CHAPTER 7: THE UNBEARABLE AND THE UNSAYABLE
I was recently speaking with a noted psychoanalyst, and he told me that clinicians generally do
not understand something important about the impact of trauma - that it changes the structure of a
person’s brain, permanently.
According to this idea, he further explained, certain pathways of
excitation and reaction are laid down “in the neurological substrate” by very severe trauma, and
once this has occurred the person is altered biologically and the central nervous system responds
It was implicit in his thinking that psychoanalytic exploration would
never be capable, in itself, of affecting these supposedly permanent alterations.
If such an idea is
true, it would appear to set limits on the applicability of psychoanalysis to those many conditions in
which severe trauma plays a role.
What is one to do with a claim such as this one?
It was offered in a very sober tone, as if there
were solid scientific evidence in its support.
In working with severe trauma survivors, do we need
to be concerned with their altered, damaged nervous systems?
Should clinicians explain to their
patients that their brains
permanently affected? It is difficult to imagine that this would
be other than a very destructive thing to say to someone.
It is also difficult to see how one would
substantiate an idea like this, it being very crude, and actually more of a fantasy than a scientific
a neurological fantasy.
It does have a meaning:
the image of irreversible changes in
the brain is probably a reification of certain feelings that lie at the heart of trauma.
What are the experiences that are being reified in such imagery?
It is a matter of a person’s
sense that he or she has been irrevocably changed by what has occurred.
It is the feeling that one
will never be the same again.
A person undergoing such a feeling might have a dream of his or her
brain having been permanently damaged or modified, but taking such an image literally, as my
psychoanalytic colleague seems to have done, is not anything one should become terribly serious
It may be that this reification serves in part as a means of neutralizing the devastating power
My colleague, it is no surprise, was himself a
serious trauma victim: early physical and
emotional abuse in his family, and multiple medical crises later that devastated his whole childhood.
The theorists of trauma in our field are often victims of trauma in their histories, and the ways in
which they have found to survive leave an imprint on the ideas that then become current in our
It would be good if clinicians and writers would think deeply about such connections.
Reification in this instance is the transformation, in imagination, of a subjective experience into