Psychiatrist Mark Epstein says that traumatic stress is the very texture of our lives. Accepting that fact, he says, allows us to lean in to our suffering and emerge as more complete people through that experience.
Epstein’s most recent book is The Trauma of Everyday Life. We spoke with him about the everyday nature of trauma, the strategies people use to avoid it, and how, if approached with an open heart and mind, trauma can be our greatest teacher.
S&H: Tell me about the “trauma of everyday life.”
Mark Epstein: The basic thing is that you can’t be in a human body without being confronted periodically with death, illness, tragedy, and chaotic things happening that you can’t control. For all of our best efforts to live a life that we do control—and we’ve made great strides over the past 1,000 years or so—it’s really not possible. Accidents continue to happen, pipes burst or leak, ticks carry Lyme disease, the airplane sits on the runway for an hour with the air conditioning turned off, and our children get teased in their schools. It’s nonstop. So there’s this constant element of trauma in life where it has already happened or it’s imminent. People are suffering either from posttraumatic stress or from what I like to call “pretraumatic stress.”
Even though trauma is unavoidable, most of us try our best to keep it at bay.
The instinctive reaction that most people have to trauma is to shut down the feelings that come along with it because they feel overwhelming. Or else they might completely give themselves over to the feelings so that they become incapacitated. I think it could go either way, but mostly it’s to shut it down. But in terms of health, it’s pretty clear that while there might be some short-term gains, that approach ends up shackling you emotionally. For example, you might become a person who’s all about cleaning up all the time, needing everything to be under control, not wanting to be late, and needing everything in its proper place or you might start to get anxious.
This is understandable, though, because it can be hard to figure out how to legitimately make room for an emotional response, like a grieving process, that you don’t completely trust or understand.
What are some of the most common strategies people use to try to avoid trauma?
The most common unconscious strategy is dissociation. Unconscious because it’s almost instinctive to turn away from the unbearable feelings associated with trauma. To dissociate means to leave the traumatic impact—the feelings associated with it—off to the side and to move the rest of you in a direction that seems more viable. So that means that we’re leaving little pieces of ourselves elsewhere, as we move through life. That tends to be restricting.
In The Trauma of Everyday Life you write that some people have more proactive strategies for dealing with trauma. Rather than turning away from it, they take up psychotherapy or meditation or something similar to try to transcend their feelings. You seem to suggest that these approaches also won’t be successful.
It’s natural to want to try to make suffering go away altogether. And it’s natural to try to get beyond it. People are pretty devious, so when they figure out that ignoring death isn’t going to work, they try to come up with other strategies that might work better. That might mean developing other mental capacities, as you would do in meditation or in psychotherapy. What I say to that is: good luck. These approaches won’t really work, either, if the primary motivation is to escape from one’s disturbing feelings. You’ve heard the expression “the return of the repressed”? Once we have feelings, even ones we object to, they remain part of us. Simply acknowledging them is a better way of dealing with them than pretending they are not there. The latter approach usually just empowers them.
And yet you suggest that we can emerge through our suffering, not in spite of it. Can leaning into our trauma lead to a kind of awakening?
Yes, because suffering is a universal experience. When something terrible happens, it feels like it’s only happening to you. But since these experiences really await everyone, then it’s not wrong that it’s happening to you. So the whole idea that it is wrong and that we should be able to emerge unscathed might be faulty reasoning.
And if that’s faulty reasoning, then what’s the alternative? The alternative is to actually make room in our emotional experience for everything that arises. We need help to do that, because we’re not really psychically prepared to be able to do that. But the idea is that if we can make room for the breadth of the experience, we find that bound up with our feelings of loss are all of our feelings of love. So when we’re trying to dissociate from the loss, we’re also dissociating from the love. We grieve because we loved the person we have lost. If we can’t acknowledge the loss, how can we stay true to the love?
If we can create what’s sometimes called a “relational home” for painful feelings, that can actually deepen our emotional capacity such that we experience more love and compassion as well. We have a deeper sense of the universality of what it is to be human.
You mentioned that it’s important to make room for all of our emotional experiences. When we do this, it’s not so much what we experience that matters for our mental health, but how we relate to what we experience.
Yes, that’s right.
Similarly, you suggest that it’s not as important to find the cause of our traumatized feelings. Isn’t that a central component to most psychotherapy?
Well, I think that’s the fantasy that comes out of Western psychotherapy. It happens occasionally, as when someone was sexually abused when they were young, and they didn’t tell anybody, and then they developed all kinds of creative ways of avoiding dealing with their feelings. To discover that history can bring a great sense of relief. But still, even in a situation like that, one has to learn how to relate to the feelings that come up in adult sexuality. You still have to work on changing the relational mode.
Often, when there is an originating cause, you can’t just pluck it out of your memory. The way you get to it is actually by changing the way you relate to your emotional life so that, instead of pushing away the uncomfortable feelings, you’re making room for all this disturbing stuff so that it can start to inform your consciousness. This is how the two ideas are linked: if a cause is to be found, it will come out of opening oneself to the dissociated feelings. But there is not always a single, or a simple, cause. It’s often a fantasy that there’s one originating cause for our suffering. We like to trace it back to some problem when we were two or three years old that set us on the road to our personality. That may be true for some people, but I don’t think it’s the most important thing.
