Preface to Portuguese Edition of Theaters of Trauma (Cenarios Psicanaliticos de Trauma)

The following is a beautiful preface to Theaters of Trauma (Cenarios Psicanaliticos de Trauma) written by Psychologist Maria João Saraiva.  Enjoy!

Prefa_cio livro Richard Raubolt – revisto v2.pdf

Detroit: Living in Between Official Trailer

“Raubolt sees Detroit not as an emblem of American decay, but as a metaphor for change, which lifts Living in Between from documentary to allegory.” -Noah Haidle, Writer: Stand Up Guys

Language of the Heart

 

 

 

 

Our hearts speak to us although we do not always recognize the language so we do the best we can to construct meaning with words. Not that words can’t and often do create confusion and misunderstanding but they are our most common method of communication. When it comes to “heart conditions” these words often carry emotional undertones:

 

A heart that is beating rapidly, at least so we notice, is a “racing heart.” Yet we seldom ask, where it is racing or from what?

 

A heart beating even more intensely becomes a “pounding heart”, like “my heart is pounding so fast I feel it could burst or jump out of my chest.” Perhaps we should ask pounding for whom or over what?

 

A heart that beats irregularly is a “heart that skips a beat.” Is this a heart in love or perhaps one in fear? Is “skipping” a warning sign or a measure of delight?

 

These are but a few examples as we listen to our own emotional and physical hearts but they do not exhaust the language. We use “heart words” to describe the behavior or motives of others as well.

 

He has a “good heart” often has no medical reference in our daily parlance. The same can be said for a “generous heart”, “full heart” or “wise heart.” Now it can be argued and research suggests that these attributes make for better overall health still we don’t usually use these descriptions for clinical reference.

 

On the other end of the continuum, without gender bias, we say that she has a “hard heart”, “unforgiving heart”, “heart of stone” or even “heartless” although we know that is physically impossible. In emotional conflagrations of a certain pitch we may become convinced we are dealing with a different species. Such individuals so described tend to have lives that are shorter and lonelier, which does not surprise many who have met their acquaintance.

 

The language of the heart extends further. Just as there are hearts identified politically as “bleeding hearts” we also know the “heart ache” of a lost love or the excitement of a “heart throb.” We know malice can be discovered by the “tell tale heart” and religious piety can found in the “Sacred Heart of Jesus.”

 

Then there are also hearts that reflect both physical and emotional reality. These afflictions of the heart include a “broken heart”, “weak heart” or “damaged heart”. When the heart gives out as we so often say it is a “heart attack.”

 

Now let me pause here to consider in more detail “heart attacks.” Why such a violent term? In the literal sense I am using we might ask is it an offensive or defensive attack?

Who is the enemy? On what grounds is this attack justified? What about the “silent heart attacks” that comprise one fifth of the total but the heart feels no pain? I wonder if the word “attack” is used because of the amount of explosive damage and even death that might result from severely blockaded arteries.

 

There is the physical pain which is often so intense but I also wonder if the aftermath isn’t equally intense but in different symptoms. Since 1 in 8 heart attack survivors develop significant mental health problems I think there may be more going on.

 

For survivors in their 40s’ and 50s’ but especially for those younger they can feel betrayed and cheated by their own hearts. They can fell attacked before they really got going with so many dreams unrealized and their sense of freedom so greatly altered. For those in their 60’s and older the attack might lead to experiences of depression as they consider their “golden years” will be spent in vigilance and on the defensive.

 

IF YOU CAN’T TRUST YOUR OWN HEART WHAT CAN YOU TRUST?

It is a sign of our times that the diagnosis of PTSD does not require the full clinical criteria to be understood. When we think of PTSD though we most often conjure up images of war, violence, abuse, kidnapping, shootings and so forth. It is in other words awful and coming from outside ourselves leaving us helpless and fearful. But there is a catch- not all episodes are done to us, they can happen inside us. One glaring example, largely overlooked is the hearts attacks we have been describing or more generally afflictions of the heart.

 

So what are some of the typical signs of PTSD regardless of the initial onset: angry outbursts, inhibitions like worry about expression of intimate feelings especially sexual,

panic episodes, excessive drinking or drug abuse including prescription medications, nightmares, fear of losing control, and withdrawal from life in general and loved ones in particular. With heart attacks this diagnosis becomes even trickier and include heart palpitations, pounding heart, sweating, trembling or shaking, sensations of shortness of breath or smothering, chest pain of discomfort and feeling dizzy or lightheaded. In other words these experiences mimic some of the initial signs of a heart attack. For this reason coordination between medical and psychological services are essential.

