Neurons, Narratives, and Neshamot
[This article is by Barbara E. Breitman, M.S.W., D. Min. She is a psychotherapist, one of the founders of Jewish spiritual direction, and teaches both pastoral counseleing and spiritual direction at the Reconstructionist Rabbinical College. This essay was delivered as a talk at the Germantown Jewish Centre, Philadelphia, Pa., as part of the observance of Tisha B'Av, the annual Jewish day of mourning for the traumatic destruction of two Holy Temples in Jerusalem, 2500 and 2000 years ago. The day is marked by a 24-hour total fast and the reading of Eicha, the Book of Lamentations. ]
Eicha! How can this be? How can this continue to be what is happening in our country? I thought that last weekend I had completed writing what I wanted to say tonight, but the release this week of the video of Sandra Bland being arrested for refusing to put out her cigarette, after being stopped for not signaling when she changed lanes, followed by her death in jail, insists that I begin with her. In the words of a young African American blogger: “The surfacing of this video confirms that Sandra Bland was subject to a violent, racist, and trauma-producing encounter with the police. … Whether Sandra Bland committed suicide or not…We must … … recogniz(e) that state-sanctioned violence can produce suicide as a response.” See http://www.blackgirldangerous.org/2015/07/why-not-ready-rule-out-suicide-in-the-case-of-sandra-bland/
This blogger is right. Suicide can be an aftermath of trauma, especially when one has been subject to repetitive abuses of power. A man emboldened by the authority of the state set out intentionally to break Sandra’s dignity and will, and that could have led her to commit suicide while in custody. If it did, he and the state are morally culpable whether or not the policeman can be held legally responsible for her death.
I need to pause for some silence in her memory before I can launch into the talk I prepared last weekend.
On the Sunday after the murders in the AME Church in Charleston, a passionate essay by Michael Eric Dyson titled “Love and Terror in the Black Church” was published in the New York Times. You may have seen it. I was deeply moved by his words. Here are some of them:
“Sites and spaces of black life have come under attack from racist forces before, but the black church is a unique target. It is not just where black people gather…..
"In too many other places, black self-worth is bludgeoned by bigotry or hijacked by self-hatred: that our culture is too dumb, our lives too worthless…
"The black sanctuary breathes in black humanity while the pulpit exhales unapologetic black love….
"The black folk gathered in the (AME) church were the living, breathing antithesis of bigoted creeds cooked up in the racist fog (the shooter) lived in. It is not their barbarity, but the moral beauty of black people that let an angel of death hide in their religious womb. Its openness and magnanimity are what make the black church vital to the quest for black self-regard. ….In a country where black death is normal….black love is an unavoidably political gesture.” (Italics mine)
In the days that followed, we witnessed the transformative power of black love. White America, including heirs to the Confederacy, looked in the mirror of innocence and forgiveness of black love and the evil of racism stared back without any illusion of mitigating circumstances. Not Trayvon’s Martin’s hoodie, Michael Brown’s demonic size, Tamir Rice’s toy gun, Eric Garner’s cigarette -- or, now we must add, Sandra Bland’s refusal to put out her cigarette.
At Reverend Pinckney’s funeral, President Obama and black church leaders professed a theology that made me tremble, at first with bewilderment and then with awe: They saw God’s hand in this profound tragedy, in the sacrifice of these blameless people. Rather than igniting a race war as their murderer had hoped, their death at the hand of a deluded white supremacist was bringing about previously inconceivable social and spiritual change. What the President called the ‘original sin’ of the United States, slavery and its racist legacy were revealed with such clarity that previously blinded minds and hearts could now see, by the power of grace that could only be attributed to God. We are challenged to respond to that grace with action.
Whatever my own difficulties with it, this theology elevated what could have been only an act of senseless, racist horror to an event of transcendent meaning. We witnessed the power of spirituality for individual and collective transformation and healing after trauma.
