“The Trauma of Everyday Life” by Mark Epstein, MD


“Trauma is an indivisible part of human existence. It takes many forms but spares no one.”

The Trauma of Everyday Life is about the parallels between ancient Buddhism and modern day psychotherapy. Buddhism and psychotherapy are remarkably similar in their approach to soothing the pain of existence, this book is an exploration of their methods and dogma. Even though one is a religion and the other strives to be modern and secular, both attempt to soothe the anxieties of life by examining personal problems and repeated behaviors. They both start by acknowledging that trauma is inevitable and attempt to figure out what to deal with it.

Simply acknowledging that trauma is unavoidable is therapeutic. Throughout this book, Mark Epstein talks about the life and teachings of Buddha and his experience as a therapist, helping others through the trauma of existence.

In line with this book, Nonzero: The Logic of Human Destiny summarizes the importance of Buddhism this way: “In the spiritual realm, India gave us Buddhism, the first major religion to stress tolerance and nonviolence, the only major religion to spread far and wide without conquest, and arguably the major religion whose founding doctrines (unembellished by later additions) most readily survive the modifying force of modern science.”

Further Links:

School of Life video summary of the Buddha and his principals.
BBC documentary on Freud and the origins of psychotherapy and mass psychology: The Century of the Self.
Buy from Amazon: The Trauma of Everyday Life

Ch.1 The Way Out Is Through

Trauma is an indivisible part of human existence. It takes many forms but spares no one.

An ancient Sanskrit proverb declares, “One should not speak unless what one says is both true and pleasant.” Buddha rejected this view. There was nothing pleasant about his First Noble Truth, spoken by him in the form of a one-word exclamation: “Dukkha!” The word, generally translated as “suffering” but carrying the literal meaning of “hard to face,” was the Buddha;s emphatic summary of the entire human predicament. When forced to elaborate on what he meant, the Buddha let loose with a torrent of explanation. Birth, aging, sickness, death, sorrow, lamentation, pain, grief, and despair are inescapable; being close to those who are loved, and not getting what one wants are all unpleasant facts of life; indeed, just being a person in this world brings suffering because of how insignificant we feel and how impermanent we are. Even pleasant experiences carry a whiff of dissatisfaction because of their inability to provide ultimate comfort. No matter how fulfilling, they eventually run their course.

It is not as important to find the cause of our traumatized feelings as it is to learn how to relate to them. Because everyday life is so challenging, there is a great need to pretend. Our most infinite feelings get shunted to the side, relegated to our dreams. We all want to be normal. Life, even normal life, is arduous, demanding, and ultimately threatening. We all have to deal with it, and none of us really knows how. We are all traumatized by life, by its unpredictability, its randomness, its lack of regard for our feelings and the losses it brings. Each in our own way, we suffer. Even if nothing else goes wrong (and it is rare that this is the case), old age, illness, and death loom just over the horizon, like the monsters our children need us to protect them from at night.

The clear-eyed comprehension of suffering permits its release.

Ch.2 Primitive Agony

There is enough trauma in daily life to awaken the desire to be free, the Buddha taught. It is right here, already a part of us, already an underlying feeling in our lives. Painful experiences do not have to be cultivated specially—they do not have to be sought after or induced—there is already more than enough to go around. A willingness to face the feelings we already have is much more valuable than trying to escape from them (as the yoga practitioners of his time intended), exaggerate them (as the ascetics attempted), or minimize them altogether (as the materialists and lay-people tend to do).

The Buddha applied this logic to both pleasure and 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.

One consequence of developmental trauma, relationally conceived, is that it affect states take on enduring, crushing meanings. From recurring experiences of malattunement, the child acquires the unconscious conviction that unmet developmental yearnings and reactive painful feeling states are manifestations of a loathsome defect or of an inherent inner badness.

A recent patient of mine described a version of this perfectly. From as far back as she could remember, she had been convinced there was something wrong with her. This manifested in her preadolescent years as a conviction that her body was flawed. Her parents had their own problems, and she hid her feelings from them as best she could. But one consequence of this was that she not only felt that something was wrong with her but also blamed herself for feeling this way. She tried everything to get away from these uncomfortable feelings: ignoring them, rising above them, insulating herself from them, and pretending they were not there. None of these approaches worked too well—or, rather, they all worked a little. My patient grew to become an accomplished woman with a career and a family. But in private she was still troubled by self-negating feelings not entirely different from those she experience as an adolescent. She could put up a good front now, but under the surface she was less than sanguine. Her body still bothered her. One day, when her college-aged children were home for the holidays, she was driving home feeling how quickly her life was passing her by. One moment her children were little and the next they were adults. Somehow, she let herself feel sad—an uncomfortable feeling she would not usually allow with such ease—and she sat in her driveway crying unabashedly before entering her home. When she told me about it some days later, she remarked upon how much worse the avoidance of the feelings was than the actual experience of them. She was touched in particular by how much love there was in her sadness.

