In an Unspoken Voice

by Peter A Levine

  “There was always something different about Paulo,” Adam stated matter-of-factly. “He was a sensitive child who was easily frightened. When he was around the age of four years old, for reasons unknown, he would awaken in the middle of the night screaming and crying.”

  By late adolescence Paulo talked frequently of suicide. “Life is too hard,” he had repeated numerous times. Adam made sure that his son was never left alone during his darkest times. He had been fatigued by this decade-long ordeal, but he persisted in his committed vigil. Despite Adam’s exhaustive efforts to save his son, Paulo—no longer able to bear his pain—hanged himself in the bathroom. It was there that Adam found his limp, lifeless body. After the shock of Paulo’s suicide, Adam found that for the first time in his life he could not push ahead. Rather than feeling shattered by grief, Adam felt nothing … a state familiar to him even before losing his son. But this time, the numbness rendered him so fully shut down that he could not function. Life for him just stopped.

  After several months of paralyzing inertia, Adam made an appointment to see a psychiatrist. He was prompted to do this by a family friend who advised him to get some medication for his despondent condition. After taking a personal history, the psychiatrist suggested that Adam’s past was preventing him from grieving his son’s death and gave him the diagnosis of “complicated bereavement.” Although the idea that his early life was “traumatic” or even implicated in his current malaise perplexed Adam, he agreed to talk to me.

  Adam was born a motherless child. A massive heart attack during labor necessitated an emergency cesarean to save her only child. She died just as he was being born two months prematurely. Since his father had been conscripted into the Russian army, Adam was given to his father’s brother to be raised by his uncle and his wife. The aunt, who was supposed to care for him, was instead a cruel, likely psychotic, woman who repeatedly beat him.

  Beyond the torment of this treacherous beginning, rife with abandonment and abuse, Adam’s life moved through a series of further trials and sorrows. At the age of four years, his uncle and two older stepsisters were deported and exterminated by the Nazis. He was then passed on to a series of Christian families who tried to hide his Jewish origins. During this time he would, according to these families, scream in the middle of the night—just as Paulo had done when he was the same age.

  At the age of nine, Adam was given to a group of fugitives living in the forest. He “loved being there” because the people liked him and for the first time ever, he felt wanted. “That year was the best of my life,” he told me. Even though he loved and felt protected by his “forest family,” his night fits continued and grew in intensity. His crying and screaming would never subside, despite all attempts to soothe him. Since he could not even be awakened, the noise of his fits put his forest family in grave danger. So tragically, before his tenth birthday, Adam was sent back to the village, where he wandered aimlessly as an orphan.

  One night, Adam was taken to the police station and interrogated. As he had been instructed, he gave the Nazis his Christian name. The police told him he would be punished if he lied. Next, they forced him to remove his pants in full view of everyone. To hide his shame, nine-year-old Adam stared at the wall, only to see a crucifix. This terrified him, causing him to believe that he would end up on a cross if he were caught lying. He was then taken to a concentration camp. “Being delivered alive to the concentration camp,” he said, “was a relief; at least I was with other Jews.”

  Upon entering the camp, one of the prisoners from the village asked Adam his name. Now among his own people, Adam gave the name he had grown up with, and the names of those whom he believed to be his parents. The man then exclaimed, “No, no, that’s not your real family name.” And he told him the names of his biological parents and how they had both died. Adam remembered being unspeakably relieved to know that the cruel mother he had experienced was not his real mother.

  While in the concentration camp, Adam witnessed people being brutally beaten, tortured and shot. Many others succumbed to suicide, often by hanging themselves. During his internment, Adam was without any real comfort or support to help him deal with such terror and horror. For most of us, Adam’s experience is unimaginable. If we were to honestly ponder the effect it would have had on us, we would be deeply disturbed by such terrible knowledge. Yet, to observe Adam in his life, he appeared, at least on the surface, little different from you or me, only more successful by modern-day standards.

  As an orphan from birth and a survivor of the most unimaginable atrocities and human suffering, Adam had risen above this torment. He immigrated to South America at the age of nineteen, hoping “to escape his past.” There he settled and built his business, becoming a powerful, financially successful, international entrepreneur. Yet, when this extraordinary human being was referred to me, he had been reduced to a broken man. He was stooped over and shuffled as he entered the room. His posture and movements reminded me of patients I have seen in the back wards of psychiatric hospitals. His eyes looked blankly at the floor, and he seemed not to notice that I was even present. I had no idea where to begin. On the one hand, he was so shut down that it seemed like nothing I could say or do would reach him; but on the other hand, I feared that if I were able to bring up feelings, they might overwhelm him so completely that he would collapse into a bottomless catatonic despair. How could I reach this man without destroying him? I felt lost and intimidated by the scope and delicate challenge of my task.