As we gather tonight, there may be those among us who, right now, are living in a place of desolation. In the immediate aftermath of shock trauma, a once familiar and comfortable world is shattered and turned into an alien and terrifying place. Trauma survivors are forced to know truths about reality none of us wants to know. With support, our worlds can resume more familiar outlines, but we are forever changed. Tonight my focus is on some of the mysteries of traumatic memory, how the traumatic past can live inside us, and the complex interplay between neurons, narratives and neshamot, body, mind and soul for healing.
The Book of Lamentations we read tonight begins with the most plaintive cry in all of biblical literature: Eicha! Alas! How could this have happened? How have we come to this? How can we bear this? Eicha’s haunting cries of desolation leave us nearly bereft. And yet, as theologian Kathleen O’Connor has written: “For readers who begin from a place of suffering, Lamentations is a book of comfort. It serves as a witness, a knowing, a form of seeing…(.in which people) can recognize their lives, symbolically or more literally, and in that recognition they are no longer alone in their pain.”
As we read Eicha tonight, we bring the harsh realities of trauma into the open. Gathering in community, we say to ourselves and each other: “We know that such horrors exist. We know they exist in our own neighborhood and community. If you have been shattered by traumatic loss, come sit beside me. We see you. You are one of us. We know one day, we might be shattered, or we already have been. There is no need to hide your pain in this place. You can grieve in the open.” Lamentations offers such a sacred space and a theology of witness.
“To lament is (also) to pray in a spirit of resistance… Because (the Book of Lamentations) denounces abusive power, it teaches resistance. It refuses to accept a view of the world where God fixes everything, for God has not done so.” (O’Connor, Tears of the World, 131)
This theology of witness is different from the theology of President Obama and the Black ministers, and it is also a call to service. It says that truth-telling, bearing witness, willingness to hear what it is really like to live daily with the devastation of grievous loss, of war, of racism, of poverty, is sacred and holy work. There can never be personal healing or social change if we don’t witness, in community, to the truth of what trauma creates individually and in society.
The medical field, which has traditionally been suspicious of the healing power of religion, is increasingly recognizing that spirituality can make crucial contributions to resilience and recovery from trauma. As one psychiatrist writes: “Religion fulfills the critical function of providing a sense of purpose in the face of terrifying realities by placing suffering in a larger context and by affirming the commonality of suffering across generations, time and space. Religion can help people transcend their embeddedness in individual suffering.”
Bessel van der Kolk, an internationally noted contemporary trauma psychiatrist, begins his most recent book saying: “Experiencing trauma is an essential part of being human; history is written in blood. Although art and literature have always been preoccupied with how people cope with inevitable tragedies of life, the large scale scientific study of the effects of trauma on body and mind has had to wait till the latter part of the 20th century….” From the earliest involvement of psychiatry with traumatized patients, there have been vehement arguments about trauma’s etiology. Is it organic or psychological? Is trauma the event itself or its subjective interpretation? Does the trauma itself cause psychological disorder or do pre-existing vulnerabilities cause it? We can now give a qualified ‘yes’ to what in the past were seen as in opposition.
When we are traumatized, we come face to face with human cruelty and we know our essential vulnerability to the potent, unpredictable forces of chance and nature. These are things we don’t want to face and therefore even the history of the Psychology of Trauma has fluctuated between awareness and forgetting, between periods of active research leading to theoretical breakthroughs, (followed by) periods of denial …, and periods of seeming amnesia as hard-earned knowledge has been repeatedly lost and subsequently rediscovered. (Van derKolk, 67) As Judith Herman, another famous trauma psychiatrist, has written: “Repression, dissociation, and denial are phenomena of a social as well as individual consciousness.” This is one of the mysteries of traumatic memory.
Probably the most well-known fluctuation involves Freud’s shift from an initial belief in his patients’ stories of childhood sexual abuse to his later recantation as he created his theories of repressed infantile sexuality. Knowing what we know now about the high incidence of child sexual abuse, it is hard to read the words Freud wrote in 1925: “I believed these stories (of childhood sexual trauma) and consequently supposed I had discovered the roots of the subsequent neurosis in these experiences of sexual seduction in childhood. If the reader feels inclined to shake his head at my credulity, I cannot altogether blame him….I was at last obliged to recognize that these scenes of seduction (in childhood) had never taken place and that they were only fantasies which my patients had made up.”
