause of human suffering.” Peter Levine

 “Trauma can be seen to fundamentally impair integration within an individual, dyad, family, or community.” Pat Ogden

“And maybe you have to lose yourself completely, to find out who you are.” Tasos Leivaditis

 “Eventually I got used to looking away, so I was saved from many disasters  //  but there are things we will never know, like the length of our horizons or the depth of our sorrow.” Tasos Leivaditis,

 “I think of all the beginnings in our lives; how they all inherently contain the seeds of what is to grow and happen, but meanwhile we may be star gazing, not noticing the planting. the repetition, the recycling, the colours and patterns of the tapestry,” Tonya Alexandri

Today’s post inevitably refers to only a few aspects of trauma, and is also, an attempt to briefly distinguish between what is actually traumatic and what might be stressful, uncomfortable and even painful, but not traumatic. The text is informed by four well known books: The Body Keeps the Score by Bessel van der Kolk, MD; In an Unspoken Voice by Peter Levine, PhD, The Myth of Normal by Gabor Mate MD, and Trauma and the Body: A Sensorimotor Approach to Psychotherapy by Pat Ogden, PhD. It also includes some recent watercolours, three poems by Tasos Leivaditis and Jane Hirshfield, and two links to meditation practices by Rick Hanson,  for those with some experience.  Finally, the second part of the article,  Resisting Dehumanization, will be posted next time once I’ve completed the translation.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

So, What is trauma?

Peter Levine writes that trauma “is about a loss of connection—to ourselves, our families, and the world around us. This loss is hard to recognize, because it happens slowly, over time. We adapt to these subtle changes; sometimes without noticing them.” He describes how trauma, especially severe trauma, imposes a worldview tinged with pain, fear and suspicion. After trauma we see through lens that distort and determine our view of how things are, and through denial we may acquire a naively rosy perspective that blinds us to real and present dangers, like “a veneer concealing fears we dare not acknowledge.” In terms of our bodily experience Levine writes that trauma represents a profound compression of energy that has not been able to complete its meaningful course of action, and that traumatized individuals are disembodied and “disemboweled.” They are either overwhelmed by their bodily sensations or massively shut down against them. He writes: “In either case, they are unable to differentiate between various sensations, as well as unable to determine appropriate actions. Sensations are constricted and disorganized. When overwhelmed, they cannot discern nuances and generally overreact. When shut down, they are numb and become mired in inertia.”

Gabor Mate views trauma as “an inner injury, a lasting rupture or split within the self due to difficult or hurtful events”. He writes that it is primarily what happens within someone as a result of the hurtful events that befall them, and not the events themselves. He describes trauma as a psychic injury, lodged in our nervous system, mind, and body, lasting long past the originating incidents, which can be triggered at any moment   Trauma, he writes, is the wound itself and the residual burdens that it imposes on our bodies and psyches, and also, the toll the wounds take on our bodies, the unresolved emotions they bring; the coping dynamics they dictate, and the unhelpful scripts we unwittingly live out.

The effects of trauma on our existence are many. Unresolved trauma constricts the self and all areas of our life. It constricts us physically, emotionally and mentally.  It dampens our capacities and numbs us. It distorts our view of the world and can wreak havoc on our health. It disrupts healthy relating with others and attracts relationships that can further wound us.  Mate writes: “It constrains our inborn capacities and generates an enduring distortion of our view of the world and of other people. Trauma, until we work it through, keeps us stuck in the past, robbing us of the present moment’s riches, limiting who we can be. By impelling us to suppress hurt and unwanted parts of the psyche, it fragments the self. Until seen and acknowledged, it is also a barrier to growth. In many cases, as in mine, it blights a person’s sense of worth, poisons relationships, and undermines appreciation for life itself. Early in childhood it may even interfere with healthy brain development. And, as we will witness, trauma is an antecedent and a contributor to illness of all kinds throughout the lifespan. “

In relation to how trauma impacts us, Pat Ogden writes that technology has made possible the detailed study of how trauma impacts both cortical and subcortical processing of information, and one of the most robust findings of the neuroimaging studies of traumatized people is that, under stress, the higher brain areas involved in “executive functioning” that allow planning for the future, anticipating the consequences of our actions, and inhibiting inappropriate responses become less active. Our cognitive processing is also impacted negatively because hypo-arousal interferes with the ability to think clearly and hinders appropriate evaluation of danger. She also focuses on the impact of trauma on our physiology. She writes: “The legacy of trauma is that these somatic (i.e., endocrine and motoric) patterns can be triggered by the slightest provocations, reactivating the physical response of the organism to past terror, abandonment, and helplessness, sometimes in exquisite detail.