  By rote, Adam went on and on with the litany he had told the psychiatrist. There was not a trace of feeling in his narrative: “That all happened so long ago,” he added with a small tired sigh. I listened, finding myself quite uncomfortable at hearing such horror described without affect. In a strange way, though, I was relieved that he had no feeling; that way I wouldn’t have to feel either. Intellectually, I distanced myself from feeling and from Adam. I was able to do this by falling back on a clinical analysis, wondering what mechanism he had used to wall himself off from his horrific experiences and how he had kept himself from winding up wandering in the streets, like he had done as an orphan, or in the back ward of some mental institution.

  As a way to try to initiate a little contact, I questioned Adam about his work, his family and friends—any topic where I thought there might be an entry point to even a tiny trace of positive feeling. Nothing came of this. I found myself, strangely, asking him to describe the last few hours of his day. Puzzled, he told me of missing his flight and frantically renting a car to drive the two hundred miles from Curitiba to São Paulo to meet with me. At the rental lot near the airport he recalled seeing children flying kites that they had made from things found at the garbage dump.h

  I caught the first flicker on his otherwise expressionless face. But then, just as quickly, his face became flat again, and his body slumped forward in resignation. Not wanting him to collapse, I asked him to stand up with his knees slightly bent. Standing requires the activation and coordination of the proprioceptive and kinesthetic systems. This had the effect of keeping Adam’s awareness online by engaging the arousal branch of his nervous system. This intervention is the opposite of allowing a client to collapse, activating the shutdown response and thus perpetuating the mortifying feelings of shame and defeat. While he was standing erect with relaxed knees, I then directed Adam to “look inside” and find some place within his body where he could “find the picture of the children playing with their improvised kite.”i At first, he reported feeling more anxious (due to sympathetic hyperarousal), but with encouragement, Adam was able to locate a small circle of warmth in his belly. I asked him to “just get to know that sensation for a little while.”

  He abruptly opened his eyes, surprising himself with his own words: “This could be dangerous.”

  “Yes,” I agreed, “it could be; that’s why it’s important to learn about feeling, just a little bit at a time. Your body has been frozen for a long time; it will take some time to thaw,”
I add. It was important that I validate his legitimate fear and offer him an image (thawing from freeze) that would help mitigate his fear, inviting him to explore his internal experience.

  Adam then sat down and looked around the room. I asked him to describe what he saw.j

  This provided the opportunity to connect the warmth in his belly with how he perceived the external world in the here and now. He looked perplexed. “Oh, I didn’t notice those flowers before—or the table they’re on.” Almost like the inquisitive expression of someone coming out of a coma, his face showed another minute flickering of awakening. He looked around noticing an oriental carpet and a painting. “They have colors, rich colors,” he said innocently.

  “So as you look at those colors, I want you to find the place inside of your body that can feel—even, just the tiniest bit, those colors.”k

  He looked back at me with a puzzled expression, perhaps awaiting further instructions. But then he closed his eyes and went inside. “It feels warmer in my belly, and the circle, it’s growing bigger in size.”

  After a few moments I asked him to stand again: “Adam, I’m going to ask you to do something that might seem strange … I’m going to ask you to visualize the picture of the children with their kites … Feel your feet on the ground and how your legs support you. Now feel your arms as you hold the kite string … and imagine that you are there in the field with the children.”

  Adam responded almost gleefully, “I can feel that in my arms and in my belly … It’s even warmer and bigger … I can see the colors; they are bright and warm … I see the kites dancing in the clouds.”

  After a few quiet moments Adam sat down and looked around the room. “Take all the time you need, Adam … Just feel the rhythm of that … of the inside and the outside.”l

  His eyes went back and forth between the table with the flowers and the painting. He focused on the table and started to describe the color and grain of the wood as warm … he paused … “like the warm feeling inside.” He closed his eyes again, without my instruction this time, rested for a bit and then opened them slowly and turned toward me, unabashedly looking into my eyes. This was the first time that Adam’s social engagement system (see Chapter 6) had awakened and come online.

  Adam’s body showed some tentative aliveness; his drooping face assumed a colorful, almost vibrant, tone, and his stooped posture extended and straightened. Adam was like a tightly curled, newborn banana leaf turning and reaching toward the sun, confiding in its warmth as it slowly unfurls itself. He was in wonder of the room—as though seeing it for the first time. He looked at his hands and then gently held the fingers of one hand in the other. He then moved his hands to his upper arms and held his shoulders, arms crossed over his chest. It was as though he were holding and nurturing himself. He surprised us both by saying, “I’m alive.”

  By learning that he could begin to feel, Adam became, in that moment, like the child, proud with the wondrous creation of his kite. That was the beginning of a gradual, rhythmical learning for Adam. Now, he could begin to feel his body-self without opening too widely the dark door of violence and horror in his soul. He was able to open up just enough to feel—to feel without being annihilated, without being swallowed up by the black hole of his horrific past or lost in the deep shadow of his immense grief and guilt about Paulo. Somehow, in this body-mindfulness, he was finding that there was a middle ground. He had uncovered a place between being completely overwhelmed and flooded, on one hand, and shut down into a deadening depression on the other.

  Adam later wrote to me that his experience of a tender, yet durable, middle ground allowed him to experience a new sense of hopefulness. From this place, he was able to feel compassion for himself as the orphaned Holocaust child. “It was also the beginning,” he said, “of my being able to mourn for my beloved son and to find joyful pleasure with my family.”