Amazingly, for the long stretch of time between 1895 and 1974, the study of trauma centered almost exclusively on its effects on white males, most who had been in combat … The most significant exception during that time was an independent line of investigation that emerged after WWII with the study of the effects of trauma in survivors of the Holocaust. Notably, those studies were conducted primarily by investigators who were participants in the war, could identify with Holocaust survivors or were concentration camp survivors themselves. Jewish psychotherapists and doctors have made significant contributions to the study of trauma from the beginning up to and including the present.
In the 1970’s, under the influence of the feminist movement, two populations which had been entirely neglected from psychological trauma research, began to be studied: namely women and children. In 1974, the nurse Ann Burgess and sociologist Linda Holstrom opened one of the first hospital based crisis counseling units at Boston City Hospital and were the first to describe a ‘rape trauma syndrome’. Their work was followed in 1978 by others who began systematic studies of battered children, domestic violence and finally incest.
Although much trauma research was focused on the veterans of WWI and II, the history of so-called ‘trauma neuroses’ among soldiers is also a fraught and twisted history, a situation which continues in the present, as the government and military struggle to assume responsibility for the suffering of Iraq and Afghanistan combat veterans: not hiring sufficient staff to receive the thousands of severely traumatized veterans, denying veterans their compensation, rationing treatment and blaming soldiers’ difficulties on pre-existing conditions. We certainly don’t want to pay for their treatment. But even more, we don’t want to know what happened to them.
We have not, however, gone into the kind of denial we did after Vietnam.
As Burgess and Holstrom were counseling rape survivors in the 1970’s, two New York Jewish psychiatrists, Chaim Shatan and Robert J. Lifton, started ‘rap groups’ with Vietnam Vets. They catalyzed an informal network of professionals around the country who were concerned about the lack of recognition of the effects of the war on these men’s psychological health. Reading the literature on Holocaust survivors, as well as older research that had been forgotten, their work eventually led to the inclusion of PTSD as an acknowledged psychological disorder in the DSM 3, in 1980. Though it was an imperfect classification, its inclusion made trauma a focus of research inquiry which has continued to the present.
The importance of this history is the acknowledgment of the intimate connection between cultural, social, historical and political conditions on the one hand, and the devastating reality of the suffering of individuals and communities we don’t want to face. “Posttraumatic symptoms are not just a private and individual problem but also an indictment of the social contexts that produced them”. All too often “The narrow application of the traditional scientific method …leads to a separation of illness from its social roots and, therefore, from issues of human rights.” (Kleber, 1995, Beyond Trauma, p.13).
As I turn to the ‘neuron’ dimension, I want to say a couple of things. The first is that because of contemporary neuroscience, we do now understand things about psychological trauma and traumatic memory that we did not understand 20 years ago and certainly not 40 years ago when I began my education as a social worker and therapist. It is important that this knowledge is now seeping into the culture and becoming common knowledge because it changes how we understand human beings. Toward the end of increasing that awareness, I am going to speak about neuroscience in the synagogue on Tisha B’Av. Secondly, one of today’s challenges is whether the scientific knowledge we now have about trauma will be used not only to change psychotherapy and mental health treatment, but also our collective conscience and social policy as it relates to societal trauma caused by racism and other forms of oppression.
Since the 1990’s, (when George H.W. Bush declared the 90’s the ‘decade of the brain’) there has been an explosion of neuroscience research, marking a new milestone in the treatment of psychological trauma. The dualism that once dominated the debate about trauma has virtually disappeared. We can longer draw demarcations between psyche and soma.
So…a quick review of basic brain structure. Please make a fist. The brain is an evolving organ… down here is the brainstem which we share with reptiles, which I refer to as the lizard brain. This is the brain most running the show in little babies. What can babies do? Mostly they can be awake or asleep, breathe, be hungry, pee and poo. Things that are so basic, except when people are traumatized and these basic functions get messed up. This primitive brain is part of the smoke detector system that recognizes threat and is responsible for the instincts of fight, flight, freeze. The lizard brain speaks the language of sensation and impulse, not words.
