Bernard Apfelbaum, PhD

THE FOCUS OF EGO ANALYSIS

Under the headline VETERANS REMEMBER DAY OF INFAMY in the May 25, 2001, San Francisco Chronicle, we read about veterans of Pearl Harbor who “still experience flashbacks 60 years later.” One reported that since his retirement he has begun getting such agitated nightmares that he has to sleep in a separate bed to avoid having his thrashing wake his wife. "I wake up and I'm back there," he said. "I'm gasping for air. I'm hoping I don't die." This is from a story on the pre-screening of the movie Pearl Harbor for those who had been there. The reporter comments that these men never talked with their families about the battle, but the movie created some release (as, undoubtedly, did the presence of the other veterans as well), and so they talked to each other and to him. Another man said that he

raised five kids and spent 30 years on the police department. But he never discussed the attack until a few years ago when his niece cajoled him into a video interview for her college oral history project. "That just got the monkey off my back," he said. "I spent all those years trying to forget it. The best thing to do was to talk about it. That really helped."

      Of course, there are some survivors of major disasters who talk about it freely and some who, when they do talk about it, get no relief, just as we might expect. But there is this striking prototype: survivors of major disasters, most notably combat veterans, will maintain a legendary silence about the experience, even despite being harassed by flashbacks. Yet when they are encouraged to simply recount the experience in detail, as this one veteran confided, “That just got the monkey off my back.” How can we explain this paradox? Years of suffering are relieved by talking about it, yet these men can be so secretive that even close family members may not know that they saw combat.
      These men don’t talk, yet when they do, even to someone who does nothing more than listen, they can be relieved of what might have been decades of suffering. What passes for an explanation of this mystery has only kept us from thinking about it further. The explanation has been that the trauma is so terrifying one instinctively blocks it out, and that when it can be allowed in, it dissipates. This is little more than a description, one that makes it seem as if there is something odd and special about severe objective trauma, removed from the world of everyday ambiguous traumas. This explanation also fails to account for what can be a remarkably rapid recovery, often in a single recounting. The essentially instant recovery of the man who told his story for his niece’s video is classical. He himself apparently didn’t wonder why, in view of this miraculous recovery, he didn’t think of talking about it sooner. That question never seems to arise, as if it was just a foolish mistake.
      Disaster counseling, as following an earthquake or massacre, consists essentially of helping the person relive the experience bit-by-bit, in all its detail. Then it can really be over. Why is this? Why wouldn't it be just one more harrowing repetition—like a flashback?
      Everyone knows that talking something out in the presence of a sympathetic listener can be relieving. Psychoanalysis began with that insight, and most subsequent therapies incorporate it. Despite this familiarity there still is something obscure about why catharsis works, when it does. The word catharsis itself is derived from the action of purgatives, which generates a metaphorical explanation: catharsis as a "cleaning out"—what one of the early figures in psychoanalysis called chimney sweeping. But, as Freud found, people don’t always want their chimneys swept; they may strongly resist it, just as do the survivors of major disasters. We can raise the same question: why do they resist talking, since it can be so relieving?
      The answer that is easy to arrive at from the ego analytic position, using the newspaper story as an example, centers on the seemingly irrelevant fact that the man’s niece was videotaping him for an oral history project. It made her a neutral observer, and also he was doing it for her. She wasn’t there to help him and, given this circumstance, undoubtedly felt no obligation to respond reassuringly.
      Most people would try to be reassuring or to help the victim to come to terms with the traumatic event—to say that what’s past is past, that there is no reason to keep torturing yourself, that it does no good to keep going over the trauma, that you need to just let it go.
      That’s how we react to continuing emotional suffering in our friends and relatives. What they hear tis that their suffering is no longer justified—that they no longer deserve sympathy, even that they are being self-indulgent. Of course, no one would say that. People just want the victim “to get on with his life.” But it comes across as “stop wallowing.” Why is that?
      Partly that is because we actually do get impatient with suffering. We would never say these things to people we thought were clearly entitled to their suffering. No one would ever tell the combat victim that he is “sitting on the pity pot,” in the demeaning AA phrase. No one would, simply because we think he has an unimpeachable right to suffer. But such airtight entitlements are rare; suffering typically is met with skepticism. Suffering in silence is considered heroic, which gets taken to extremes in the movies that help shape our ideals. Some thinkers have gone so far as to argue that the very word victim should be struck from our vocabulary (opposed to this age-old system of denial is the recent concept of "blaming the victim.")
