What survivors of trauma have taught this eminent psychiatrist about hope

He dedicates the book to “survivors who witness catastrophe and bring us hope.” In two phone interviews, he expounded on his observations. The interview has been edited for length and clarity.

You’re well beyond the retirement age for most people and you still have the passion to keep going. Why did you write this book?

I wrote this book out of a conviction that my understanding of survivor power could contribute to surviving catastrophe in general. I tried to present a combination of the survivors’ struggles and an avenue of hope because survivors can be at the center of resilience and renewal. I think what’s key here is the transformation from the helpless victim to the agent of survival. In Hiroshima, for instance, I interviewed people who had undergone the most extreme kind of trauma and victimization. And yet they were partly by means of that experience able to transform themselves into life-affirming groups so that the very same people who had so suffered from trauma could make use of that trauma as a source of knowledge and power.

What did you find among the survivors of Hiroshima and Nagasaki that might bring hope to survivors of catastrophe?

There are so many Hiroshima and Nagasaki survivors who on the one hand suffered as victims and on the other hand found ways to form a collective narrative and in turn have contributed to political stands against the bomb.

I interviewed people who had undergone the most extreme kind of trauma and victimization. And yet some of the very same people who had so suffered from trauma have shown what I call “survivor wisdom” — they transformed themselves from helpless victims to agents of survival

You heard powerful and disturbing stories from the survivors – the man who told you nearly 20 years after the bombing that he could still smell the stench from the corpses and cremations, those who remembered the “deathly silence” or the low moans from people around them or seeing corpses everywhere they looked. Is it therapeutic for these survivors to talk about their experiences?

We human beings are meaning-hungry creatures. For survivors that’s doubly so. When people undergo very great trauma, they either close down or open out. I called the closing-down “psychic numbing,” by which I mean a diminished capacity or inclination to feel. There are times when people need to be silent because it isn’t possible for them to speak. But as they emerge from that silence, as they sometimes could in their dialog with me, they could increasingly confront what they had been through. And a certain amount of emergence from that silence, from the numbing, is necessary for survivors to begin to play the role of agents of [their own and society’s] renewal.

There are survivors who have emerged as the basis and baseline for social change and for anti-nuclear achievements – take the recent U.N. decision that all stockpiling of nuclear weapons is against international law. That decision was very much enhanced by the efforts of Hiroshima survivors. And for some hibakusha, repeatedly expressing the details of their experiences has been crucial to their own healing. They are giving their extreme trauma, their victimization, a sense of meaning and purpose. And that has a definite healing impact.

And if they don’t go so far as to get involved in a movement, if they just share their story with a therapist or a friend or a family member – can storytelling still be helpful?

It can still be very helpful to them – sharing their stories so that others hear and their suffering is recognized as is their achievement in having survived it.

There are phases, sometimes even lifelong phases of Auschwitz survivors, many of whom I interviewed, during which they are unable to talk about what they went through. Because the pain is too overwhelming and it’s a reminder of being back in Auschwitz. It becomes important for most of them to find a way to articulate what they saw and experienced. Otherwise, they can be stuck in their trauma, and stuckness means lacking the capacity to confront or articulate what they had been through. There is a parallel to them and Hiroshima survivors — there is doubt when there is such murderous behavior from one human group to another and doubt about the continuity of human life in general. And that’s another reason why it becomes important to make contact with survivors of Auschwitz, to help them regain that confidence in the continuity of human life in general. Once they are able to confront what they had been through, if they are able to do that, it can be very therapeutic for them.

Do all survivors of trauma have the capacity to benefit from storytelling?

I don’t know that I or anyone else can answer that question with certainty. Sometimes people who have remained numb for a long time can make that so-called swerve or sudden shift and share their story. And sometimes people can never do so. It does have something to do with prior tendencies of identity and how much one can reach back to one’s own roots as a person with some moral compass or development. But having said that, one can be quite surprised in when this positive swerve occurs and doesn’t.

In your new book, you talk about how COVID has traumatized many people, and you note that you’re encouraged by the emergence of survivor groups working to bring more attention to long COVID, seeing the activism as a way to work through the trauma. Do the benefits of talking hold for other people who’ve been through other traumas or who have suffered individual traumas like being a crime victim?

The principle is that severe trauma can be converted into life-enhancing response is a general principle, but the way of doing it may differ in each culture. In Japan, for example, a dialog about corpses or dead bodies might be particularly difficult. The history of trauma and the psychological pattern that one has to address may differ in various cultures. The larger principle of that transformation nonetheless holds in all cultures.

Certainly some people are never able to overcome their reluctance to enter into a life-enhancing dialog that would be therapeutic to them. It doesn’t mean that the narrative need isn’t there. It may be that they never encounter the circumstances. There can be a reluctance based on their own psychology — their own roots and their own moral compass can play a large part. And so those people can seem to be absolutely impervious to narrative gain. But nonetheless, the narrative need never goes away. It may be inaccessible, but it’s always there.

What about trauma after, for example, suffering extreme weather conditions or being in a refugee camp?

It’s not exactly the same, but it does have parallels so that if one’s village is upended and one’s community is destroyed in general, that also is a human intervention and threatens one’s sense of the continuity of human lives. Storytelling will occur in any case. If the storytelling can include the transformation from the helpless victim to the life-enhancing survivor, then the storytelling is crucial. The storytelling we most encourage is that kind that enables the formerly helpless victim to be transformed in the story, to transform himself or herself, collectively transform themselves into life-affirming survivors. That’s the key transformation, and that’s the story we [listeners] seek to help them achieve.

You’ve spent a large part of your life listening to very difficult stories and writing about them. Has this focus on the worst mankind has to offer taken a toll on you?

It certainly affected me. People say, Well, you must be very brave. But it isn’t so much a matter of courage as it is an evolving sense of my identity as one who does these things. And I’ve found I need to have alternative involvements and that includes a lot of love and close relations to one’s family and close friends. It also includes diversions. In my case, I am a rabid fan of the Los Angeles Dodgers.

Even after they abandoned New York for California?

Many people in Brooklyn just said the hell with them once they moved. But I have a sense of loyalty, and that helps sustain me, too.

Joanne Silberner is a freelance journalist and former health policy correspondent for NPR. She has covered global health issues since the outbreak of HIV.