One of the unintended consequences of this kind of story, and of the recent focus on developmental trauma in general, has been to encourage the fantasy that relief can come through identifying where, or with whom, one’s trauma occurred. My patient and I both has the tendency to assign fault, if not to her then at least to her parents for having failed her. Although proponents of the relational perspective are quick to point out that “the possibility of emotional trauma is built into the basic constitution of human existence,” it is still very tempting, when dealing with pain of this nature, to look for someone to blame. Disappointment is compounded when one discovers that tuning in to the lack of attunement does not, by itself, bring relief. The hope remains that by uncovering a single primal memory, or hearing a single insightful therapeutic interpretation, one will be healed.

The thoughts the Buddha was after are rooted in the way we seek relief by finding someone or something to blame. The trauma within prompts us to search for a culprit, and we all too often attack ourselves or our loved ones in an attempt to eradicate the problem. This splitting of the self against itself or against its world only perpetuates suffering.

Ch.3 Everything Is Burning

Everyday life is trauma, the Buddha proclaimed: It is as if everything is burning. He spoke of trauma as if it were a fire:

Bhikkhus, all is burning. And what is all that is burning?

The eye is burning. Visible forms are burning. Eye-

consciousness is burning. Eye-contact is burning. Also

Feeling, whether pleasant or painful or neither-painful-nor-

Pleasant, that too is burning. Burning with what? Burning

With the fire of lust, with the fire of hate, with the fire of

Delusion; it is burning with birth, aging and death, with

Sorrow, lamentation, pain, grief and despair, I say.

The ear is burning. Sounds are burning…

The nose is burning. Odors are burning…

The tongue is burning. Flavors are burning…

The body is burning. Tangibles are burning…

The mind is burning. Mental objects are burning.

And he used his metaphorical imagery to drive home his vision of the ubiquity of trauma. Everyday life is on fire not only because of how ardently we cling to our own greed, anger, and egocentric preoccupations.

Subliminally, the Buddha was saying, we are all tending these fires (of greed, hatred, nd delusion), motivated as we are by our insecure place in the world, by the feeling, the dukkha, of not fitting in. The fires of greed, hatred, and delusion are defenses against acknowledging that everything is on fire, instinctive attempts at protecting ourselves from what feels like an impossible situation. The Buddha stressed the burning nature of the world in order to show his listeners what they were afraid of. By placing their spiritual aspirations outside themselves they were shoring up their egocentric defenses. Only by looking into the traumas they were made of could they find release.

She had recently started group therapy and discovered that, in her tendency to try to make everything okay for everyone, she was avoiding her own anger.

Speaking in the vernacular of his own time and place, and going completely against the norm, the Buddha systematically took apart all conventional notions of permanence. He insisted that there was no eternal essence in a human being, for example, no spirit that was one with God, no immortal soul that survives death, and no sacred fire that must be tended. Even consciousness cannot be shown to exist independently, he claimed. Nothing exists in its own right or under its own power. We emerge, as infants, from a relational matrix and then struggle to come to terms with the struggle of aloneness. While all things remain contingent, relative, and relational, our object-seeking instincts desire a security we assume is our birthright. As a patient of mine, Carl, once ruefully said, in describing how tenaciously he could cling to unavailable women who were turned off by his neediness, “I’m scared to lose what I don’t have,” The Buddha said much the same thing about the rest of us. We cling to the notion of permanence that, according to Buddha, never existed in the first place.

Ch.4 The Rush to Normal

“When a person says to a friend, ‘I’ll see you later,’ or a parents says to a child at bedtime, ‘I’ll see you in the morning,’ these are statements, like delusions, whose validity is not open to discussion. Such absolutions are the basics for a kind of naive realism and optimism that allows one to function in the world, experienced as stable and predictable. It is in the essence of emotional trauma that it shatters these absolutions, a catastrophic loss of innocence that permanently alters one’s sense of being-in-the-world. Traumatized people are left with an experience of “singularity” that creates a divide between their experience and the consensual reality of others. Part of what makes it traumatic is the lack of communication that is possible about it. “The worlds of traumatized persons are fundamentally incommensurable with those of others,” Robert Stolorow writes. Trauma creates a “deep chasm in which an anguished sense of estrangement and solitude takes from.”

