Dr. Bookworm

I flagged so many pages of Bessel van der Kolk’s The Body Keeps Score that it became kind of ridiculous. But it is that important. Van der Kolk is a psychiatrist who has spent over thirty years working with trauma survivors. He has worked with patients with PTSD, victims of natural and man-made disasters, and people who were abused or neglected as children, including clergy sexual abuse victims. The Body Keeps Score explains the physical basis for trauma symptoms and offers a plethora of effective treatments. This is tremendously hopeful.

Here are the critically important breakthroughs he describes:

• Van der Kolk offers anatomic and physiologic correlations to the symptoms that trauma victims exhibit: fight, flight or freeze. This is akin to correlating someone’s belly pain to the x-rays of gallstones. This approach lays down a scientific framework for many of the psychological treatments that are based on theories (psychodynamic, cognitive, behavioral, etc.) that are not anchored to what is actually happening in the body.
• The treatment of traumatic injury is urgent because, according to van der Kolk, “[b]eing traumatized is not just an issue of being stuck in the past; it is just as much a problem of not being fully alive in the present.” (italics mine.) People five, ten, twenty years out from their trauma cannot fully experience their current lives.
• According to van der Kolk, child abuse is “the gravest and most costly public health issue in the United States.” “[E]radicating child abuse in America would reduce the overall rate of depression by more than half, alcoholism by two-thirds, and suicide, IV drug use, and domestic violence by three-quarters.”
• Prevention is the best solution. “… [S]ocial support is the most powerful protection against becoming overwhelmed by stress and trauma … being truly heard and seen by the people around us, feeling that we are held in someone else’s mind and heart.”

Van der Kolk describes many victims of trauma suffering from “timeless reliving; re-experiencing images, sounds, and emotions; and dissociation.” While writing this essay, I

heard a radio interview with Garrett Graff, author of a new book of oral histories about 9/11. He said that, in talking to people who lived through that day, he was struck by people reliving their sensory experiences: the taste of the dust and the feel of the ashes all around them; the feel of the heat; the ankle to knee-deep water (from the sprinklers) they waded through to get out.

Van der Kolk’s research shows that many kinds of treatment are helpful. He divides therapy into two categories: “top down” and “bottom up.” By top down, he means treatments that require language. These include cognitive behavioral therapy, mindfulness, EMDR (eye movement desensitization and reprocessing), writing and art. The “bottom up” approach uses the body’s sensory awareness to soothe the brain. (The body sends as many messages to the brain as the brain sends to the body.) These include yoga, dance therapy, Heartmath, Pilates, theater and more. He is not against medications. They have their place.

My own experience of trauma seems very mild compared to van der Kolk’s patients or the 9/11 victims. Some years ago, we had a birdhouse on a tree that overlooked our back porch. Eurasian tree sparrows had set up household. We eagerly awaited the babies. Then, one day, a male house sparrow stuck his head in the hole and pulled out a naked, half-formed chick, maybe an inch and a half long with little bits of fuzz. It laid on the wooden porch boards. The violence of it unnerved me.

When I was in college, my boyfriend took me to the home of one of his friends. We were all chatting. The wife — I think her being Asian made it more distressing to me — came in and said something to her husband. Without warning, he started chasing her around the room and hitting her with a pair of slippers.

When I was a kid in Hong Kong, all the kids in our little neighborhood ran to the man who hawked sweet soy bean curds. There would be a mob of kids twenty strong. I joined them. We bought our little bowls for him to fill. As he did this, he ran his fingers through our genitals. He was so fast and stealthy. Two questions stayed with me. What did he get out of it and why did we keep going to him?

Logically, the real trauma of my life was not having a dad until I was eight years old. He left China when I was one. We (my mom, my sister and me) joined him in America seven years later. In trying to get to America, we moved from Shanghai to Hong Kong. This required learning new languages. Then, learning English, of course. Traumatic? I don’t

know. Two results. I am a more reluctant traveler than many (Peace Corps? Go somewhere where you don’t know the language or how to get around? Been there, done that!) Also, I always felt I needed to protect my parents in this new land. I imagine it’s a common immigrant story. When I think about it though, there were hardly two more competent people than my parents.

As you can infer, Bessel van der Kolk is brilliant and energetic. He is also deeply compassionate. He states, “It is much more productive to see aggression or depression, arrogance or passivity as learned behaviors: Somewhere along the line, the patient came to believe that he or she could survive only if he or she was tough, invisible, or absent, or that it was safer to give up. Like traumatic memories that keep intruding until they are laid to rest, traumatic adaptations continue until the human organism feels safe and integrates all the parts of itself that are stuck in fighting or warding off the trauma.” I am not always so charitable. Sometimes, I think arrogant people are just jerks.

Trauma sufferers have a great advocate in Bessel van der Kolk. The Body Keeps Score gives hope both in unravelling the physical reasons for trauma symptoms and in offering a review of a wide range of effective treatments.

Tell me: Do you know of a “bottom up” treatment program that one wouldn’t necessarily associate with treating trauma?

