Words&Dirt

Summary:

Paul Conti’s Trauma: The Invisible Epidemic provides a basic introduction to the topic of trauma and summarizes what Conti has learned during his career working with trauma victims. In Part One, Conti defines trauma, breaks down the different types of trauma, and suggests some conceptual frameworks for how to best understand trauma’s effects on individuals and communities. In Part Two, Conti explores the sociological aspects of trauma, including how trauma is (mis)handled by America’s healthcare system and how it invades and compromises our social networks. In Part Three, Conti describes trauma’s impact on our thought patterns, emotions, and biology, highlighting its relationship with mental illness as well as various physical disorders that are not always thought to be associated with trauma. In Part Four, Conti lays out his argument for a “humanist social commitment” that we should all make in order to collectively prevent trauma and mitigate the damage when it occurs.

Key Concepts and Notes:

• Probably the best features of this book are the many metaphors Conti deploys to help readers understand trauma’s subtle and pervasive effects. In particular, I found his comparison of trauma to the parasite toxoplasma (AKA toxoplasmosis) to be both novel and highly effective for framing how trauma can make us insensitive to dangerous situations in a way that tragically increases our chances of experiencing more trauma. His characterization of trauma as a force that distorts our “map of life” and makes it more difficult to navigate through challenging circumstances is also apt.
• The text is replete with vignettes describing various patients and situations Conti has encountered in his career. These sections keep the book grounded and provide real-world examples that complement Conti’s general arguments.
• I appreciate that Conti doesn’t ignore the sociological factors that produce trauma and impede its treatment. He makes a strong case that structural barriers such as poverty, childhood adversity, systemic discrimination, and lack of access to health services cannot be ignored if we are to fully understand and effectively respond to trauma.
• Conti’s examinations of how trauma generates various types of cognitive distortions––especially negativity bias––are extremely well-crafted.
• My one major disappointment with this book is that it doesn’t provide specific tools for trauma therapy. Conti makes lots of general recommendations (e.g. self-care, meditation, utilizing social and/or professional support, language mindfulness, patience and compassion for others, etc.), but he doesn’t get into the nuts and bolts of how therapists can help traumatized clients learn to confront, discuss, and work through their trauma during sessions. Perhaps these details weren’t considered appropriate for this particular book, but even an appendix or two with some more technical advice would have been nice.

Favorite Quotes:

You can’t see trauma itself; you just see it at work––silently but maliciously. As it harms one person, it replicates and jumps to another; then it spreads to another and often back again. Unfortunately, there aren’t vaccine trials for trauma, and early testing for trauma is woefully lacking. And until we employ all of the tools at our disposal and finally face the threat of the trauma virus, not only will our happiness and well-being remain threatened but also our survival. (10)

There’s still this common idea that trauma is something discrete, or limited to the time when the event happened. It’s almost as if we can only see it through a legal lens. Like, something bad happened at some point in the past, where the trauma is sort of contained, but especially when it comes to children, trauma isn’t like that at all. It affects everything else in life going forward. What we don’t get is that people are fundamentally changed by trauma. They’re changed biologically. They’re changed in terms of gene expression and hormones and chemicals and neurotransmission, and that goes on forever. My hope is that people’s notions of trauma catch up with the scientific research. (44)

Compassion, community, and humanity are intertwined in that they exemplify the full expression of who we are as humans. Although trauma can make us feel isolated and lonely, the truth is that we’re all in this together. Compassion enables us to care about other people, to relate to them with kindness, and to consider the world from their perspective. Community is the embodied acknowledgement of our interdependence with other people––our behaviors affect one another. Finally, humanity is the recognition that––as people who share this world––all of us suffer. Furthermore, that suffering matters.

Compassion, community, and humanity are our birthright. For people, they’re what makes the world go round. They’re also some of the first things to go when trauma finds its way into our homes. (55)

Trauma changes our emotions; changed emotions determine our decisions. (109)

We’re not meant to face trauma alone. To that end, it’s important to rely on allies––family and friends, doctors and therapists, pets, support groups, medicine, gardens, you name it. By this point, I hope I’ve made the togetherness aspect of trauma work (especially in the form of compassion, community, and humanity) clear. It’s crucial that we develop the inclination to rely on the wisdom and kindness of others, and I have learned not to underestimate the power of the warm hand and the written word. Other people remind us of who we are, help us uncover our true maps, and advise us as we chart new courses to where we want to be in life.

That being said, we also need to learn to be better allies to ourselves. This can also take many forms––positive self-talk, thoughtful self-care, self-confidence, self-assertion, and the habit of making well-thought-out choices about our health, careers, and the people we spend time with. (144)

Wisdom and patience arise when we experience ourselves and others through the lens of compassion, when we see through the lies trauma wants us to believe about ourselves, and when we see how trauma influences our affects, feelings, and emotions. Wisdom and patience also occur every time we feel something powerful and intense arise in us, and we choose to wait and reflect instead of instantly reacting. Wisdom and patience come from putting words to all of the thoughts and messages arising in us and from sharing our needs and wants with others. And we foster our growing wisdom and patience every time we make an intentional decision and see the degree to which trauma has previously made our decisions for us. (152)

Damaging stories about ourselves are sort of like myths that no one really wants to read but that get knitted together anyway into the collection of stories that become our false life narrative. A false life narrative amplifies negative stories, forgets or hides positive ones, stifles any present evidence that might challenge our views about ourselves, and projects the promise of repetitive negativity into the future. Trauma is the author of these false narratives, and if we don’t take an active hand in the editing process, we’ll be stuck with stories that work against us.

In fact, we can take the pen away from trauma altogether and write our own true life narratives. These narratives treat us with respect and fairness. They acknowledge our courage and the effort it takes to make even the smallest triumph happen. A true life narrative recognizes what it takes to raise children, support a family, proclaim one’s gender identity, embrace one’s sexuality, persevere despite racism, or continue one’s degree after an assault. True life narratives are honest, inspiring, and serve us in the face of trauma. They’re also the blueprints of our future. (158)

Before trauma scrawled all over the maps we were born with, they showed us where we were and how to get around. On a map untouched by trauma, we can draw paths almost anywhere we wish to go, explore life’s terrain, navigate the struggles and challenges of life, and eventually find our way home. We want that map back––not just for ourselves but for others, too. We want reliable signposts that don’t lead any of us astray. We want to be able to travel life from coast to coast, discover the goodness that’s our birthright, form valuable memories, join other travelers along the way, and lend a helping hand where it’s needed. (169-70)

Rating: 8/10