Facing the traumas we are made of, and the new ones that continually shape us, makes more sense than trying to avoid them, if the mind is in a balanced enough place to hold the truth. Trauma is unavoidable, despite our strong wishes to the contrary. Facing this truth, this disillusioning attack on our omnipotence, with an attitude of honesty and caring strips it of much of its threat. When we are constantly telling ourselves that things shouldn’t be this way, we reinforce the very dread we are trying to get away from. But feeling our way into the ruptures of our lives lets us become more real.

Ch.5 Dissociation

Therapists today have a language for for trauma’s impact on the mind. They recognize that the mind’s primary defense against agony is dissociation is stability. Especially in situations in which unbearable emotions are stirred up, the self’s only choice is to wall itself off from whatever is threatening it, to remove itself from what it cannot regulate. My friend whose parents were both alcoholics with violent tempers became a person who was always eager to please. Her parents used to have terrible arguments, smashing furniture while she cowered with her siblings under the bed. Yet she showed not a trace of her anger or fear to anyone as she moved into her adulthood. She was ultra capable but suffered, in her thirties, from what seemed to her to be irrational bouts of intense anxiety about her children’s safety and well-being. This capacity for dissociation is a survival mechanism. It allows us to go forward with our lives but in a compromised condition. The shock of trauma sits outside awareness like a coiled spring.

In the second chapter of Ashvaghosha’s Buddhacarita there is a single verse about the demise of the future Buddha’s mother that speaks directly to the defense of dissociation. Written in Sanskrit, the verse was recently translated as follows:

But when queen Maya saw the immense might

Of her son, like that of a seer divine,

She could not bear the delight it caused her;

So she departed to dwell in heaven.

I was startled when I first came upon this verse. “The immense might” of the infant! His mother’s inability to “bear the delight it caused her”! The verse seemed to support Winnicott’s descriptions of the merciless way an infant loves his mother, the way he beats her like a drum with a mix of what we in hindsight would call need, hunger, love, aggression, and entitlement but that in an infant comes in one package, undifferentiated, like a force of nature. As Winnicott explained in an early paper, “The normal child enjoys a ruthless relation to his mother, mostly showing in play, and he needs his mother because only she can be expected to tolerate his ruthless relation to her even in play, because this really hurts her and wears her out. Without this play with her he can only hide a ruthless self and give it life in a state of dissociation.”

Love enlightens but also frightens, not only when it falters or when it is unrequited but also when it is unleashed, dissolving us in the heat of its expression. It takes stamina and faith to maintain oneself in the midst of such passion.

Ch.6 Curiosity

Do not grasp after the pleasant or push away the unpleasant, but give equal attention to everything there is to observe, taught the Buddha.

Relief comes, in part, when we stop fending off the unpleasant and allow it to be an equal part of our experience.

When one is upset or anxious or frustrated or angry, one tries to find “who” is feeling these things at the same time as one explores the feelings. The search is for what is sometimes called the “intrinsic identity habit” or the “intrinsic identity instinct,” the way we unconsciously take ourselves to be “absolutely” real, as if we are really here, absolutely; fixed, enduring and all alone; intensely real and separate; in what is often called, in Buddhist psychology, “the cage of self-absolutization.” Robert Thurman, a professor of religion at Columbia, quotes his old Mongolian Buddhist lama, whom he met in suburban New Jersey in the early 1960s, as explaining to him, “It’s not that you’re not real. We all think we’re real, and that’s not wrong. You are real. But you think you’re really real, you exaggerate it.” The picture we present to ourselves of who we think we ought to be obscures who we really are.

The effort that goes into protecting ourselves from uncomfortable feelings can have untoward consequences. Shutting down one kind of feeling inevitably shuts down all of them. In protecting ourselves from the unbearable affect of trauma, we also close ourselves off from love, joy, and empathy. Our humanity resides in our feelings, and we reclaim our humanity when we direct our curiosity at that which we would prefer to avoid.

Ch.8 Feelings Matter

“It’s not what you experiencing that’s important,” Joseph would often say, “It’s how you relate to it that matters.” I always found this shocking—each time I heard it, I felt like I was hearing it for the first time. Splinters of pain did not have to be obstacles to awakening; they could become vehicles of it once the “conceit” that attaches to them is abandoned.

There are feelings we carry in our minds, ones that are not dependent on our immediate sensory surroundings but ones that define who we think we are, that entangle themselves with our sense of personal continuity. Often such feelings come from an early place, so early that they were there before we were, before our selves were formed enough to hold or understand them.