We also know that the memory of traumatic events can be repressed, only to resurface years and even decades later. Bessel van der Kolk writes: “Dissociation is the essence of trauma. The overwhelming experience is split off and fragmented, so that the emotions, sounds, images, thoughts, and physical sensations related to the trauma take on a life of their own. The sensory fragments of memory intrude into the present, where they are literally relived. As long as the trauma is not resolved, the stress hormones that the body secretes to protect itself keep circulating, and the defensive movements and emotional responses keep getting replayed.” Meanwhile, if elements of the trauma are replayed again and again, the accompanying stress hormones engrave those memories ever more deeply in the mind.  So, in some sense it’s a vicious cycle that needs to be disrupted if one is to heal from the aftermath effects of traumatic events.

He adds: “As long as a memory is inaccessible, the mind is unable to change it. But as soon as a story starts being told, particularly if it is told repeatedly, it changes—the act of telling itself changes the tale. The mind cannot help but make meaning out of what it knows, and the meaning we make of our lives changes how and what we remember.” In his book he explains, how for veterans the war experiences that belong to the past are often in the present played out on the battlefield of their own bodies, usually without a conscious connection between what happened and the present triggers and symptomatology.

He refers to a client, he calls Stan, who instead of remembering the accident as something that had happened three months earlier, he was reliving it. Van der Kolk writes that Stan’s scan revealed the reason “people can recover from trauma only when the brain structures that were knocked out during the original experience—which is why the event registered in the brain as trauma in the first place—are fully online.” He states that breakdown of the thalamus, for instance, explains “why trauma is primarily remembered not as a story, a narrative with a beginning middle and end, but as isolated sensory imprints: images, sounds, and physical sensations that are accompanied by intense emotions, usually terror and helplessness. In normal circumstances the thalamus also acts as a filter or gatekeeper. This makes it a central component of attention, concentration, and new learning—all of which are compromised by trauma. “

There are many in the trauma field that discern two types of trauma, but like all human experience trauma lies on a spectrum, and also, the same trauma, for a hundred different reasons, might have a different impact on different people. There are many factors that converge to determine how events will impact us. Traumatic events can include: natural disasters, war and conflict, dire poverty, imprisonment, being a victim or witness of a crime, being involved in or witnessing a serious accident, being exposed to death, injury or violence through one’s work, being exposed to an unexpected tragic or stressful event like unexpected or violent death of a loved one, complicated childbirth; enduring painful medical procedures, interpersonal physical and psychological violence and all kinds of abuse, neglect and serious lack of care, emotional connection or prolonged separation from caregivers, especially when very young.

According to Mate, who cites Levine and Van der Kolk, the first type, which is often referred to as “capital-T trauma” involves “automatic responses and mind-body adaptations to specific, identifiable hurtful and overwhelming events, whether in childhood or later, which give rise to multiple symptoms and syndromes and to conditions diagnosed as pathology, physical or mental—a linkage that remains almost invisible to the eyes of mainstream medicine and psychiatry” and “underlies much of what gets labeled as mental illness. It also creates a predisposition to physical illness by driving inflammation, elevating physiological stress, and impairing the healthy functioning of genes, among many other mechanisms.” What is often termed “small-t trauma” consists of events that nobody escapes as we go about our daily life. Chronic and frequent “small t traumas” can have a toxic cumulative effect over time. Trauma of this kind, Mate suggests does not require overt distress or misfortune of the sort mentioned above, but can still lead to a host of issues. He quotes the psychiatrist Mark Epstein: “The traumas of everyday life can easily make us feel like a motherless child,”

And then there is also complex trauma, which is characterized by events being repeated or ongoing or difficult or impossible to escape from. Complex trauma, which is when trauma occurs with cumulative exposure to traumatic experiences that may involve prolonged interpersonal violations and often occurs during childhood either within the child’s care giving system or in other contexts. It is differentiated from an acute exposure to a single traumatic event. It can occur in later stages in life, as well, either in chronic abusive relationship or social contexts, in conflict zones, and so on. Finally, trauma that has occurred within relationships is generally more difficult to treat than trauma resulting from traffic accidents or natural disasters (Bessel van der Kolk).

Maybe at this point I should clarify that not all stressful or painful events can be defined as traumatic. Peter Levine states that “Certainly, all traumatic events are stressful, but not all stressful events are traumatic.” Mate describes how “an event is traumatizing, or re-traumatizing, only if it renders one diminished, which is to say psychically (or physically) more limited than before in a way that persists. Much in life, including in art and/or social intercourse or politics, may be upsetting, distressing, even very painful without being newly traumatic. That is not to say that old traumatic reactions, having nothing to do with whatever’s going on, cannot be triggered by present-day stresses.”

To make this clear I will provide examples from my own experience. I will refer to two events, one took place in the distant past and one quite recently, one was traumatic and one unpleasant and even stressful.  They both took place in the street. About four decades ago I was involved in a road accident that could have cost me my life or the cracking of my skull or spine. Instead I sustained a concussion and it was traumatic, although at the time I did not perceive it as anything other than a life event that put me at great risk and injured me physically.