      There is another reason why these attempts to be helpful come across to the sufferer as “stop wallowing.” We respond to our own suffering in the same way; we blame the victim when it’s us. Victims are already feeling that they should get over it. They may begin feeling that pretty quickly—like right away.
      When teams of disaster counselors are sent to the scene of a massacre, these people are rarely professionals. They do not need to be, any more than did the man’s niece with her video camera. Not much training is required, only the insight that their reassuring, nonjudgmental presence is what finally reconciles the person to the traumatic experience. They know to suppress the reflex to tell victims to quit feeling sorry for themselves or to offer all the disguised versions of this advice. In other words, they are trained to not respond the way everyone does. Difficult though it can be to suppress these reactions, when they do, and when they can stand having the victim tell the story in increasing detail, the traumatic reaction subsides. The presence of a nonjudgmental counselor earnestly and respectfully asking the victim to go over the traumatic event is both unnatural and relieving.
      Our reflexive disqualification of suffering goes pretty deep, and as you get more fully into it, it becomes apparent that at its core is the feeling of self-responsibility. Incest and rape victims are the most prominent and obvious examples since they have always been the most susceptible to blaming the victim—judging themselves as well as being judged by others this way (for an illustration, see On Entitlement to Feelings). It is so problematic for them that the memory may be blocked and they just have mysterious panic attacks when smelling a certain kind of men’s cologne. Hiroshima survivors reportedly felt that in some vague way they brought the bomb on themselves. The bereaved person may suffer less from the loss than from being assaulted by thoughts of having not done right by the deceased. Survivor guilt—guilt about surviving when the others didn’t—is another self-blaming disqualification of suffering. (One man at the Pearl Harbor screening said, “It hurts more now because I'm an old man and I think of all the living those fellas [who died] never got to do.") Sometimes this reaction is obvious. Holocaust survivors are often fully aware of survivor guilt. They are not so easily relieved of it, no matter how unreasonable it may be.
      Since survivors of profound and obvious disasters are so numbed to their pain, this should tell us that the usual run of much more ambiguous everyday blows must give us more trouble than we realize. We are all familiar with how during major disasters—earthquakes, fires, massacres, combat—people hold it in, and then when it's over they have the experience. Then they are overcome with grief, flooded with shame, plunged into regret, trembling with fear. But in the moment they aren’t feeling anything. It also can happen that after the crisis is over they still aren’t feeling anything—but the feelings don’t go away. They keep coming back, haunting them in flashbacks, dreams, and associations. If the trauma is chronic—imprisonment, family and school abuse, ethnic and racial prejudice—the experience may be chronically held in, manifested as apathy.
      Since even victims of massive trauma can doubt their right to their pain, this should help us to feel entitled to our doubts about how much we deserve to suffer from ambiguous or hard-to-detect everyday blows. This is to say that we have a lot of difficulty telling whether an experience is traumatic or not. We have mini- disasters, maybe micro-mini-disasters all the time in reaction to external and internal events. But that is not the problem. The problem is that it is hard for us to recognize these crises. If it helps, you can think of us as being thrown into a mild state of shock more often than we realize. Sometimes we are obviously bushwacked by a crisis (stage fright, mental locking up), even though we still may only be able to guess about why that is (about stage fright, see the first example in Vignettes). More often we hardly register the effect.
      One of the prominent features of the reaction to major disasters that appears to distinguish it from ordinary emotional shocks is being plagued by waking and sleeping flashbacks. But we can learn from the vivid replays that plague the combat victim that everyday emotional trauma may reverberate just as insistently, even though not as obviously. We are not very good at coping with emotional trauma at any level of intensity, and when one hits it rattles around in our mind, looking for a way to get included and, failing that, peppers us with mnemonics.
      For a quick illustration of this, consider road rage. After venting his spleen the person has to cope with a lot of instant replays, “cope” because it’s not a pleasant experience. It’s like being nagged, an action that is better described as “persecuted” in the case of the combat, rape, or incest victim. He may just be getting these flashbacks as replays, without much thought accompanying them, or he may be aware that he has to keep reviewing the experience, trying to decide his case or to shore it up in order to resolve it. Being victims of our own behavior is far removed from the stereotype of the victim, but it makes up the bulk of our everyday traumas.
      The target of road rage, the other driver, also has to contend with compulsory instant replays, whether or not he is explicitly active in trying to present his case to himself in the form of going around on the question of whether his driving had been inadequate, selfish, or immature. As happens to the combat veteran, the experience just keeps knocking on the door of our consciousness unless and until we can find a way to comfortably include it.

