And What About Prevention? Obscene Incongruence In A Time of Genocide
(My impressions from the recent Action Trauma summit in Belfast)
(If you have received this by email, please click on the title to access the most up-to-date version. I often continue to edit and correct typos after publishing the first version)
Last week I attended a two-day trauma summit in Belfast organised by Action Trauma. It was my first event with this organisation. It is also my last. On the face of it, Action Trauma is a well-meaning organisation. It seeks to bring together all the knowledge we have on trauma. It aims to educate practitioners from psychotherapy, and other related fields about trauma, and the devastating impact it has on people.
It was a polished event, almost too polished. Despite lip service paid at the very start of the conference to ‘making contact’, and asking us to look at the person next to us to say ‘hello’, the event was deeply impersonal. How could it not be with 1000 delegates? We were crammed into an otherwise well-functioning, well-appointed, ultra modern, technologically advanced conference centre.
There were hi-tech signs on the doors of workshop spaces, good lunches, pretty, reusable water bottles we were allowed to keep, and lots of convenient water stations to refill them. A considerable staff team was employed to make sure we had regular supply of tea, coffee, and refreshments. The staff at the refreshment tables, and everywhere else for that matter were visibly tense. Running the event efficiently and to a ‘high standard’ was clearly the priority. There was no time or space for simple human acknowledgement, like eye contact, or a little smile. By the time you started to say ‘thank-you’, the attendant was already serving the next three people. This is what happens where there are too many people to serve. I avoided those refreshment tables or information desks, and felt sorry for the staff. For a psychology-minded event, I saw little concern for the welfare of the people who took care of us, who were likely on zero-hour contracts, or otherwise on low pay.
Everything was regulated with efficient but impersonal QR codes. People who are not so tech savvy, and not comfortable with downloading, or using apps on their phones (or maybe do not have a smartphone…) were quite lost. I have seen a few who looked lost and confused. There was help, and it was not the end of the world. But it is quite obvious that the organisers chose this technology because of the large numbers of participants.
It was hard to move around with so many people everywhere. When you cram any group of mammals into a limited space, it inevitably generates stress. It is not possible to create any kind of meaningful human contact, when everyone rushes around trying to dodge the constant flow of people in all directions. Even those who like living in big cities, and are used to navigating crowds, would inevitably feel stressed.
I had a room at the same hotel as the conference, so could retire to it whenever I needed ‘introvert space’. I am an Introvert (INFP on the MBTI). The ‘I’ in my Myers-Briggs profile is for ‘Introvert’. As a typical introvert, I get drained when I am in the company of people for too long. The larger the crowd around me, the quicker my energy seeps out. Over the decades, since I have learned that I am an introvert, I have become quite adept at regulating myself. In all areas my life I make sure my ‘batteries’ are regularly charged by taking regular time in solitude. It does not matter if I ‘miss out’ on things from time to time, and I certainly earn a great deal less than I would have if I were an Extravert. My wellbeing is more important to me than anything. Unless someone is in immediate danger, I do not compromise. I am no use to anyone if I am not well, and being chronically ‘introvert-overloaded’, takes a massive toll on our physical and psychological health. It can be a dangerous downward spiral, if you do not know how to meet your introvert needs.
The main auditorium at the conference had around a 1000 seats to accommodate the crowd for the main talks. For an introvert, the space alone felt oppressive, even before people started to come in. It was not hard to spot the other introverts in the crowd. Like me, they came in early, chose seats at the edges of rows, and did not talk to anyone. They took time on their own before, and after talks. They buried their faces in devices, or reading material in an attempt to create that necessary bubble of solitude in the middle of a crowd that I too know how to create.
As a child and teenager I used to bury myself in books, and in my studies to try to have some illusion of solitude. We lived in a tiny flat, one of sixteen in a crowded block of flats in a grey street, lined with featureless blocks like ours, as far as the eye could see. Israel is a pressure cooker of frantic and intense anxiety, and constant tension. Being alone was discouraged, and there was constant pressure to be with people all the time. It was an introvert hell. I always thought that there was something wrong with me. Eventually, later in life, I learned I was an introvert. I understood what I needed as an introvert — which instinctively I knew, but always thought it was part of what was ‘wrong’ with me — and what it meant for my wellbeing.
When you are an introvert and you do not know it, you can feel like there is something wrong with you, and you need to ‘steal’ your solitude. There are more extraverts born in society than introverts, which means society is organised mostly by extraverts, for extraverts. Introverts are rarely accommodated, even in spaces and events in my own profession, that you would expect to be more aware of, and more sensitive to people’s needs.
Your Myers-Briggs profile has enormous implications for your learning style, and for how you interact with information, and with people. I have found over the decades that my profession rarely pays attention to people’s needs. Just like the education system, my own profession can also operate like a ‘sausage factory’, where one size is expected to fit all.
