Memory as Medicine: How one Heals After a Trauma

By Norman Fried –

A research study from a group of Chinese scientists reports a new drug that successfully erases memories from the minds of mice. The study reveals a molecular genetic paradigm through which a given memory, such as new or old fear memory, can be rapidly and specifically erased in “a controlled and inducible manner in the brain.” The experiment points to the possibility of the eventual development of a precise and quick method for manipulating people’s memories.

In response to these findings, I offer some psychological thoughts. In particular, I write here about the human reaction to traumatic life events and the psyche’s use of memory as a means to cope with stress.

The response of survivors to extreme life events teaches us a great deal about our common human needs, capacities and wishes. Victim and non-victim alike, all of us carry within our memory banks traces of our past that remind us of our greatest weaknesses and awaken within us our formidable strengths. Researching a molecular genetic paradigm through which a given memory can be rapidly and specifically erased can offer little toward the emotional healing of an individual in pain. When memory is used as medicine it is, at its best, a healing art. And this is essentially what psychotherapy is. Our painful memories summon us from within and ask to be honored. And it is only in the honoring of such memories that they will eventually be “erased.”

Moreover, as cognitive psychologists assert, traumatic events and subsequent grief reactions are not printed on the mind the same way that other “ordinary” events are. Rather, they remain separate, and are partly-to-fully out of our awareness. Coined by Freud as a “splitting of consciousness,”  the dissociaion or numbness that a victim of extreme stress experiences is the psyche’s way of protecting itself from painful thoughts and emotions.

Mark Mayford, who studies the molecular basis of memory at the Scripps Research Institute in La Jolla, CA, states that a drug to erase memory would “scramble things up in the neurons that are active during a specific recollection.” Such a concept has long been understood by neurophysiology researchers, dating back to W.B. Canon in 1939, when he coined the concept of the “fight or flight response” to traumatic events. Even Charles Darwin noted that, in order to cope with a variety of dangers, animals and humans evolved a variety of mental and physical behaviors.

What is required here is not a drug that will allow the erasure of memories, but rather a psyche that will allow the “hauling up” of unbidden recollections that beg to be addressed. Science can explore many ways to ameliorate the effects of painful memories on the human psyche. But the antidote for relief from pain is, paradoxically, to explore, honor and understand how our memories shape us, and impact us, as we live our lives everyday.

Reach Norman Fried at his website, www.normanfried.com.

The Poetry of Death: Can It Comfort Us?

By Norman Fried –

Modern poetry has often found a critical muse in the concept of death. In words apocryphal or mundane, spiritual or skeptical, modern poets have used their art as a means to describe their terse and terminal views of the inevitable.

Wallace Stevens, perhaps one of the most skeptical of modern poets, considered death as a “termination” or cessation  of all life energy, an “absolute without memorial.” We see this in Steven’s famous but dark poem, “Madame Le Fleurie,” in which death is likened to a “waiting parent,” ready to devour us beneath her dew. William Carlos Williams is also known for his clinical depictions of the dying as a “godforsaken curio” or a “thing ” which love can not touch.

These words stand in stark contrast to the notorious “wager” proposed by Blaise Pascal, the seventeenth century mathematician and philosopher who stated: “Let us weigh the gain and the loss in wagering that God is…. If you gain, you gain all; if you lose, you lose nothing. Wager, then, without hesitation that He is.”

What, then, can the serious writings of many of our most famous modern poets offer us with regard to the problems of loss and grief? Religious scripture offers promise of transcendence and redemption. Children’s folktales implicate magic and personal wishes as the archetype for healing and restored health. Mystics and mediums pre-suppose a transition from the physical to a spiritual realm. But modern poetry often leaves us struggling to find a vision of death as more than, as British poet Philip Larken stated in the 1970s, “total emptiness for ever.”

Pascal had it right with his notorious “wager.” Many who are nearing death, or who are facing the imminent and certain loss of a loved one, find themselves drawn to a belief in a redemptive divinity or mystical force for solace and comfort. For it is important to remember that, just as Pascal challenged three centuries ago, there is longing in each and every one of us to “gain all” in the process of our own inevitable dying.

The words of John Donne from The Oxford Book of Death are more helpful when he proclaims: “One short sleep past, we wake eternally.” For as the dying and their loved ones face the inevitable pain that lies ahead, the tersely optimistic final sentence of John Donne’s sonnet offers, perhaps, the greatest solace of all:

“Death…thou shalt die.”

