What turns a terrible experience into a traumatic experience? Often, it’s that the subject is—and remains—alone with their pain.
That was one of the many insights to emerge from conversations following an online premiere screening earlier this month of “The Wisdom of Trauma,” a documentary by filmmakers Zaya and Maurizio Benazzo. The film spotlights the work of Dr. Gabor Maté, physician, addiction medicine specialist and trauma expert. He is the author of four best-selling four books, including “In the Realm of Hungry Ghosts” and “When the Body Says No.”
The premiere week also featured conversations between Maté and other experts in the field, including Dr. Peter Levine, a psychologist with a doctorate in medical biophysics. Levine is a pioneer of somatic (body-based) therapy for trauma, which was described in his best-selling book, “Waking the Tiger: Healing Trauma.”
In this conversation, Levine talked about the unique role of the body in helping people heal from trauma. Maté and Levine shared their frustrations and hopes about the current level of awareness of the pervasiveness of trauma and adversity and the need for across-the-board efforts to address them. They also talked about the need for connection and how trauma takes hold in its absence—a central theme of the film.
In one segment, for example, a homeless man in San Francisco who suffers from addiction talked about how he came from a background of privilege. “I had everything given to me,” he says, as an animated scene shows a child being handed a baseball mitt, a car, and a telephone as a brick wall is built around him. “That was their way of parenting. They’d give me everything so I’d just shut up and wouldn’t bug them.”
The camera cuts to Maté: “Children don’t get traumatized because they’re hurt,” he said. “They get traumatized because they’re alone with the hurt.”
In fact, the notion of being alone with the hurt led to the title of Levine’s book. Levine’s client, a woman called Nancy, was suffering from the autoimmune disorder fibromyalgia, irritable bowel syndrome, severe panic attacks and agoraphobia. “She couldn't even leave the house unless she was holding on to her husband’s arm,” said Levine.
When he started working with her, Levine said, “What came up [for her] was an image of when she was four years old. She was being held down by doctors and nurses who were putting an ether mask over her face for a tonsillectomy. So, her whole body for 20 years had wanted to run from that situation.
“At the far end of the consultation room, I could see an image of a tiger crouching, getting ready to pounce. And that's when I said—not quite knowing why at the time—I said, ‘Nancy, there's a tiger, there's a tiger chasing you: Run! Climb those rocks and escape!
“And I could see that she still was stuck. She couldn't move and I encouraged her. I said, ‘You can do it, Nancy, just feel your legs, feel your legs! And all of a sudden, her body starts to shake and tremble. Her hands turn icy cold and then warm. She’s taking deep, spontaneous breaths, [part of] a whole pattern, which I later recognized as being key in moving people out of trauma. When she got up to the top [of the imaginary rocks], she looked down, and she saw the tiger. And she felt safe because the tiger couldn't get her. She felt safe, which is very important in trauma therapy.”
After the breakthrough with that client, Levine said, “I knew my life would never be the same. I didn’t realize how different it would be, but this was clearly a turning point.”
A helping hand made the difference
Often, Maté said, patients who are suffering aren’t able to identify the story that corresponds to their traumatic experience, as Nancy did when she recalled being anesthetized against her will as a child. “My answer is always, ‘It’s good to know the story, but you don’t have to, because it’s actually showing up in the present anyway.”
In addition, knowing the story without having the tools to show compassion to one’s own wounded inner child can be damaging, according to Levine. He told of a woman in therapy who had been sexually abused as a child. She knew her story, but every time her partner would touch her, she would freeze. “So, you have to work from the bottom up,” he said. “You have to have the bodily experience, the affect of experience, and then you can connect it to the cognitive narrative.”
In keeping with the theme of working from the experience in the body, Maté asked Levine to recount how he was able to prevent himself from becoming severely traumatized after being hit by a car as an adult.
“I was out of my body. It was as though I were above looking down and seeing myself sprawled out on the ground,” said Levine. “And a woman came and knelt down. She sat down next to me. She took her hand and put her hand on my hand. And just that physical act of touch was enough to bring me back into my body, so it didn't become trauma.”
Even with his background, Levine said, “I don’t think I could have done that without that person’s presence. It’s not just what happened to us. It not just what we hold inside, but what we hold inside in the absence of the empathic other.”
Maté said that trauma can be so nuanced that it doesn’t necessarily take something terrible to cause it. What underlies trauma for many people he’s encountered, he explained, is that when someone felt some sadness or some grief, “there was nobody there for them to connect with. That is the wound.”
Levine agreed, and provided another example of how connection and empathy work to heal. He recounted a training he was giving to Palestinian and Israeli psychologists in Jerusalem about 20 years ago. Someone had asked if it were possible to work with someone if you don’t know what their trauma was. “I said yes, all you need is to know a symptom.”
Inner peace comes first
An Israeli named Haim, who had pioneered psychoanalytic treatment for Holocaust survivors, volunteered to discuss his symptom. He explained he had experienced back pain for the past 30 years. Levine asked him to focus in on the muscle tension beneath the pain: Was it felt on both sides of his back or more on one side? The man reported it was much more on his right side. Levine guided him to let the tension move his body very slowly. As the man did so, he started to fall backwards, and Levine caught him.
Over the next 40 minutes, the man shook and trembled, a pool of sweat forming at his feet. “We later found out that he had been an army doctor in a truck with soldiers and they were ambushed. He fell out into a ditch on his back, and when he crawled out, everyone had been brutally murdered, so that’s what he was holding,” said Levine.
But the story had another unexpected twist. A Palestinian mental health worker from Gaza spoke up later and said that when Haim had gone up to the front of the room to work with Levine, she only wished for him to be retraumatized, “because I have nothing but hatred, because your people have killed and humiliated my people.”
But something happened,” she said, “and all of a sudden, I felt this compassion for you and I was praying that you would find healing. And I realized until we find peace within ourselves, we will never find peace with each other.’”
Maté brought the discussion back to “The Wisdom of Trauma.” One thing missing from the film, he said, is that it only focused on his work, when so many other pioneers, such as Levine, have contributed to the field.
Levine said the documentary didn’t need to be perfect to have an impact.
“Anything that helps people understand trauma and how trauma affects our lives, and how medicine is floundering without an understanding of trauma [is necessary],” said Levine.
Thanks to the work of many, people are realizing that we can't deny the impact of trauma anymore, he said. “And if we choose to deny it, then we'll continue to repeat it. And the power of repetition is powerful indeed.”
Maté said that what frustrates him is that “we have all the evidence for the impact of trauma on physical and mental well-being or the lack of it. I mean, the research is complete. It’s exhaustive. It’s fully documented.” Nonetheless, he said, the average physician, teacher, and lawyer have never even heard about the long-term effects of trauma.
“There’s an alternative universe, which somehow doesn’t penetrate the practical world,” he said. “But it’s beginning to gain attention. It is promising, but the promise is still so far away from reality.”
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