Our own and our clients’ Myers-Briggs profile also has significant implications to our relationship with our clients, on therapeutic communication, and on the process of therapy. It is why my teachers thought that we needed to learn about it as part of our psychotherapy degree. My school, the Jansen Newman Institute (JNI) in Sydney, was incredibly enlightened, and sophisticated. It was one of the last in a ‘species’ of psychotherapy training institutes that was becoming rapidly extinct.
The deadly and deadening neoliberalist grip on the world was becoming ever tighter during my time as a student, and my profession did not escape it. An inseparable part of neoliberalism is the objectification of people, and an enormous pressure to conform. Neoliberalism sees humans as interchangeable, generic economic units. We are expected to satisfy our natural need to express our unique individuality through the colour of our mobile phones, or our choice of TV steaming service.
It was obvious that this conference was an exercise in money-making, and not the first I have seen in my profession. People set up organisations with good intentions and ideals. But once they begin to realise the profit they can make from offering training and organising conferences, they get seduced by the celebrity culture, and money-making, and sell out. Many of the presenters proudly announced that their entire family was involved in the ‘family business’. This too was not the first time that I have encountered this.
There were at least two big book signing events during the conference. Has anyone ever stopped to think about book signings? What do I care if an author signed my book? What is the purpose of the exercise? It would have been much nicer if authors took time to sit together with small groups of people, and chat about their books, discuss, answer questions. Book signings serve no purpose that I can see, except to satisfy a sycophantic instinct. Every workshop presenter had a ™ next to the title of their particular approach to working with trauma. I found this uncomfortable. I could easily trademark my own approach to therapy, but I would never do it. I believe that if we know something that can help people, we have a duty to share it widely and freely, not hoard it to ourselves. In a neoliberal world, this is a ‘commercially naive’ position.
It seems to me, I am afraid to say, that all of this is largely driven by American culture. US culture does not see anything wrong with monetising everything. ‘Catching the wrong end of the stick’ comes to mind. The late M. Scott Peck lamented this facet of US society in his 1993 book, A World Waiting to Be Born.
Everyone, including people who have made an important contribution to the profession seem to be under pressure to become ‘merchants’, and self-promoters. Once they develop a ‘product’, it is now time to sell it. Your level of ‘success’ is determined by how well you sell your product. Earning a lot of money for doing what you do, is the greatest virtue in US society, and sadly, it is being successfully exported to the rest of the world. The reason the US has succeeded so well in selling its ‘way of life’, is because it taps into our human limbic survivalist fears. In a world where the most important thing is to survive, doing well at survival makes sense.
The US seems to have set the ‘gold standard’ for how things should be done in my own profession, and far beyond. The space near the main auditorium was crammed full of exhibitors selling their technologies, books, props, paraphernalia, and programmes. I could not help but feel that I was in a marketplace, where everyone was trying to sell me something, and it left an unpleasant taste in my mouth. It reminded me of the produce market in Tel Aviv that I sometimes used to visit with my grandmother. Each stall owner would sing, or call out to the crowd exalting their wares, each louder than the next. They were all trying to draw people to buy from them, and not from the other guy in the next stall. They provided a necessary service, but they did not care about the welfare of their customers. Everything was about the ‘bottom line’, how much money they were able to earn by the end of the day.
There is something charming about produce markets. They can feel vibrant and exciting. But underneath there is an air of desperation that I sensed even as a child. I found the pushy merchants more intimidating than charming. The shabby, rickety stalls of my childhood market might have been replaced with clean tables and sophisticated displays, but the atmosphere was the same. I could not help but feel embarrassed for the people who sat at those stalls. The ‘market’ was located right outside the main auditorium, which was the largest venue. If you attended a talk there, you had no choice but to walk through the ‘market’. The event organisers clearly promised the exhibitors a good return on their investment by ensuring a large, captive crowd, and heavy traffic. (It costs money to be an exhibitor in a conference. The more high profile the conference, the higher the exhibitors’ fee). The more people attend an event like this, the higher the profits.
US culture knows how to do things big. But big is inevitably impersonal and objectifying both to sellers and buyers. One of the many books available for sale was Gabor Maté’s The Myth of Normal. Before purchasing it at the conference, I checked the listing on Amazon. Interestingly, the book was not available, except as a part of a bundle of three or more of Maté’s book. I paid £15 for the book, because naively I thought that I would not find it elsewhere. I have just checked Amazon, and the book is available, and selling for £5.49 for the paperback. This is not a coincidence. A lot of shrewd economics and planning goes on behind the scenes of big events like this conference. I cannot help but feel a bitter taste in my mouth.
If I had to describe this event in one word, it would be ‘incongruous’. Almost every speaker focused on wellbeing and human potential. But the event itself was the epitome of greed and objectification, the exact opposite of what we need in order to grow to our potential and to thrive.
What About Prevention?