 Reach Dr. Norman Fried through his website, www.normanfried.com

How Families Survive Trauma and Loss

By Norman Fried –

What are the lessons that trauma, loss and recovery can teach us about family relationships? And what are the changes that occur in families that have to endure tragedy and loss?

We know that trauma and loss bring about changes not just in each individual family member but in the family system as a whole. In children, for example, we learn that the clinical after effects of trauma involve a sense of disconnection from others and a feeling of “loss of power.”  Recovery, therefore, is based upon the establishment of new and “safe” connections for these children, and a feeling of empowerment in the face of all that is changing around them.

But changes exist for the parents of traumatized children, as well.  More specifically, as adults, our grief reactions are centrally connected to our experiences of self, parent and spouse. For many, our sense of self is altered in several ways. First, we may feel a ruptured sense of competence as a parent. The promise we made to our infant child long ago has been broken, and we feel we have failed our basic socio-biologic function of protecting our offspring.

Second, we may struggle with survivor guilt. We find ourselves saying “It should have been me.” Additionally, many among us may ruminate about the events that lead up to the trauma in an attempt to “master” what we have been through. As one mother put it, “I should never have let my son go out that fateful night. I felt the ‘death waves’ come over me and I should have trusted my gut.”

Another change to our sense of self includes “a loss of purpose.” As one parent told me, “Being her mother was the only job I ever wanted, and the best job I ever had. Who am I if I am not my child’s mother?”

Still other parents among us feel a loss from the ‘hospital family.’ More specifically, when a loss occurs after a prolonged illness, many parents feel a sense of abandonment from the nurses and doctors who cared for our child. The support staff including social workers, child life specialists and psychologists, are no longer available for bedside attention and succor. Thus, a second wave of loss develops that oftentimes makes the journey toward recovery more difficult.

But still we prevail. We know that we have other children to care for; or friends and relatives who need us. We say that it is better to be numb than to be in pain. But the waves of shock and numbness eventually ebb, revealing a stronger will to survive. We search for answers and think we find some through our faith, or our spirituality. We speak of increased strength and resilience. We find ourselves attracted to those among us who may have suffered similar losses, similar traumas; for these people speak our language and understand us in ways that old friends simply can not.

Eventually, we discover an increase in our ability to give and to receive help. We reach out to others who are walking the same embattled surf, and we allow ourselves to love again, and with greater intimacy. We know that we have faced the greatest challenge in life, and we become determined to survive, and to make meaning and sense out of the senseless. And as a family we say to ourselves, “If we can survive this trauma (and we will!), we can survive anything.”

Reach Norman Fried through his website, www.normanfried.com.

Survivors of 9/11: Rediscovering the Heroes Inside

By Norman Fried

In her front page article in Wednesday’s New York Times, Anemona Hartocollis reports on the current lives of some of the survivors of the September 11 attacks on the World Trade Center. ”Maimed on 9/11, and Trying to be Whole Again” highlights several men and women who were critically wounded, partially paralyzed, and emotionally transformed as a result of the events of that day. But her article is also a treatise on the human will to survive and to “rebuild a harbor,” as poet Yehuda Amichai once said, long after the ship has gone down.

According to Hartocollis, there is no clear accounting of how many people were injured on 9/11. She reports that $1 billion out of the $7 billion raised was distributed to the injured, including firefighters; a total of 2,680 physical injury payments made in all. Burns accounted for 40 of the 2680 injury payments; no clear numbers are available for the cost of psychological support to families of those who were killed, as well as for those who survived.

What is clear from the testimonies and the stories of the survivors of 9/11 is the triumph of the soul over adversity. Their stories command us to ask:  What, or who, is a hero? What is the common denominator among those who managed to escape the struggles of that day, and struggle still to recreate their lives?

According to the ancient myths, the hero is one who is willing to take the first step on a path whose end is uncertain. Like Heracles who bears the misfortunes that the gods have sent him, or Jonah who struggles in the darkness of the belly of the whale, the hero puts himself or herself at the service of whatever necessity arises.

The heroes of 9/11 offer all of us a glimpse of the human heart; their stories of survival include a dimension of vulnerability and the possibility of failing. In rescuing others, or themselves, from an unspeakable fate, and relearning the world in which they now live, the survivors of 9/11 teach us that a hero’s voyage is one of rediscovery.  What was lost has to be found: one’s own self, one’s own purpose. Moreover, through their failings and triumphs, survivors motivate all of us to become the heroes of our own story, so that, one day, we may believe in the regrowth that comes out of a fallen world.   

