Dr. Avraham Cohen’s Field Notes
July 1, 2025
Avraham Cohen, PhD, RCC-ACS, CCC
dr.avrahamcohen@gmail.com

The guest author this month is Chris Nicol, MA, RCC-ACS (Provisional)

https://www.uasingishunews.co.ke/the-state-of-agriculture/

Quotes:

• Painful or frightening affect becomes traumatic when the attunement that the child needs to assist in its tolerance, containment, and integration is profoundly absent. (Robert Stolorow)    

• Symptoms as such are not our enemy, but our friend; where there are symp­toms there is conflict, and conflict always indicates that the forces of life which strive for integration and happiness are still fighting. (Erich Fromm)

• A true spirituality opens up to the numinous, a word that speaks to something approaching us, soliciting our engagement, not willed by the ego. This means that even traumatic experience can and often is numinous, because it hits us with the radical mystery of the other and obliges us to reframe our sense of self and world. (James Hollis)

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I will be authoring my next Field Note on October 1, 2025. —Avraham

Recording of Field Note:

It was 1997, not long after I entered into this line of work as a Key Worker at a safe house for high-risk youth, that I attended a two-day workshop for various professionals—social workers, counsellors, Ministry of Children and Family Development (MCFD) staff, police officers, outreach workers, youth addictions and detox staff. On the first morning we were asked by the facilitator to take part in a brainstorming exercise. The task was to place stickies on the whiteboards placed around the room identifying the issues that we thought should be discussed during our time together. After about 20-minutes we all sat down and looked at what we’d come up with. We talked a bit about some of the apparent themes, and then someone raised their hand and asked a question that has resonated with me ever since:

“Where’s trauma?”

Not one of those stickies identified trauma, and in retrospect it’s curious that none of us, whose daily work involved trying our best to support some of the most psychologically wounded kids in our community, had identified what was arguably the primary source of their distress: the trauma from which they were trying to escape, and that led them onto our professional paths. I vaguely remember the room’s unspoken response to that social worker’s question—it was like a terrible faux pas had been committed; there was an awkward, embarrassed silence.

It was only five years prior, in her seminal work, Trauma and Recovery, that Judith Herman helped us to understand that silence:

“The study of psychological trauma does not languish for lack of interest. Rather, the subject provokes such intense controversy that it periodically becomes anathema.” (1992)

Maybe that’s why it didn’t make it on to a white board that day—because everyone unconsciously took it for granted; it was, is, and always will be a part of life. Or maybe it’s because it was just too vague a concept, because those in the room knew that we wouldn’t be able to reach consensus on what it is exactly, let alone how to go about ‘treating’ it. Or maybe it’s because, as Herman reminds us, to consider trauma is “to come face to face both with human vulnerability in the natural world and with the capacity for evil in human nature,” and that was something none of us were prepared to take on.

At that point in my career, I was naïve if not ignorant about trauma. I had a layperson’s familiarity with PTSD, especially in the context of war, natural disasters, and those who have experienced serious forms of physical assault. But I had no idea that I would, in a few years, find myself on the crest of a wave that would broaden our definition and understanding of trauma and, in doing so, make it a concept that we were less likely to shy away from. (Indeed, a mere twenty years after that workshop, the evolution of trauma gave rise to the now ubiquitous, very welcome, and long-overdue idea of trauma-informed practice).

Fast-forward nine years after that whiteboard exercise, and I’m working my first job as a clinical counsellor at a community health centre in downtown Vancouver. My job title was Alcohol and Drug Counsellor. I don’t know if this job title still exists (I hope not), but looking back now it strikes me as a stubborn hangover, a reflection of a collective reluctance, if not resistance, to acknowledge and address what we now generally accept as fact: the role of historical pain in what we call “addiction.” To my mind, an “A&D Counsellor” is like a doctor who specializes in sneezing. It’s a job title that places all of the emphasis on the ‘symptom’ rather than the actual source of the distress or dis-ease: pain.

But pain, as Robert Stolorow reminds us, is not the core issue:

“Pain is not pathology. It is the absence of adequate attunement and responsiveness to the child’s painful emotional reactions that render them unendurable and thus a source of traumatic states and psychopathology.”

So really, what I and my fellow counsellors were doing at that clinic was a kind of pain-management, and as a colleague of mine at the time pointed out, the type of therapy we were offering was, by and large, trauma therapy. This would explain why the Making Sense of Trauma support group that our counsellors developed was the most well-attended group in the clinic’s history.  

And yet, a few years later, the public realm’s reluctance to accept historical trauma as the primary source of distress for many, if not most, of the people coming to us for support re-appeared in the form of a job title change, from A&D Counsellor to Concurrent Disorders Counsellor. This is a job title that, in my opinion, added insult to injury. Assuming the perspective of the client, this might mean that not only am I “disordered,” but I’m disordered at least twice over. A more humane perspective might acknowledge that these individuals, consciously or unconsciously, had discovered more than one way to help them cope with the trauma-wounds that had been inflicted on them by circumstance. Regardless, trauma seemed to remain an “anathema” and the medical/diagnostic paradigm ruled the day.  

