Living through trauma: to bear the unbearable, to speak the unspeakable

Abstract

ABSTRACT A traumatic situation can be both cataclysmic and disorganising, while putting the whole existence of the individual to the test. Every trauma causes either minor or major rifts in the psyche, thus putting a strain on the patient’s present, past and future. Specifically, when the traumatic experience remains without adequate mentalization, in an instinctive form, it can severely affect the patient, both psychologically and socially. In this paper, we discuss the dual dimension of the traumatic experience. Firstly, since the psyche cannot elaborate the traumatic event or situation psychologically, only minor symbolic or mental representations are available, and the traumatic content cannot find its place in the patient’s psychic history. Since the trauma cannot be worked through psychologically, it usually comprises a massive experience of deadly anxieties, mixed with somatic and sensorial memories. Secondly, the consequences of the trauma have a social dimension. Individuals may feel disconnected and disengaged from their social existence and identity, alone and unprotected, as trauma can lead to them questioning their social identity. The unearthing of the previous psychic traumas explains why the therapy of traumatised patients demands in-depth, individual therapeutic work. Trauma therefore attacks in a dual manner, setting out to test all the aspects of the individual’s functioning. The therapeutic challenges for working with traumatised children and adolescents are considerable, as the clinical vignettes illustrate.