I give my vote to Prison Performing Arts. Van der Kolk states that humans have been re-integrating war veterans back into society through ritual since the Greek tragedies. This organization puts on plays by people in Missouri’s prisons. I have been to a performance by women in the Vandalia Correctional Center.

 

 

 

 

 

 

 

I decided to read Say Nothing: A True Story of Murder and Mystery in Northern Ireland, by New Yorker staff writer Patrick Radden Keefe, because a recently solved forty-year murder mystery sounded intriguing. Also, I wanted to learn something about Northern Ireland. Much of the discussion around Brexit brings up the Ireland/Northern Ireland border as a flashpoint. Why? What is the big deal about that border?

The book focuses on Dolours Price and her sister Marian. When The Troubles started in early 1969, I was 21 years old. Dolours was a couple of years younger than I. Marian was even younger. A picture of the sisters show them in jeans and mini skirt. Their photo reminds me of my Catholic high school friends — fresh-faced, full of the future.

I remember the late ‘60s and 70s as heady times. There was a great heaving movement of youth.Young people integrated public spaces and registered voters in the South. American athletes raised the Black Power salute at the Mexico City Olympics. Students at scores of universities held sit-ins and other demonstrations against the Vietnam War. Women formed consciousness raising groups and read Our Bodies Ourselves. We took the Pill. There was Woodstock, the Summer of Love and communal living. Liberation was the byword. 

In Northern Ireland, young Catholics re-ignited the fight to rid Northern Ireland of British rule, to unite the island under the Irish flag. They formed the Provisional Irish Republican Army (IRA), a paramilitary group, to seize power when peaceful protests failed. Sometimes with them and sometimes against them were the old timers of the traditional IRA, who won Irish independence in the 1920s. Those loyal to the British formed their own paramilitaries. Also in the mix were the Northern Irish police, and later, the British army. The fighting lasted nearly three decades: Protestant vs Catholic, Loyalist vs. Republican, British vs Irish, old IRA vs Provo IRA. The conflict was also economic. Catholics were kept out of government and top jobs.

The de facto segregation and unequal treatment of the Catholic minority was brought home to me in an unexpected way this summer. Bill and I were watching the British Open Golf Tournament, held this year in Northern Ireland. Two people we had watched for years, David Feherty, the sports writer, and Darren Clarke, a pro golfer, both Northern Irish Protestants old enough to remember The Troubles, talked about the segregation by religion. Both said that if it weren’t for golf, they would know no Catholics. 

Like the catalyzing forces of the assassinations of Martin Luther King and Robert Kennedy and the violence at the Democratic convention, the Price sisters were radicalized when a peaceful march for Catholic rights was viciously attacked by loyalists at Burntollet Bridge. A while later, Dolours and Marian joined the newly formed Provisional Irish Republican Army.

The tactics included assassinations, kidnappings and bombings. Some of the murdered were dumped in the streets as a warning. Others were “disappeared,” kidnapped and buried with no one knowing that person’s fate. Retaliation included prison, being shot by the police or by paramilitaries or by British soldiers. The worst sin wasn’t being the enemy but being an informer or “tout.”. As it turned out, people betrayed their own side with alarming regularity, and thus, the aptness and irony of the book’s title, Say Nothing.

As a member of the Provisional IRA, Dolours Price “had no intention of being relegated to a supporting role…she wanted to do exactly the same work that a man would do.” She got her wish and was swept into the spiraling violence. She killed people. She set bombs. She did jail time. She went on a hunger strike and was forcibly fed. 

Dolours died of an accidental overdose in 2013 at the age of 62. Because of the physical and psychic toll of her IRA activities, and because there was no resolution or reconciliation after three decades of fighting, it felt to me like she could never outrun the consequence of youthful decisions. 

For me, my life in the 70s feels like someone else’s life. I rode in the middle seat of a friend’s Ford Pinto to one of the big anti War marches in Washington. I handed out leaflets and was told by a young man to “Go back to where you came from.” I did not burn down the Washington University ROTC building, despite Bill’s joking claim. I lived in a commune. I farmed for the first — and last — time. My response to gender equality was to go to medical school. 

My political leanings haven’t changed much, but I support them with checks these days. And climate change has taken the place of the anti-War fervor.

Reading Say Nothing, made me wonder. What if I had chosen a more radical route? What I had fallen under the thrall of some charismatic leader, like Gerry Adams for Dolours? I remember that feeling that all things were possible, the thrill of making a difference. Some in our country did turn to violence and made decisions that turned out to be irrevocable: the Weather Underground, the Symbionese Liberation Army, the Black Panthers. 

The official end of The Troubles, the Good Friday Accords, did not resolve much, legally, morally and most of all, emotionally. Northern Ireland sits like a scab that could break open at any time. And that murder mystery? By the time the big reveal came, I had given up caring. By that time, nothing could make up for the lost lives, the warped survivors, the grieving families, the orphans, the betrayals, the suffering. 

Tell me: What were your young adult passions?

 

 

 

 

 

 

 

 

I tend to pick up long, dense literary works when I’m stressed out: Faulkner, Beowulf, Dante. I find hope that I can chip away at my troubles one problem at a time the same way I can finish lengthy tomes by reading a few pages every day. To be transported into other worlds and to marvel at language beyond my imagination are happy bonuses.

