TRANSCENDING TRAUMA
SUBLIME GROWTH FROM TRAUMA AUTHORS Martin Huecker , MD & Nicholas Nash , MD
John F . Kennedy famously stated that the two characters making up the Chinese word for “ crisis ” translate to “ danger ” and “ opportunity .” Though Kennedy and the many who have since cited this mistook the translation , the true meaning of the characters , “ danger ” and “ change point ,” still provide hope . Change point seems more persuasive – we may squander opportunities , but change is inevitable . Trauma and tragedy create inflection points in our lives and our patients ’ also , but we can mitigate the harm and potentially , grow in the face of adversity .
Unexpected , uncontrollable and demoralizing trauma has always been part of the human experience . Our need to confront trauma runs so deeply that we depict tragedy in fiction and the arts . Philosopher Friedrich Schiller believed that compassion in the face of suffering was the highest calling of humans . Instead of sympathy , Schiller argued that the experience of the Sublime defined the noble human response to catastrophe .
Many philosophers and writers of fiction have described and contemplated the Sublime . The Sublime experience contains a twostep process : 1 .) Overwhelming , terrifying , disruption of everyday familiarity , but 2 .) Awe , wonder , connection , something outside the boundaries of everyday life , and necessary for human thriving . Kant saw the sublime as fear plus a curious confidence ; succumbing to an infinite power but having enough self-sufficiency that we may comprehend and even withstand it . “ We are never safe from disease , loss , and death , but we know that we can face even our own annihilation with dignified calm .” The “ mixed-valence ” ( negative and positive ) impression results in connection to a larger whole , freedom / detachment from everyday affairs , expanded imagination and a desire for the experience to continue .
As we encounter unavoidable trauma with our patients , we must recognize how to heal them not only with our hands but with our words . Judith Prager and Judith Acosta have written a few books about the power of words during a crisis or trauma . Their book The Worst Is Over builds an impressive structure on which to base care for patients , or loved ones , who have experienced trauma . Prager and Acosta review the mind-body false dichotomy and the frankly remarkable literature on the placebos ( 33-77 % effective across the board ). We should utilize this powerful ( and universal ) effect in all patient interactions , especially in those vulnerable and suggestible .
One of the most amazing experiments mentioned in the book relates to a protocol for paramedics in Kansas . The intervention includes removing people from the environment , reciting a specific paragraph ( below ), and partaking in no other conversation .
( continued on page 16 ) JULY 2021 15