The Trauma of Everyday Life

pain. It is as silly to reject pleasurable feelings as it is to cultivate painful ones, he taught, but equally foolish to mindlessly pursue unstable pleasures in an attempt to blot out the anguish inherent to life. In later years, in the Buddhist cultures that grew up in India and then in Tibet, the word that was used to describe the world we inhabit translated as “tolerable,” in the sense of being barely tolerable. The Buddha believed that this quality of “barely tolerable” was perfect for spiritual and psychological growth. The fragility of things is apparent to those who look, but if the mind can be taught to hold the instability with some measure of equanimity, a new kind of happiness reveals itself.
    Because of his unvarying emphasis on
dukkha
, the Buddha’s teachings were often taken to be pessimistic, as if he were still a practicing ascetic. But he was not. As Upaka recognized but could not embrace, Buddha rejected the cultivation of painful states. But he always claimed that, like a doctor, he had to be realistic. One can of course deceive with false consolation, denying the illness; or one may exaggerate the malady and give up hope completely. 4 But such a physician would be of little use. Buddha rejected these two extremes and continually applied the therapeutic middle. In a famous sutra, he compared himself to a surgeon pulling a poisonous arrow from a patient’s flesh. 5 The tools he offered were powerful, but he admonished his listeners that even if the arrow were removed the patient could still die if he did not tend to the lesion himself. Even the best physician needs the cooperation of the patient, the Buddha affirmed. And every patient has to deal with his or her own wounds.
    In today’s world there are still contemporary versions of the ancient ascetics, with world views that are remarkably similar. Some of them remain in the wilds of India, living much as they did thousands of years ago, cultivating hardship in order to release themselves from the prisons of their attachments. But others are right here in our own culture. Today’s examples include those who suffer from anorexia and starve themselves into an emaciated kind of invulnerability or those who hurt themselves, even cut themselves, to express and/or transcend inner wounds they are not entirely reconciled to. But there are many much less extreme but equally debilitating examples. People who are convinced of their own unworthiness, who cling, like my patient Monica, to the masts of their own insecurities, who are caught in one way or another by their negative feelings, bear close resemblance to the ascetics of the Buddha’s time. Like his old friend Upaka, they have a very hard time seeing past their ingrained versions of reality, driven as they are by self-condemnation. As the comedian Louis C.K. has put it, in a contemporary twist on the Buddha’s teachings, “Everything’s amazing, and nobody’s happy.”
    Therapists today, building on detailed observations of the infant-parent relationship, now have a way to explain this ascetic strain in the contemporary psyche. Their model, of “developmental trauma,” is based on the realization that “there is no such thing as an infant” 6 ; there is only a mother-child relationship. Infants are too dependent to be called persons in their own right—they survive only because their parents give themselves over to their care. This “relational” paradigm sees unbearable emotion as the determining factor in trauma. Intense feelings are present in a baby from birth. They take many forms—an infant’s ruthless mix of appetite, need, and distress is well-known to any parent—and it is the parent’s gut response to engage these rudimentary emotions and try to make them bearable, or barely tolerable, for their child. When this does not happen adequately, when the painful emotions or unpleasant feelings are not picked up and handled by the parents, the infant, or child, is left with overwhelming feelings he or she is not equipped to deal with, feelings that often get turned into self-hate.
    My favorite example of this kind of parent-child attunement comes from a children’s book one of my patients gave me after hearing me talk about this. The book is called
What’s Wrong, Little Pookie?
7 and in it a mother can be heard questioning her child about what is bothering him. She goes through a series of hypothetical questions (Are you hungry? Are you tired?) that become