 

SO THAT IS THE BAD NEWS. WHAT CAN SOMEINE DO ABOUT IT?

 

In addition to following the medical protocol for recovery talking out the fearful and confusing signs with others of similar experiences is helpful. Group therapy has been researched and demonstrates to be an effective and helpful tool for many. Being with people who “get it” because they have “had it” reduces the isolation and loneliness of carrying these burdens alone. Although not easy to do group therapy can make a huge difference in the quality of living and relief of symptoms.

 

Simple mindfulness exercises can also be extremely helpful in alleviating stress and anxiety.  One brief experience I use is called STOP. S=Stop whatever you are doing at the moment of anxiety. Consider it a three minute pause for refection. T=Take a breath. Actually take two or three deep breaths from your diaphragm. Feel your chest rise and fall making sure your exhalation is longer than inhalation. O=Observe your thoughts and feelings as they whirl by but without judgment or attachment. Just watch as these experiences ebb and flow. P=Proceed on with your activities with awareness and a modulated pace.

Richard Raubolt, Ph.D.

Detroit: Living Between

By way of brief introduction–I am a psychoanalytic psychologist who grew up in the Downriver area and who has remained enthralled with Detroit ever since. For those unfamiliar with contemporary psychoanalysis, or those thinking that Freud still reigns, my field may be seen alternately as the art of questioning what is real or as the practice of listening to a patient’s own reality. Using our tools of reflection, introspection, interpretation and empathic responsiveness we seek to understand mixed, varied and even conflictual experiences, dreams and desires.

As therapists, we practice mainly within the confines of our private office spaces in hushed tones, and in isolation from the intemperate world banging at our doors. With the emergence of trauma studies, our work has widened beyond the abiding focus on individuals. We can now leave our consulting rooms, and venture forth without our favorite theories and comforts. Such changes in practice and perspective introduce us to the actual world of living nightmares and dreams, as well as to the death of reason in favor of emotionality and at times violence. This change also brings us into contact with the vibrancy of lives growing and developing no matter how uneven or messy. We participate in the creation of “new-nows” often beyond what history suggests is possible.

Perhaps, deservedly, we have often been dismissed so we must prove we have something to offer and not merely relics of times gone. Each of us has to answer for him/herself if one is to interact with the world. For me it means stepping in and pushing back as I find a venue to offer understanding and a context for deurbanization, corruption of power, suburbanization and the politics of racial discrimination among other issues.

Detroit, referred as the “mecca of urban ruins” will be the focus of this documentary. Psychoanalytic theories will be held lightly as the voices of Detroiters will be given precedence as they teach us what the city was, is and may become, This seems only fitting as they have been have witnesses to an alarming decline that has left Detroit isolated and in the sad position of the largest shrinking city in the country. Those who have expressed an interest in the city are seemingly more captivated by “ruin photos” than by the human stories. Finding and honoring other healthier emotional narratives, much like analysis, may offer understanding to the marginalized while highlighting transitions to better possibilities.

I hope you will allow me the privilege of hearing your stories. If you have questions please feel free to contact me by email using the contact form below or by phone at 616.940.1100.  I can also be reached by mail at:

Richard Raubolt Ph. D

967 Spaulding Ave SE

Ada, MI 49301

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Book Excerpt: Weightlessness Part 2

The following is an excerpt from Theaters of Trauma, the acclaimed book by Dr. Richard Raubolt.  All rights reserved.  Part 1 of this piece is here.

The real work of Ceely’s therapy could now begin in earnest: writing her own life story without the lies, distortion and misrepresentations she had heard about herself for so many years.

Over the next two years we explored the relationship Ceely had with her mother. With my encouragement she returned again and again to the scenes that were first devoid of personal memory, but slowly with each retelling more of her own emotion emerged. What was originally seen as help and guidance from her mother she now experienced as cruel, humiliating, dangerous and traumatic. Ceely had trouble understanding the full extent of the pervasive on-going traumas of her pre-adolescent and adolescent years. Still caught in a web of shame about her weight she could relapse into spirited, if brittle, defense of her mother.