      Ego analysts are, in effect, disaster counselors about subtle crises. The reaction, if we are aware of it at all, is typically to feel at fault, to experience some kind of internal scolding or shaming, either seeming to come out of nowhere or, if more specific, being the self-recrimination that you should have been able to do something about it, or that you didn't deserve to be the survivor, or that you should have been more loving, less selfish, immature, crazy, or bad. But, unlike really clear self-recriminations, as in first-stage grief, the effect of our collisions with experience can be hard to describe, other than that the person feels unentitled to the experience or that, as Dan Wile has put it (in How to be a Spokesperson), the effect is loss of voice.
      What does feeling unentitled to the experience and losing one's voice about a subtle crisis look like? First of all, it may look to the naked eye like nothing happened, at least nothing that could be called a crisis. For example, think of the veteran of Pearl Harbor who tells, not his student-niece about his experience but, say, a neighbor over a beer, who on hearing the story shakes his head mournfully, saying, "Man, you were one of the lucky ones." What the veteran hears is that maybe he should have been one of the ones who died or who spend their lives confined to a Veterans Hospital. He feels, in effect, condemned, but how can he possibly know that? So that night he has one of his more horrifying nightmares.
        In other words, the trauma is in not being able to figure out what hit you. Here is another example, one that just happened to appear in a mass magazine at this writing. It was in an article about a therapist who described her therapy as working by giving people positive strokes. A woman in her therapy group described feeling tyrannized by her boyfriend and having no way to cope with it. The therapist was quoted as advising: "Life is pretty simple. You don't like something? You either accept what is, or you change it." The therapist thought her forte was encouraging people to take charge of their lives.
        With every intention of being encouraging, the therapist comes down hard on the point that this woman just should take charge of her life. She might just as well have said to her, "Look, this is a test of character. Do you have what it takes or not?" Can you imagine the woman responding with, "Well, that's not very sympathetic!" or, "You're just turning it back on me!"
        Like the rest of us, this woman probably had trouble figuring out whether she was being traumatized; she can't tell when she is being made to look foolish or when she is being bullied. Then she is stuck. She may not have repetitive nightmares or flashbacks; what she will be stuck with is ruminations about the right thing to do about her boyfriend. Not being able to have the experience, she will be stuck trying to find a solution, a way out of it. The therapist offers her one, making it harder for her to have her feelings, harder for her to believe she has a right to her pain—stuck trying to solve the problem, but unable to have the experience and unable to know that that was her problem. The post-traumatic reaction could be hard to trace. Maybe she would awaken the next morning to find that she had been transformed into a gigantic cockroach (skip this reference if you are not familiar with Metamorphosis).
        The woman apparently brightened and nodded appreciatively, which can be a reaction difficult to distinguish from embarrassment or from being in a mild state of shock. She was being told, in this cheerful way, that she was making life complicated and that complaining about her boyfriend was pretty lame. She may well have felt a little foolish, like the butt of a joke, but she would have not been able to acknowledge that feeling, even to herself. After all, she was accustomed to being tyrannized, as by her boyfriend.
        She may have genuinely wanted to feel grateful for this therapist's pronouncement, out of some vague hope that by accepting her as a wise all-seeing authority and, correspondingly, her own weakness or foolishness, she would somehow be ultimately empowered. This could make it especially hard to not take the therapist as she defines herself. The effect is loss of voice, certainly for any embarrassment.
        What creates relief for trauma survivors is being helped to believe that they have a right to suffer. If they doubt their right to suffer, what about the rest of us? What about this woman with the oppressive boy friend? Applying the logic laid out so far, we can guess that she was being nagged by the question whether she had any right to complain-after all, she would be likely to tell herself (just as any friend would) that she should just move out, or maybe just be more assertive, not let him walk all over her. From this vantage, the way to help her would be to bring out these doubts and have her see how they undermine her and also are not easily relieved —how they may well create the position of weakness with her boyfriend that she describes. This can make understandable (validate) her helplessness, meaning, in effect, that she "deserves" sympathy.
         That can seem like cold comfort, but only because we underestimate how difficult it is to believe you deserve sympathy. We automatically imagine knee-jerk support—as if the response is, "You poor thing." It requires showing how the person's suffering is genuine. In the case of the woman in the group, it would mean pointing out that she was being seriously undone by doubts that are difficult to dispel.
         It might have been better if the therapist had just let her tell her story, as a disaster counselor would, but of course that would not have been enough. Perhaps the point about major disasters is that the victim can more easily see how he or she was not to blame, at least when going over the experience with a counselor, simply because they were so obviously not responsible. And perhaps the point about the victim of everyday mini-disasters is that it is not at all clear that they are blameless, and it is not at all clear whether there even was a disaster.