In the middle is the mammalian brain, responsible for emotion and the crucially important experience of attachment. This brain also has no words, but it does hold memory. (Think about your pets, how they strongly they attach, communicate feeling states, and remember without language.)
It is only this top part, the frontal cortex, which I refer to as the wizard brain that is the uniquely human brain, responsible for language, thought, judgment, logic, insight, and analytic abilities. During the human life cycle, it is slow to develop and doesn’t reach full maturity until age 25. (Parenthetically, knowing this helps us better understand, if not live through, the emotionally volatile and impulse ridden time of adolescence!)
When we experience a big ‘T’rauma… a terrifying event or experience (a bear jumps out of the woods, a rapist jumps out of the alley, a bomb explodes) the thinking brain goes off line so we can respond instinctively. …the heart pumps faster, blood rushes to the arms and legs so we can run or fight, blood flows away from the stomach and urinary tract so we don’t need to stop to eat or pee. But with the thinking brain off-line, we cannot witness what is happening or create a coherent narrative of events.
The imprint of trauma is not on our cognition. It is on the body. Trauma, especially repetitive, prolonged trauma as in child abuse and neglect, domestic violence, unemployment, poverty, wartime alters the smoke detector system in a thoroughgoing way. So people can’t sleep or they sleep all the time, we develop eating disturbances, numb out, over-react or under-react emotionally, can become impulsively aggressive, prone to addiction or paralyzed in a collapsed state of inaction. Therapy needs to reach these non-verbal parts of the brain. The wizard brain from where language, thought and narrative emerge, cannot control the elemental brain. We know this from regular life, if we are having difficulty sleeping, we can’t simply tell ourselves, “Just go to sleep.”
Because of trauma, the body continues to fight the unseen enemy and stays pre-occupied with what happened in the past, but not as narrative memory, as somatic experience. Like soldiers who functioned magnificently in combat who cannot play with their children when they come home because they cannot calm down and be with family. Their nervous system stays in hyper alert scanning for the next explosion or attack, beneath conscious awareness. Trauma interferes with our ability to engage life in the present, either to enjoy its pleasures or to cope with its challenges.
When traumatic memory is triggered, which can happen at any time, with or without an obvious stimulus, we experience increasing somatic distress…an accelerated heart rate, muscle tightness, a hollow feeling in our chest or sickening sensation in our stomach, or some other distressing somatic sensations …and again the wizard brain goes off-line… so all kinds of danger get assigned by the meaning-making brain to these bodily sensations. For example, if many years ago I was raped by a man in a red sweater, and today I step into an elevator with a man wearing a red sweater, that memory may be evoked. I may get panicky, tremble, have difficulty breathing, and the narrative creating part of the brain whose job is to make sense of what is happening in my body, will produce thoughts like: “I’m going to die. I’m all alone. I’m trapped”, even when this doesn’t make sense of what’s happening in the present, which is “I’m just in an elevator with a man whose wearing a red sweater.” We do not interpret these sensations or thoughts as memory; we experience them as danger happening here and now. These are body memories that do not carry with them the inner sensation that something is being recalled.
Until recently, most forms of psychotherapy have primarily engaged the thinking brain …. talking about experiences, connecting story with buried emotion, and re-writing life narratives. While this ‘top-down processing’ is still important to healing, it doesn’t address somatic experience. New approaches integrate ‘bottom-up processing’ with the “top-down processing” of the talking cure, engaging people to recognize somatic activation as body memory, practicing ways to calm a dysregulated nervous system, bringing mindful awareness into moments when trauma is triggered, thereby bringing the thinking brain back online so people can make wiser choices. In the process, fragments of memory that had been buried may return and people can change self-loathing victim narratives into narratives of survival and resilience.