Trauma takes us out of time. There is no past or future when one is overtaken by it; it is as if it were happening now. Experiences of trauma become freeze-framed into an eternal present in which one remains forever trapped, or to which one is condemned to be perpetually returned through the portkeys supplied by life’s slings and arrows. The sense of one’s own continuity, of what Robert Stolorow calls the “stretching along between past and future,” is collapsed by trauma. The traumatized individual lives outside time, in his or her own separate reality, unable to relate to the consensual reality of others.

Ch.11 Reflections of Mind

Mara (lord of desire) appeared to the Buddha as a warlord mounted on an elephant commanding a legion of threatening troops. He unleashed army after army, ten in all, their psychological equivalents portrayed as the following: sensual desire; discontent; hunger and thirst; craving; lethargy; fear; doubt; restlessness; longing for gain, praise, honor, and fame; and extolling oneself while disparaging others.

As Stephan Batchelor has written, “When the stubborn, frozen stolidity of necessary selves and things is dissolved in the perspective of emptiness, a contingent world opens up that is fluid and ambiguous, fascinating and terrifying. Not only does this world unfold before us with awesome subtlety, complexity, and majesty, one day it will swallow us up in its tumultuous wake along with everything else we cherish. The infinitely poignant beauty of creation is inseparable from its diabolic destructiveness. How to live in such a turbulent world with wisdom, tolerance, empathy, care, and nonviolence is what saints and philosophers have struggled over the centuries to articulate. What is striking about the Buddhist approach is that rather than positing an immortal or transcendent self that is immune to the vicissitudes of the world, Buddha insisted that salvation lies in discarding such consoling fantasies and embracing instead the very stuff of life that will destroy you.”

“The highest skill lies in the realization of selflessness,” said Atisha (Bengali monk, 980 CE). ‘The highest nobility lies in taming your own mind. The highest excellence lies in having the attitude that seeks to help others. The highest precept is continual mindfulness. The highest remedy lies in understanding the intrinsic transcendence of everything. The highest mystic realization lies in lessening and transmuting the passions. The highest charity lies in nonattachment. The highest morality lies in having a peaceful mind. The highest tolerance lies in humility. The highest effort lies in abandoning attachment to works. The highest meditation lies in the mind without claims. The highest wisdom lies in not grasping anything as being what it appears to be.”

Ch.12 A Relational Home

Suffering! Its reality permeates our lives, shadowing the good times and insinuating itself into everything. Trauma is a basic fact of life, according to the Buddha. It is not just an occasional thing that happens only to some people; it is there all the time. Things are always slipping away. Although there are occasions when it is more pronounced and awful and occasions when it is actually horrific, trauma does not just happen to a few unlucky people. It is the bedrock of our biology. Churning, chaotic, and unpredictable, our lives are stretched across a tenuous canvas. Much of our energy goes into resisting this fragility, yet it is there nonetheless.

Suffering is part and parcel of human existence. It is in all of us, in one form or another. The choice we have is how to relate to it. We can try to avoid it or we can use it as grist for the mill.

The key, taught the Buddha, lies in not taking trauma personally. When it is seen as a natural reflection of the chaotic universe of which we are a part, it loses its edge and can become a deeper object of mindfulness. In the famous stories of Kisagotami and Patacara (two women traumatized by the death of a loved one that the Buddha consoled), victims of what we would call unspeakable traumas, this was the Buddha’s first intervention. “You thought that you alone had lost a son. The law of death is that among all living creatures there is no permanence,” he told Kisagotami. “It is not only today that you have met with calamity and disaster,” he cautioned Patacara, “but throughout this beginningless round of existence, weeping over the loss of sons and others dear to you, you have shed more tears than the waters of the four oceans.” You think the suffering is your suffering, taught the Buddha, but all suffering is one. This does not mean that it stops being painful, but, like the splinter in his foot, it becomes an inevitable consequence of a human embodiment.

The most important thing we can do about suffering is to acknowledge it. Simply acknowledging it, while seeming like a minor adjustment, i— actually huge. A friend of mine told me how, when his mother died when he was five years old, his father told him one morning that she was gone and would not be coming back and then never talked about her again. While extreme, this response is emblematic of our natural instincts. We would like to pretend that everything is okay, that death does not touch us, that we are not possessed by primitive agonies whose origins are murky at best, that we are somehow immune from the unbearable embeddedness of existence. But trauma is part of our definition as human beings. It is inextricably woven into the fabric of our lives. No one can escape it. Acknowledging it, as the Realistic View encourages us to do, brings us closer to the incomprehensibility reality of our own deaths. As far as death is concerned, the way our is most definitely through.

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