The body doesn’t forget anything: ways out of trauma

dangerous to relax. The body has become the enemy.

Van der Kolk emphasizes that we find this not only in cases of trauma caused by war events, but also in experiences of violence and neglect in families. The body bears the trace of trauma. It is therefore consistent that his therapeutic strategy tries to help the patient feel safe in his body again.

I would like to introduce a psychoanalytic way of working that I somatic narrative name and which relates to this trauma memory. A distinction must be made here. Those traumatized by war know what happened. He remembers the event that traumatized him. Memory therefore exists in two ways: as pictorial memory and as physical memory. In psychoanalysis we often deal with clinical pictures in which only the body memory remembers the trauma that occurred at a time when other forms of memory could not yet be formed. These patients lead lives that seem fairly normal. Still, everything feels laborious and your own body is a scary and dangerous place.

In search of trauma

In some cases, there is an event in early life – a premature birth or a life-threatening operation – that explains the formation of a trace of trauma. But I would like to report on a therapy in which this was not the case either. Mr. C’s birth was normal. He had grown up in a family full of conflicts and tensions, but they did not rise to the level found in many families. Neither violence nor neglect determined Mr. C’s upbringing.

Mr. C. was successful professionally, but at the same time constantly felt uncomfortable and out of place. Entering into intensive friendships or even romantic relationships was unimaginable for Mr. C. at the beginning of the therapy; feelings of shame were overwhelming. The focus of his suffering, however, lay in his relationship to his own body, which he experienced as unattractive. Above all, he had to constantly distract himself with computer games. Only after a while did we understand that he was primarily avoiding the perception of the traces of trauma in his body.

After we began to pay attention to his physical experience, it became clear what a desperate inner situation Mr. C. was constantly living in. He felt a black hole in his body that threatened to destroy him. To understand this symptom, I have to take a moment to explain:

Starting in the 1940s, psychoanalyst Donald Winnicott studied the earliest mother-child relationship and described how it was a difficult task for the newborn’s psyche to connect with its body. The newborn can only achieve this connection if it is supported by attentive maternal care. If this does not succeed, breaks arise in the newborn’s attitude to life, the continuity of being breaks down and the newborn experiences a hopeless fall into nothingness. Winnicott was the first to describe the symptom of falling, which I encountered in Mr. C. and which I also know from treating many other patients.

However, the feeling of falling is a Body experience and none fantasy. Psychoanalysis usually works with conscious and unconscious fantasies, as expressed in dreams or symptoms. These fantasies can be changed through accurate interpretations. What is unconscious is made conscious and what has been rejected can be integrated. However, body memory is on a different level and is not associated with symbols.

Where does this desperate anger come from?

In the somatic narrative I choose a different approach. I do not ask about thoughts and associations, but encourage my patients to describe their physical experience and accompany this description over longer periods of time with reserved attention and without interpreting.

With Mr. C. the turn to somatic narration was a dramatic moment. I hadn’t initially suspected that he might have traces of trauma, as he had reported neither violence nor neglect in his early life. So we worked with the normal psychodynamic orientation towards inner fantasies and relationship experiences. What you do as a psychoanalyst. After about a year, Mr. C. suddenly shouted at me in a desperate rage that I didn’t understand anything about him and didn’t see his loneliness and deep despair. I was shocked and at a loss. In fact, I didn’t realize his situation was so dramatic. Even in the moment of his anger, I could hardly react empathically and had to admit to myself that I actually couldn’t empathize with his desperation. So what to do?

Fear of a black hole

I asked him to describe the way he experienced his body here and now on the couch. The atmosphere of the therapy changed suddenly. Mr. C’s voice lost the self-deprecating tone and he described, with intense fear that I could now empathize with, that he was afraid of this black hole fear that it was always within him and that he didn’t dare to approach because it would suck him in.

Supported by my presence and my compassion, it now became possible to approach this hole. It changes the body self when patients in therapy are able to confront the traumatic fears that are stored in the body’s memory. This form of collaboration is extremely physically demanding. The intense body awareness leads to catastrophic body sensations (the feeling of falling into nothingness) unfolding and being able to be shared by me. Now they become accessible to the self-regulation of the body self, the breaks in the self can heal.

This journey took many months working with Mr. C. First, it became possible to approach the hole and view it from a safe distance. Slowly it became less sucking-destructive and more one Hole in the body that was just there and the wind whistled through. Then, in an hour that remained vivid in our memories, Moss over the woundand for the first time inner space had safe boundaries. Some time later Mr. C. described one Lava lake inside him. The powerful emotions were hard to control, but they were firmly contained.

Working with Mr. C. led to a development that I know from other treatments: the body’s self changes through joint attention. The hole closes and little by little it becomes possible to lead a normal emotional life. The physical self, when functioning normally, is the birthplace of emotions. When this factory of emotions is not permanently disorganized by traumatic fears of annihilation, inner life begins to normalize and life begins to be fun.