However, in the book, you do discuss “primitive agonies.” Isn’t the idea with primitive agonies that what happens to us when we’re babies has an impact on us in ways that reverberate throughout our lives?
The idea is that, even when we’re babies and under the care of a good-enough parent who’s able to put his or her primary focus on the child, there are still going to be times of suffering. There are still going to be times when the baby is awake in the night and the parent isn’t there to comfort him. After waiting and waiting for the parent, eventually the baby gets beyond a certain point of having faith that the parent will be there, and so he’s totally alone. There’s the sense of being dropped, of being infinitely dropped, of crying and crying and then giving up hope.
To one degree or another, most people are subject to those kinds of experiences even when they’re growing up in loving families. So there’s a history of what is sometimes called primitive agonies that get shunted away. Some people think they’re hidden in the body somewhere, or they lie in wait for adult relationships that then trigger them. So it’s a kind of posttraumatic stress in a person’s relationship life. For example, when your husband or wife or lover isn’t attentive to you in the way that you might wish, some of those early primitive feelings, which can include an intense rage, might arise and be very destabilizing for the relationship.
Let’s get back to the idea of leaning into trauma. If we really allow ourselves to experience all of the feelings that come along with trauma, how can we function in the everyday world? Sometimes we might need to push it away in order to get through the day.
Oh, yes, of course. You might have to push it away in order to get through the day, but there’s still the evening. Lots of people push it away completely. They have the notion that they should be able to get over it in a certain period of time. They believe they should be able to go through the five stages of grief—like a day or week or month for each stage, or whatever—and by the end they should be at acceptance and then ready to go again. I think the concept that there are feelings that come around grief is extremely helpful because there are those feelings. But the idea that it’s a linear path, and that you will return to who you were before something happened, is not always helpful.
We’re all touched and changed by suffering. Or perhaps “seasoned” is a good word for what happens to us after loss. There’s no formula for how that’s supposed to go. It’s a kind of personal discovery. You can’t chart it out beforehand. Often you need other people to help you make a little space to explore what the feelings are. Some people need to go to the seashore, some need to go to the mountains, and some need to lie in bed with their lover. Some people need to meditate; some people don’t. We often need some space in order to know what it is that we’re feeling.
And it could come in an instant. I’m not saying you have to be hanging out with those feelings all day long. But you do need to be respectful of those moments that remind you of someone or something that has happened—the light strikes in a certain way or there’s a certain smell—by paying attention to them. It’s happening on many levels. You think you’re going about your everyday life, but, really, there are always these little glimmers of other things happening in everyday life.
That reminds me of a piece you wrote in the New York Times a couple of years ago. You tell the story about how your mother started to talk about the loss of her first husband only after your father died.
Yes, my mom lost her first husband very suddenly to a heart attack when she was in her 20s. Then a couple of years later she married my dad and never really talked about the earlier loss—certainly not to her children.
When I was 10 years old and we were playing Scrabble, I discovered in her dictionary that she had written her first name with a different last name. I started asking questions and found out that she was sitting on this thing. It wasn’t really until my father passed away in his 80s, about eight years ago, that my mom felt free enough to really start talking about what the earlier loss had meant to her. She had to keep it locked up for all those years, I think, because my father didn’t really want to hear about the pain of it and she probably didn’t really want to deal with it either. She had to move on and make the new marriage work and have children. It just got buried.
But right away after my dad died, she started talking about her experiences a lot, as if the two deaths were conflated, and that deepened our connection. The past is not just history, it is still alive in our individual memories and is an inextricable part of our consciousness. Our emotional lives are built on the past, and while we don’t need to be victims in this regard, we can actually be more free when we acknowledge it.
Opening to the Music of the Random Cellphone
When I teach meditation to a group of people I sometimes ask them to turn their cellphones on before we begin. Then I ask them to sit up straight, in a relaxed but alert state of mind, and to close their eyes and put all of their attention into the sounds of the room. Sometimes it is very quiet, sometimes there are random sounds from the outdoors, from the street, or from the fidgeting of the other people in the room. And sometimes, at random, people’s cellphones go off with an unexpected beep, ring, or snippet of song. I ask everyone to listen in a meditative way, as if it were all music, not pushing away the unpleasant and not clinging to the pleasant, not dismissing some sounds as not musical and attaching to others that are.
Listening to sound is a wonderful way to train the mind. It is surprising what can happen.
Once, at the end of a session, a young woman told the group about her father who had recently passed away. “I had a special ringtone on my phone for when he called me,” she said. “After he passed away, I never could bear to hear it again and I put it away. But today, in this exercise, someone else had the same ring and it was like hearing my father again. I was so glad to be able to hear it with all of you here.”
Listening to music is a kind of meditation in itself. If you give yourself over to it and let it pass through you, paying attention to whatever it brings in its wake, you are making more room for your emotional life to surface. This is the essence of both meditation and psychotherapy. Who knows what you will feel? —Mark Epstein