An extract from my more personal writing written a few years ago:

“The Bird with the Truths’ from The Autumn Manuscripts by Tasos Leivaditis

“One morning a bird sat on the opposite tree and whistled. Oh, if only I could understand what it was saying to me!  Perhaps I could have found the meaning of the world / universe.”

It was around that time….  my husband and I were returning home after a peace march or maybe a demonstration for or against something in the centre of Athens. We were on a moped waiting for the lights to turn green when a white car packed with a large family as if hypnotized bumped into us, and since I was caught off guard I flew off my seat and landed metres away on the asphalt. In the process my helmet had fallen off and I sustained a concussion, but before I heard the thump of my skinny body hitting the ground I experienced the vastness of the night sky and a euphoric thought had rushed through my mind ‘the sky is full of stars’.

A sense of falling sometimes still wakes me up at night, but in my dreams I fall off roof tops or balconies… and it often feels like a free fall into an abysmal star lit sky that cradles me and prevents my crashing….

As I heave and cough this autumn of 2015 I think of all the beginnings in our lives; how they all inherently contain the seeds of what is to grow and happen, but meanwhile we may be star gazing, not noticing the planting, the repetition, the recycling, the colours and patterns of the tapestry,”

The second event occurred this summer and it involved something much less dramatic. My husband and I were returning home from the beach. We were on his motorbike and he was not wearing his helmet because he felt it was too hot, a bit like being under a vintage bonnet hair dryer, I suppose….  Meanwhile, an acquaintance of his warned him that the police were stopping people that were not wearing crash helmets a little further down the country road we were on. I suggested he either wear it or turn around and take another route home. He  took the risk, and sure enough we were soon stopped by the police.  He was asked to hand in his license plate and driving license for a month, maybe longer. Removing the license plate however proved difficult because the screws were rusty, so he had to go off and find a mechanic to do the job. Meanwhile, I waited by the side of the road.

Bessel van der Kolk writes that symbols related to the original trauma, however benign in reality, are thoroughly contaminated and so become objects to be feared and avoided. So, this recent event on the road included many symbols pertinent to the road accident years ago, and it had the potential to trigger aspects of that past traumatic incident. Any of the following could have triggered that event: the motorbikes, the helmet theme, the presence of the police, my waiting at the side of the road for quite some time.  However, because I believe I had to some extent healed that old trauma, I remained calm and present, and aware that the context had the potential to trigger fear, but also, that this was a different situation. I was not back there lying on the road half dazed or hoping that a vacant taxi would show up to take us to a hospital. This current event was an inconvenience, something I would definitely not have chosen to put myself through had it been up to me, but still I was safe and this was just an unpleasant incident that would soon be over. I was grounded in the present, looking forward to the whole drama being over, to a shower and a meal.

I will end this post with poetry from the Greek poet, Tasos Leivaditis, mentioned above,  a poem by American poet Jane Hirshfield, and two links with meditation practices by Rick Hanson, PhD:

https://www.rickhanson.net/meditation-talk-how-to-use-fear-and-not-let-it-use-you/

https://www.rickhanson.net/meditation–talk–see–the–whole–be–the–whole/

First Aid   by Tasos Leivaditis

Late. // The cafe is empty. //  Friends have left.    

And I daydream all alone,   //  pretending to fiddle with the hairs on my chest,

while I carefully remove one by one  // the bullets of the conversation.

Extract from Tasos Leivaditis’ poem:  But ιn the evenings

And see we’ve got here   //   Without luggage
But with such a beautiful moon

I too dreamt of a better world   //   Poor humanity, you couldn’t
write one further chapter    //   Like a plank from a sad wreck
our old continent travels

But in the evenings how lovely   //  the earth smells

Of course he loved    //   the ideals of humanity,
but the birds   //   flew further away

Harsh, heartless world   //  that never opened an umbrella
over the tree when it poured

But in the evenings how lovely   //  the earth smells

Then they discovered the compass   //   so that they could die in other places, too
and greed   //   so they would remain dead for ever

But as evening arrives   //   somewhere a flute   //   or a star  advocates  //
for all of humanity

But in the evenings how lovely   //   the earth smells

As I remain  in my room,   //   suddenly  brilliant ideas come to me

I wear my father’s jacket  //  and so there are two of us,

and if they once heard me bark   //    it was to bring an air of the counryside in the room

But in the evenings how lovely   //   the earth smells………..

Extract from Jane Hirshfield’s poem: For What Binds Us

And see how the flesh grows back

across a wound, with a great vehemence,   //   more strong

than the simple, untested surface before.

There’s a name for it on horses,

when it comes back darker and raised: proud flesh,

as all flesh,

is proud of its wounds, wears them

as honors given out after battle,

small triumphs pinned to the chest—