I read The Divine Comedy, a few cantos at a time, in my bed in the basement of my home while my parents, unable to care for themselves, slept in Bill’s and my bed upstairs. 

Dante may well have been the very first “gonzo” writer, even though his life bridged the 13th and 14th centuries and the term was coined by American writer Hunter S. Thompson. Thompson’s “gonzo journalism” combined reportage, memoir and wildly subjective and speculative opinion.

Isn’t this what Dante has done in The Divine Comedy? The hero, after all, is named Dante. Both Dante the author and Dante the character are from Florence. The story is set in 1300 when the actual Dante was 35 years old and when Dante the traveler journeyed “half of our life’s way.” Dante’s descriptions of his adventures in Hell, Purgatory and Heaven are certainly subjective and speculative. 

It delights me to think of Dante as a gonzo writer because I came to write my Dr. Bookworm “gonzo book reviews” as a result of reading The Divine Comedy. I started reading it at a very tough point in my life, just as Dante the traveler found himself in a “dark wood of error,” and as Dante the writer suffered exile from his beloved city of Florence. Bill and I were caring for my infirm parents in our home. That alone stretched our physical and emotional resources to near breaking point. In addition, a family member criticized everything we did. They didn’t like the food we served, the physical therapy, the caregivers we hired, the TV shows we watched with Mom and Dad, the money we spent. This person spent hours on the phone degrading us to relatives and family friends

I thought Dante’s Inferno would give me some release. I wanted to see a place where bad behavior was punished. I wanted to see bad guys “get theirs.” I hoped for a vision of hell like that painted by Hieronymus Bosch or in Chinese folk paintings of Buddhist hell. I was not disappointed.

 In Inferno, gluttons are eternally pelted by stinky rain and ice; corrupt politicians are dipped in burning pitch while devils poke them with prongs; churchmen, including Popes, who made money from their office, are jammed upside down in holes with flames licking their feet.

Reading about tortures was satisfying, but Dante gave me much more than vicarious revenge. Dante’s conversations with the inhabitants of the afterlife sparkle with personality. Francesca da Rimini eagerly tells her story of lust and death: seduction, 14th-century style. She says,“One day, to pass the time away, we read/of Lancelot — how love had overcome him. …And time and time again that reading led our eyes to meet, and made our faces pale.” The only problem was that Francesca was sharing that look with her husband’s brother.

I was immediately taken by the writer’s use of imagery. He uses everyday examples to illustrate some rather bizarre scenes. Dante the traveler encounters Count Ugolino and Archbishop Ruggieri. In their struggle for political advantage, they betrayed their own people and double-crossed each other. Here’s the description of their eternal punishment: “and just as he who’s hungry chews his bread, /one sinner dug his teeth into the other/ right at the place where brain is joined to nape.”

Purgatorio has a very different vibe. Rather than the class and regional jealousies
evident in Inferno, people in Purgatory greet Dante as kin and countryman. It is a place where sinners atone for their sins, and all are guaranteed entrance to heaven through God’s goodness. Dante converses with many artists, who praise their colleagues, bringing up such names as Giotto, Pisano, Cimabue.

As Dante and his guide, the Roman writer Virgil, travel up the seven terraces of Purgatory Mountain — each terrace represents a deadly sin: pride, envy, anger, sloth,
avarice, gluttony and lust — the Arts play a prominent role. Eight times a day, everyone stops what they are doing to sing the Liturgy of the Hours. Dante converses with  a musician who had set his poems to music. In the very first canto of Purgatorio, Dante speaks of his “talent,” his writing skills, and how he would “sing” of his trip through Purgatorio. 

The visual arts are highlighted in Purgatory. Atoners carry heavy blocks of stone on their backs, but not as punishment for punishment’s sake. These stones are used to carve

devotional scenes on the walls of the terraces. At the top of Purgatory Mountain, Dante and Virgil arrive at the Garden of Eden. There Virgil eases himself out and Beatrice becomes Dante’s guide. Virgil, as a pagan, is not allowed to enter Paradiso. 

In Paradiso, Dante discourses with philosophers, saints and apostles; emperors,
popes and founders of religious orders; fellow Italians; ordinary people and an ancestor. He sees all the orders of angels, the Virgin Mary and a vision of the Triune God. And he is blown away by God’s Goodness.

His ancestor, a crusader, and St. Peter urge him to write about his remarkable journey. They tell him that that is his mission. He has to make the poem we are reading. He worries if he’s capable of doing justice to the experience, but he has to try. He has to become Dante the writer. He must make Art. Dante the traveler and Dante the writer become one. 

As I read through the one hundred cantos of The Divine Comedy, the anger and angst about my life situation faded. I decided that I have to write. My life experience is as unique as Dante’s, and only I can tell my own story. As Dante the poet put everything he knew about history, geography, politics, the Bible, the Greek and Roman classics into his work, I too would incorporate everything at my intellectual disposal. I, too, would transform stress and joy into stories. And thus, Dr. Bookworm was born. 

Tell me: Do you have a literary revenge book?