And now, we seem to be teetering on a kind of imaginary mountain peak; behind us is the stubborn reluctance to acknowledge the prevalence of traumatic wounding, and ahead of us—a slippery slope leading down to a gully full of such varied hurtful experiences that it threatens to dilute trauma to the point of obscurity.    

How has trauma gone from being a description of the aftermath of near-death experiences to a bloated, all-consuming concept that includes everything from being insulted by a co-worker to ongoing abject physical abuse? Well, that might be a question for an altogether separate Field Note, but it seems to me that the proverbial pendulum has swung too far in the opposite direction. That is, in an intellectual scramble to shove trauma into the light of day, we’ve inadvertently pushed it beyond its own conceptual margins, to the opposite end of the spectrum, rendering it murky and potentially impotent.

At one end of that spectrum, there’s a historical concreteness to the term “trauma” that fails to capture its nuances, its subtlety, its changeability and dialectical qualities. And at the other end, trauma fades into a kind of a platitude, a vacuous construct that has become so diluted that it borders on meaninglessness. Like certain of the “mental health disorders” we so often hear and read about, trauma is becoming a container tasked with holding too much, a container into which we throw all that we can’t otherwise find language for, or that we simply don’t yet understand. It’s been stretched, torn and so bent out of shape that all of its contents are threatening to fall out—including those that helped establish it.

Trauma as a construct, I believe, needs an overhaul, a deconstruction. Or perhaps it needs to be respectfully retired, put out to pasture having served an essential purpose as an epistemological stepping stone. Maybe it’s time to create some space for language that better-reflects our current understanding of the intricacies of the psyche, how it bends and bows, gyrates and flexes, swells and shrinks, brightens and dulls, all in response to the hazards and happenings of our daily lives.

This is an idea that’s consistent with the foundational Buddhist teachings known as the Four Noble Truths, the first of which being: life is hard, for everyone. Whether we experience it as unsatisfactoriness, suffering, pain, loneliness, loss, neglect, or any of those other psychological constructs born of the human imagination: anxiety, depression, OCD, ODD, BPD…the list goes on.  In its more literal translation, the Pali term dukkha means “uncomfortable, unpleasant, uneasy, imperfect, hard to face.” This, for better or worse, is what trauma is morphing into, like a vortex that sweeps up and subsumes all that is closest to it.

Gabor Mate reminds us that “trauma is not what happens to you, but what happens inside you as a result of what happened to you.” He stresses the idea that, in the context of our childhoods, what didn’t happen but should have, is no less important than what did happen but shouldn’t have. The most common ‘symptoms’ of these internal wounds can be thought of as sign posts pointing clients and therapists alike towards gaping absences, current and historical, often residing in the shadows, and that have created a vulnerable psychic space for the kind of scarring trauma can cause. I think this is a critically important idea that represents a kind of course-change in our understanding of trauma—a course change that might require a reconceptualization of the concept itself.

So now, almost 30 years after that workshop and all of those stickies, how might we respond to the question, “Where’s trauma?”

Well…maybe it’s somewhere in between the concreteness of “shell shock” and the over-stuffed container that it’s become. Maybe it’s where it always has been—within all of us, an unavoidable by-product of birth, a chronic and dynamic psychic presence with unimaginable potential, and that instils in us a sense of hope, fear, worry, compromised safety, uncertainty, at times terror, but also feelings of worth and wonder.

Rather than separating us from them, the safe from the dangerous, the ill from the well, the explainable from the mysterious, maybe trauma flutters like darkened wings within our own interiors—within all of us—a liminal presence that conjoins rather than divides us, like the mingling of tides.

For we are all just one or two bad days away from the dread of  depression, a stressor away from the churning of anxiety, a loss away from the unanchoring of grief. That is to say, we are all, at times and inevitably, skirting the boundaries of our safe and familiar psychic territory and brushing up against our own tortured shadows.

Just this morning, I received an email promoting an upcoming conference, the theme of which is “Post-Traumatic Growth and Awakening.” So maybe trauma is our constant and discomfiting companion that holds the potential to, at one and the same time, contribute to our growth and awakening while threatening to thwart our passage. Maybe, just maybe, trauma can help guide us, in its own unsettling way, along and up, into the warmer embrace of this mystery called life.  

Chris is a registered clinical counsellor in private practice, providing on-line therapy from his home on the Gulf Islands, where he lives with his wife and their cat, Jim.  He likes to read two books at the same time (one fiction, one non-fiction), make things out of wood, feed the hummingbirds, walk in the forest, write poetry, and live in the moment…as much as possible.

Website: https://www.chrispnicol.com/

Email: chrispnicol@gmail.com