Reach Norman Fried through his personal website, www.normanfried.com

 

9/11 and the ‘Shelf Life’ of Grief

By Norman Fried  

It is a widely accepted belief that, as time passes, mourners’ responses to loss and trauma change. We understand that the physical reactions of grief, including psychomotor retardation, disorientation, fatigue, and panic seem to lessen. We know that spiritual growth and religious connections develop for some mourners as time begins to pass. And we agree that many who have suffered a loss find themselves more mobilized as time marches on, devoting their energies to fund-raising or consciousness-raising programs in honor of a loved one who died.  

But the question remains: Is there really a “shelf life” for grief?

The answer, for anyone who has suffered a loss, is a resounding “No.” For all of us, grief knows no calendar. It is not linear. It is not predictable. As Hope Edelman states in her book, Motherless Daughters: The Legacy of Loss, ”mourning has no distinct beginning, middle and end.” Grief, as Edelman states, goes in cycles, like the seasons.

Many of us start our grief work immediately after a death, but some tend to grieve in spurts. We start and stop depending upon the support we receive, or the temperament we were born with. For children, grief reactions may not start for as long as six to nine months after an actual death, when the adults around them are beginning to show signs of improved coping.  And as for gender, it is more common for a man to express his grief years after the woman in his life has expressed hers. Furthermore, mourners who have sought the help of a grief therapist, the clergy, or a spiritual guide, may show signs of improved functioning well before mourners who “go it alone.”

While there is no shelf life, the concept of “old grief vs. new grief” does merit attention, for this September 11 marks the seventh anniversary of our collective trauma as a country, and our personal grief as individuals. For most of us, the movement of grief is very deep. The internal shift from physical pain to psychic and emotional pain is surreptitious, numbing and preconscious. We do not enter into grief: Grief enters into us. And with this new tenant, we are forced to learn whole new ways of coping. We go from asking, “Why did this happen?” to asking, “How will I go on?” We move from disbelief and shock, to an unbidden reality that this is our new way of living.

Several mourners I work have likened this shift to that of “trying on a coat.” “In the beginning,” one mourner stated, “the coat was stiff, it didn’t fit. It was scratchy and itchy and I noticed I was wearing it. I hated wearing the coat. But as time has gone on, the coat has become more comfortable. It fits my body perfectly, for it has become the ongoing vehicle of my relationship with my loved one.”

Other grievers state that old grief, as opposed to new grief, is an “action-oriented” state of being. It is a way of being close to a loved one, a means of involving him or her in our lives. Some call it ”mature grief,” and they claim that it involves putting aside the physical, and moving deeply into the spiritual side of a loved one’s essence. “My grief is more than just a collection of memories,” one mourner says. “It helps me define who I am now; it gives shape and substance to the relationship I have with my loved one. For without my grief, I could not have a connection to him.”

Regardless of how we define it, the movement from new grief to old grief is an essential part of the mourning process. Well-meaning friends and relatives who tell us to “move on,” or “get over it,” do not fully understand that we will never “get over grief.” But with the proper love and care, we can, and do, learn to live alongside our grief, allowing it to be the unbidden, but familiar, companion we carry through life. And if we are successful in our grief work, we discover that, unlike the tidal wave that once carried us under, our old grief is more like a spindrift of fallen tears. We may still see the world through a haze of sadness, but the future, and our place in it, comes back into view.

The Story Of Gana: What Animals Teach About Grief

By Norman Fried

Last week, the internet and newspapers across Europe and America posted pictures of an 11-year-old gorilla named Gana clutching the corpse of her 3-month-old baby Claudio for days before surrendering his lifeless body to zookeepers.  As Gana persisted in cradling her baby, questions by primatologists, psychologists and other social scientists arose.  Do animals have a cognitive appreciation of their own mortality? Do they grieve as adult humans do? Or are they simply confused?

In her September 2nd article in The New York Times, Natalie Angier presents data by scientists that suggest another theory: that elaborate displays of primate maternal grief, like those of Gana toward her son, reveal less about our shared awareness of death than they do about our shared impulse to act as if death never happened.

Indeed, for many of us, a common mode of coping with death is denial, and this system of denial rests on one of two major premises: We are either personally inviolable to death (”This can’t happen to me”), or we are protected eternally by an ultimate deity or rescuer. Coined by Otto Rank as a ”death fear,” our anxiety of separation, loss and lack of connectedness causes us to employ either one of these two fundamental defenses.