As Jews, we remember and ritualize the telling of our narratives of collective trauma. That is why we gather tonight. It turns out that the most powerful predictor of resilience in the face of trauma is emotional attachment, in families and communities. We know this as Jews. We saw the power of religious community in Charleston. Attachment, deep connection is essential for biological survival in children and it enables adults to create and sustain meaning. Ritual and liturgy are healing not only because they encompass traumatic loss within narratives of meaning, but also by including chant, song, movement, prayer and silence in community, we calm and heal the body.
But when it comes to collective trauma and memory, it is narrative creation that matters most. It is the stories we tell ourselves about our histories of national suffering that make the difference. As social theorist Jeffrey Alexander writes: “while the cultural construction of collective trauma is fueled by individual experiences of pain and suffering, it is the threat to the collective rather than individual identity that defines the suffering at stake.” As a people or a nation, “trauma narratives can create significant repairs in the civil fabric.” (as we saw in Charleston) “They can also instigate new rounds of social suffering” (as we see in the Middle East) “ It depends on how political leaders and symbol creators of all kinds identify the victims and the enemies to weave together accusatory (or more redemptive, healing) narratives.
The rabbis designated Tisha B’Av as one day to commemorate the worst traumas of the Jewish people. Originally, to mourn the destruction of the First and Second Temples, but later other calamities became associated with Tisha B’Av: the crushing of the Bar Kochba revolt: the day the Jews were expelled from England, when we were expelled from France, from Spain, the beginning of the Final Solution, when the mass deportation of Jews from the Warsaw ghetto began.
But the rabbis also associate Tisha B’Av with the story of the Golden Calf, and with the day the 12 spies returned from scouting the land with a negative report that caused the people to panic and despair. These associations point toward a different narrative …one that says Idolatry, worshipping anything other than the living God, the God in whose image all humanity was created, that is how we create trauma. From that narrative direction, comes the midrash that the Messiah will be born on Tisha B’Av… Messianic consciousness will somehow break through the history of human cruelty and transform us.
On the eve of Tisha B’Av we need to ask: How do we remember our collective trauma history as Jews? Do we do so to become more open to the possibility of messianic transformation? How do we recognize moments, perhaps like right now, when that transformation is trying to break through and we are called to carry it forward?
As we reach toward each other and God tonight, may we expand our narrative, remembering as Martin Luther King adjured us, “we are caught in an inescapable network of mutuality, tied in a single garment of destiny. Injustice anywhere is a threat to justice everywhere.”
On this Tisha B’Av we look for ways forward for healing for people in our own community and for our nation. We also remember that last year at this time the trauma most immediately in our awareness was unfolding in Israel and Gaza.
In the name of expanding the boundaries of what we mean by ‘our collective history’, I want to close with a poem by Rabbi Tamara Cohen, written last year …because it also has wisdom for this moment in history and in the United States.
No Pain Like My Pain (Lamentations 1:12) - for Tisha b'Av 5774/ 2014
That's how it feels Dear God.
That's how it felt to the lamenters exiled and Temple-shorn.
That's how it feels to each grief-wracked mother, father, sister, son, family, nation.
הביטו וראואם יש מכאוב כמכאובי
"Look carefully and see if there could possibly be pain like my pain, like the one bestowed by You upon me."
No pain like my pain,
no exile like my exile,
No land my land,
No desolate city like my desolate city.
No heart like my own aching heart.
No fear like the fear of my people.
No genocide like our genocide.
No humanity like our humanity.
No right like our right.
No wrong like their wrong.
No rage like my rage.
No pain like my pain,
immediate and raw and righteous,
ancient and true and etched in our genes by history's injustices.
Dear God, help us look,
look closer so that we may see
our children in their children,
their children in our own.
Help us look so that we may see You --
in the bleary eyes of each orphan, each grieving childless mother,
each masked and camouflaged fighter for his people's dignity.
Dear God, Divine Exiled and Crying One,
Loosen our claim to our own uniqueness.
Soften this hold on our exclusive right -- to pain, to compassion, to justice.
May your children, all of us unique and in Your image,
come to know the quiet truths of shared pain,
May it be Your will.
and may it be ours.