When we seemingly hit an impasse and her weight began to increase, even while in therapy, I offered Ceely an interpretation that served as a turning point.

In a measured, calm but firm voice I said: “Ceely, you are desperately trying to hold on to a past that never existed. You continue to protect the myth of a caring, loving mother but your own body betrays the lie. Your weight increased then, as it does now, in silent protest against your mother’s exploitation. What you can’t say, even think for very long, your body reveals. You were and still are in a fierce battle where you will not give into your mother’s tyranny. No matter how extensive the violence, your body would not give in or be defeated. You have been fighting the only way you know how, and that is with food.”

Ceely glared silently at me for a moment. Then pounding her fists on the same arms of the chair that she used for support, she screamed: “Damn her, damn her to hell!” Once this rage erupted, she was on fire with burning images, stories, accusations and memories. No longer silent, she grew hard and defiant. As she found verbal expression for her feelings, her weight began to slowly edge downward, although my focus was never to direct her weight loss.

Ceely was talking, allowing herself to dream of a future, standing up for herself with confidence and in doing so her depression was lifting. She also stopped obligatory visits with her mother, since criticism of her weight continued, unabated by the years. For many years before I ever met her, Ceely had been on anti-depressant medication. She now wanted to discontinue the medication and I agreed that it was time to revisit the issue with her psychiatrist. Ceely, however, made the decision on as her own and following advice on the Internet and from friends with nursing experience, she began to taper off the medication. Then a point came where her anxiety grew, and she agreed to schedule a medication review. Ceely met with her psychiatrist and a few days later, in our session, I realized it did not go well.

The session began with Ceely saying: “This is what I worried about all along but trusted you. You led me to believe that what my mother did to me was bad and that I didn’t deserve what had happened to me. You told me my anger was a healthy response to my mother’s actions. Now, I find you were wrong.”

I was stunned. What, I wondered, happened to so drastically alter Ceely’s perception of me and our work together?

I did not have to wait long as she continued: “My psychiatrist told me I was having trouble going off the medication because I still needed it. He said I would continue to need it until I forgave my mother. He told me you were wrong and the anger I feel is just another symptom of the depression.”

Upon hearing what was said to Ceely, I admit I was feeling anything but forgiving toward this physician. I took a few deep breaths to regulate my outrage at the intrusiveness of this man, so I could more effectively address Ceely.

After a pause, I said: “Forgiveness is a complicated and confusing process. There are many factors to consider and since the subject has been broached, we would do well to explore them. Let me say this to begin. I don’t believe someone can be ordered to forgive, nor do I believe forgiveness is a valid indicator of emotional health. Since I have told you what I thought before, as you point out, I will again be honest. The rabbis of old have a saying: ‘Whoever is merciful to the cruel will end up being indifferent to the innocent.’ I believe the conduct of your psychiatrist suggests there is truth in this saying.”

Ceely reacted by asking: “Are you saying that he was indifferent to me?”

I answered simply: “Yes. He offered you a simplistic self-righteous judgment that undermined confidence in yourself, me and this process of therapy. You went there for his medical opinion about medication and you were instead greeted with a morality lesson that implied condemnation.”

After a few minutes of silence, Ceely said: “We have a lot to talk about.”

Yes, we did and the talking continues. In the back and forth, we discovered many lessons together, with so much more still to learn. We came to believe that forgiveness is a decision and is most authentic when it is carefully thought through and recognized as existing along side of conflicting emotions. Forgiveness is not about forgetting or allowing for abrogation of responsibility for acts of cruelty or violence. Even without her mother’s atonement, Ceely could mitigate her mother’s influence by refusing to condone her behaviors, accept blame for them or continue to reside in the shame that was instilled. Forgiveness is also not about squelching ambiguity, ambivalence, anger, hurt or even the desire for justice.

We recognized it could be necessary, at times, not to forgive if forgiveness means passive surrender for the sake of acceptance or forgiveness in order to avoid conflict at the cost of self-respect or capacity for self-defense. Anger can provide healthy protection against being victimized. Such anger becomes damaging only if it is frozen as bitterness or resentment that precludes developing a responsive, emotionally fulfilling life. Someday, Ceely may forgive her mother, with or without her apology, but that is her call to make. The success of such an intimate process as therapy must never hang on only one measure.