The conference focused on the intricacies of trauma, and on various approaches to ‘treatment’. As professionals we know a great deal about the impact of trauma, and the way it interferes with brain development, and with our ability to develop to our human potential. We also know that trauma reverberates through the generations, and that unresolved trauma perpetuates itself. No news there. Most therapists have a decent understanding of the complexity, and effort involved in recovery. Recovery from trauma, as both Dan Siegel and Gabor Maté reminded us requires significant restructuring of our brain architecture.
We understand trauma and recovery, but what about prevention? What are we doing to prevent trauma from being inflicted in the first place? Telling therapists what they already know, does not make much of a difference to the events and societal attitudes and structures that cause trauma. We, therapists, are called upon to intervene once trauma has already been inflicted. But what is my profession doing to prevent it? I contacted Action Trauma a few months before the conference to ask if they were interested in joining me to lobby the United Nations to declare trauma a crime against humanity. The response I received, while friendly and polite, offered me all the reasons for why it could not be done, or was too difficult to even contemplate. The responder did wish me well, if I decided to approach the UN on my own.
It is hard not to be cynical. Suppose, hypothetically, that overnight we were able to eradicate all the conditions that cause psychological and developmental trauma. Imagine a world without child abuse or neglect, without domestic abuse, parental alcoholism or substance abuse, without bullying, poverty, exploitation in all contexts, prejudice and discrimination of all kinds, cruelty, crime, war, genocide, colonialism, dehumanisation, and objectification in all contexts. Imagine a world that does not demonise or dehumanise victims, and that does not kick them when they are already down or penalises them for their trauma. Imagine a world with an abundance of all the ingredients every human being needs in order to develop to their full potential. Imagine a world where compassion, patience, kindness, and time for others, are the norm, not the exception. What role would psychotherapists like me have in such a world? What role would organisations like Action Trauma have in a world like that? The answer is simple. We would become obsolete.
Prevention of trauma needs to be as important as learning about the intricacies of trauma, and how to help people recover. Our role in prevention should not be a footnote, or a side comment. More than one speaker at the conference acknowledged the toxicity of our culture, and how hard it is to be well in it. Dan Siegel was the only one who mentioned, at the very end of his talk, that as psychotherapists our role is not only to work with our clients. We have an essential role to play in changing society.
When I studied sociology for my undergraduate degree, I remember being taught that organisations and groups develop their own survival instinct. Once an organisation or a group is created, they increasingly become motivated by their own survival. The goal they were created to fulfil then becomes secondary. Once organisations are born, they do not want to stop existing. Psychotherapists and psychotherapy organisations that focus only on treating trauma, and ignore prevention, do so for their own survival.
A horrific genocide is unfolding in front of our eyes. Tens of thousands of human beings of all ages have so far been murdered with the assistance, and backing of Western powers. We can count the dead. But can we quantify the amount of trauma that Israel is deliberately and systematically inflicting on millions of human beings? Can we quantify the suffering, the lifelong trauma, the suffering of subsequent generations?
With the exception of UK Palestine Mental Heath Network, I know of no other organisation in my field that addresses this genocide. (If you know of any other, please let me know). My impression since I began working in my field has been that psychotherapy as a professions shows little interest in changing the world. This conference only served to confirm my impression.
Here are the last few paragraphs from the letter that I sent to the World Health Organisation (WHO). The WHO covers physical and mental health.
There is no bigger crime against humanity, against what it means to be human, than inflicting unnecessary trauma that deprives people from developing to their full potential. Hence, I ask the World Health Organisation and the United Nations to consider classifying the infliction of psychological trauma in any context, a crime against humanity.
It may be a symbolic declaration initially, and it may take a long time to work out how to implement and enforce this. But it can be an important declaration of intent to change our focus as a species from survivalism, to growth and development. It can offer a new goal for humanity to work towards, and it is something that every human being yearns for anyway. Our need to grow to our potential is universal. It is what we all have in common, no matter where we are in the world. It is what unites us, even if we do not yet acknowledge it.
Framing the infliction of trauma as a crime against humanity will change the conversation about what it means to be human. It will place our need to grow at the centre of everything. It will offer a new way of thinking about how we organise ourselves as societies.
I have just returned from a two-day trauma summit in Belfast. My profession knows a great deal about trauma, and how it impacts on people. But we are not able to do much in the service of prevention, at least not in any robust way. This is why I appeal to the World Health Organisation to consider my suggestion, and bring it up with other relevant bodies in the United Nations.
As a global organisation in a strong leadership position, you can help usher in a new direction for humanity. It is time we stop chipping away at our problems, and start looking more closely at our priorities as a species. We have to re-evaluate our tendency to focus on physical survival, at the expense of growth towards our human potential. A focus away from survivalism, and towards our development will help us cooperate better, and become a gentler species as we face global challenges, such as climate change. This will benefit not only us, but all other life forms that share this planet with us.
I worry a lot about the trauma being inflicted upon Palestinians and others too, Avigail. Thanks so much for taking action.
I think it's a great initiative to lobby to get the infliction of large scale trauma designated as a crime against humanity.