“The mind blanks at the glare,” wrote the British poet Philip Larkin in  his famous poem entitled “Aubade,” as he contemplated the “dread of dying and being dead.”

Grieving, and the strength needed to endure suffering, is not a linear process. It more resembles a spiral staircase on which are recapitulated themes of loss, anger, disbelief, and the hope for eventual repair. Like Gana holding her dead baby Gorilla in her arms, we humans require time to wrap ourselves in our grief. We require attention and respect, and the freedom to express disbelief, anger, and confusion, until — like Gana surrending Claudio — we give up our denial and accept the fact of death. 

Norman Fried

Grief and Female Suicide Bombers — the Connection

By Norman Fried

The growing wave of female suicide attacks in Iraq introduces a newer, more insidious threat to our American soldiers overseas. It also highlights the need for greater understanding of the psychology of spousal-loss, sibling-loss and child-loss.

According to the United States military, 43 women have carried out suicide bombings in Iraq since 2003, 20 in this calendar year alone. The most recent of these attacks was carried out by a woman named Wensa Ali Mutlaq, who lost her husband one year ago to fighting in his province’s capital and lost her brother several months later after he detonated a suicide bomb.

Military analysts, journalists, and Iraqi provincial council members have all offered their explanations for the developing trend in female suicides bombings. Some suggest that for many young Iraqi women, sexual abuse by older al-Qaeda leaders, carried out under the veil of marriage, is to blame. Others attribute the trend to insurgent recruiters and religious instructors who offer promises of eternal paradise. In one case, a suicide attack was forcefully conducted through the use of remote control detonation.

Understanding the growing trend of female suicide attacks in Iraq generates new light on the actions of suicide in general; and it asks us to consider the damaging effect that suicide has on its survivors, especially wives and mothers. Studies of spousal grief reveal that bereavement following suicide is qualitatively different from other causes of death. In particular, wives of a suicide are more likely to experience a prolonged search for motives; they may often deny the cause of death; their grief may culminate in feelings of anger more than sadness; and they may become more susceptible to suicide through family credo.

In their book Spousal Bereavement in Late Life, Carr, Nesse and Wortman report additional reactions to suicide, including depressive symptoms, loss of appetite, sleep disturbances, fatigue, and a wish to be reunited with the deceased. Spousal grief engenders not just personal reactions, but practical consequences as well. Research reveals that the expected female-type tasks of cooking, cleaning and laundry are now compounded with more male-type tasks such as household repairs and financial concerns. Thus, in a Muslim culture where women’s roles are clearly split across gender lines, and where suicide is considered an act of heroism, even greater complications to the grief response arise.

Given such findings, it becomes prudent that well-planned and immediate attention are paid to the survivors of a suicide within a community. The U.S. Department of Health and Human Services reports that providing social support for victims of stressful life events reduces the likelihood of depressive symptoms. In addition, tangible forms of support, such as helping widows and mourning mothers to develop social networking skills, and maintaining spiritual connections, can also be beneficial. Postvention programs, staffed by professionals who are trained in crisis intervention, have been utilized effectively in our American schools since 1991.

These programs have been successful in reducing the likelihood of cluster suicides in the school system, and copycat actions across the nation. Their successes indicate that similar proactive outreach to the survivors of suicide in Iraq can be vital to the safety of our soldiers, as well as a necessary humanitarian effort to our fellow man.

Norman J. Fried, Ph.D., is director of psycho-social services for the Division of Pediatric Hematology/Oncology at Winthrop University on Long Island, New York. Dr. Fried is a Disaster Mental Health Specialist for The American Red Cross of Greater New York, and he has a private practice in grief and bereavement counseling on Long Island. He is married with three sons and lives in Roslyn, New York. His website is www.normanfried.com.

The Lessons of Father’s Day

By Dr. Norman Fried

In the weeks and months after the September 11, 2001, attacks on the World Trade Center, many American newspapers published intimate articles about men who lost their lives on that fateful day. In reading their obituaries, I was moved by a common theme that ran throughout: Many of the victims were fathers who left little children behind.
It is now six-and-a-half years since the tragedy that changed the lives of all Americans. Many of the mourners have re-married; many of the children have inherited new father-figures. But the children’s connection to the past, and to the men who dreamt of raising them and guiding them through life, remains altered still, and forevermore.
The approach of Father’s Day invokes a host of emotions for which many are unprepared. For some, it leaves us Read more