  Discussion Points

  I reflected on our session and on what might have brought Adam out of his immobilizing depression and into the stream of life. He was able to identify with the slum child’s exuberance—an exuberance that transcended the child’s deprived fate. Adam was able to feel, in his own body, the innocence, excitement and joy of a child flying a kite improvised from scraps of scavenged trash. In a similar way, Adam collected scraps from the trash heap of his devastating and dehumanizing past. This time, instead of collapsing under its weight, he marshaled a creative solution. By standing up (kinesthetically contradicting his habitual collapse) and physically grounding his pain, he mobilized his life force and joined with the transcendent flight of the kite. He could feel himself being drawn upward by the soaring image, and toward the possibility of authentic freedom and spontaneous play. Metaphorically, he reacquainted himself with the allegory of his namesake. Adam connected with the innocence of the biblical Adam—before the bitter fruit of terrible knowledge had singed his tongue with the bitter taste of man’s cruel and evil inhumanity. This formerly broken man now had touched into the grounded embodiment and resilient self-compassion enough to begin grieving and thus initiate a movement back into life. I did not want to expose (and most certainly flood) him with the shock of seeing his son hanging in the bathroom. My main consideration, at this point, was to coax his nervous system out of the shutdown caused by the shock and to begin establishing a base of resilience and self-regulation.

  I’d like to invite you, the reader, to ponder the following considerations. Were Paulo’s inconsolable screaming episodes beginning at age four and his choice of hanging himself mere coincidences? (Remember, Adam’s wife reported that her husband would also scream and cry during the night, just as his son had done). Or were these incidents some deep transgenerational reenactment of his father’s unfelt experiences and unprocessed emotions? Such possibilities are among the mysteries of trauma and of the human spirit.

  Certain authors discussing the Holocaust, such as Yael Danieli103 and Robert Lifton,104 have written groundbreaking analyses of the victims who lived through this horrific massacre. In working with Adam and a few other survivors of this kind of experience, I am personally confronted not only with the terrible knowledge of the cruelty that human beings are capable of, but also of the remarkable process by which the body is somehow able to compartmentalize the effects of this cruelty and go on with life. It maintains its tenuous hold, that is, until something is added to the unsustainable containment of their burden. Yet still, the smoldering flame of the deep self can miraculously reignite, given the right opportunity and carefully calibrated support.

  Epilogue

  After our session, Adam returned to the Polish town where he was born in search of any knowledge about his real mother, who had died during his birth. The Nazis had not destroyed the tombstone, and Adam replaced it with a new memorial stone because his heart “was so touched by knowing about her existence.”

  Vince: A Frozen Shoulder

  The collision between the two contrary processes, one of excitation and the other of inhibition, which were difficult to accommodate simultaneously, or too unusual in duration or intensity, or both, causes a breakdown of equilibrium.

  —Ivan Pavlov

  It is not uncommon, particularly for a fireman, to be reluctant to see a psychotherapist—a “mind doctor.” This is especially true for a problem that is “obviously” physical. Vince was seeing a physical therapist for a frozen right shoulder. This disability was making it impossible for him to function in his job as a fireman. Treatment was not going well: after several sessions he was still barely able to move his arm from his trunk by more than a few inches. The consulting orthopedist had advised surgery: an operation in which the arm is “manipulated” (yanked violently) under general anesthesia in an attempt to free it. Such a surgery requires extensive and painful rehabilitation and often doesn’t improve the situation very much.

  Since there was no apparent physical injury, the therapist, in the hope of avoiding the difficult procedure, referred him to me. The symptoms had begun a
couple of months before our appointment. He was working in his garage and picked up a starter motor to put into his car. As he lifted it, he felt “a twinge of something” in his arm. The next day his shoulder felt tight and sore. Over time, the pain became more acute, and his range of motion progressively worsened, becoming chronic. Not surprisingly, Vince attributed his shoulder “strain” to working on his car. This is somewhat like the person who reaches down and picks up a piece of paper, only to have their back go into spasm. Common sense, and the clinical observation of most chiropractors and massage therapists dictates that this was already a back primed—“an accident waiting to happen.”

  Vince is obviously confused about seeing a “mind doctor,” and he is reluctant to engage with me. Sensing this, I reassure him that I will not be asking him personal questions, but would just focus on helping him get rid of his symptoms. “Yeah,” he says, “my body sure is broke.” I ask him to show me how far he can move it before it starts to hurt. He moves it a few of inches and then looks up at me: “That’s about it.”

  “OK, now I want you to move it the same way, but much slower, like this.” I show him with my arm.

  “Huh,” he replies as he glances at his arm. He is clearly surprised that he could move it a few inches farther without the pain.

  “Even slower, this time, Vince … Let’s see what happens this time … I want you to really give it your full attention; focus your mind into your arm now.” Moving slowly allows awareness to be brought to the arm. Just moving it quickly, without mindfulness, is likely to re-create the protective holding pattern.