But chillingly, trauma has a second, even more covert mechanism. It can affect children and adults directly, as in primary trauma, or it can function vicariously, make a long, stealthy leap from one person's mind to another person's, across space and time. Secondary trauma, the vicarious sort; is a term used most often by psychotherapists, to refer to the fact that a person (such as a psychotherapist) can begin to show significant symptoms of post-traumatic stress disorder merely from hearing repeated stories about the traumatic experiences of other people (such as trauma patients). Secondary trauma quietly and pervasively occurs even in the lives of those who are not psychotherapists and who do not treat trauma patients, for the simple reason that, in a world where too many children have never even slept on a mattress, extreme human misery is not far removed from any of us.
In 1993, the International Federation of Red Cross and Red Crescent Societies stated in World Disaster Report that in the quarter century between 1967 and, 1991, disasters in various places around the world killed seven million people, and directly affected another three billion. In the same report, the Red Cross estimated that, between the end of World War II and 1991, about forty million people were killed in wars and conflicts, our perennial manmade disasters.
Indeed, viewed in cold objectivity, we are shell-shocked as an entire species.
If we travel a little away from the developed world, we find that more than one fifth of the global population still lives in extreme poverty, and life expectancy in some of the least-developed countries is forty-three years. At least one billion people now living on our planet suffer from chronic hunger, and a human child dies from malnutrition every four seconds. The World Health Organization reports that half of humanity still lacks regular access to the treatment of common diseases, and to the most basic medicines.
In terms of both space and time, we are not very far away from similar levels of human suffering, though we seldom reflect upon the fact. If the history of humanity is compared to an hour, the so called developed world is but a few seconds old. Many of our great-grandparents, and even some of our grandparents, spent most of their lives in conditions we would consider unbearable.
Commonplace horror is only two or three generations behind us, and in places, not behind us at all. The Holocaust is a living memory. Other projects of ethnic genocide are being pursued even as these words are written.
And most of us have heard the stories, usually while we were children, and usually from people we cared about. For some, the accounts were only of the walking-to-school-five-miles-through-the-snow variety. But for others, the stories were about surviving daily hunger, or a war, or a death camp.
One of the most poignant examples of secondary trauma that I have ever known involved a woman who had seen various therapists because of a vivid nightmare. This nightmare wrecked her sleep every night, leaving her chronically sleep-deprived and exhausted. Forty-four-year-old Magda was the granddaughter of a Polish physician, whose daughter, Magda's mother, had emigrated to the United States just after World War II. When she left Europe, Magda's mother was the only surviving member of a large family that had been decimated in the camps.
Magda's father was an American physician, whom her mother had met soon after her arrival here, while he was still a student. On account of her father, Magda's own childhood and adolescence, spent in an idyllic setting in western Massachusetts, had been financially privileged; and because of her mother, she had been a gently treated and obsessively watched-over child.
“Salon appointments were always the big thing. She always had my hair done, even when I was quite little."
As an adult, Magda kept her brown hair very long, and wore it invariably in an elaborate French braid.
When I asked Magda whether she had ever been traumatized, she replied, in wholly unaccented English, "No, of course not. Nothing like that." But somehow, even given her considerable intelligence and her distinguished forebears, Magda had not lived up to her family's ambitions for her. As a child, she had wanted to be a doctor, like her father and her legendary grandfather. Instead, he had dropped out of Harvard University in her junior year, and had spent more than two decades being haunted by her nightmare, suffering intermittently from major depression, and barely getting by as a nurse's aide.
"It's the story my mother told me," she explained, sallow-faced and sad, "except it's not my mother. It's me."
"It's you? You mean it's you in the dream?"
"Yes. It's what happened to my mother, only it's happening to me. Over and over again, every night."
"Your mother told you a story about what happened to her in the war?"
"Oh yes, many times. Always the same story, about the camp."
"How old were you when she first told you this story?"
"I don't know, really. I don't remember a time when I didn't know it. I must have been really little."
"And your dream is always the same?"
"Always the same. Always just as bad. I'm with a lot of people, in some kind of a long line. I'm naked, and I'm really, really cold. Someone shoves me down to the ground, and I see that they're taking away my mother and my father. I scream "Mother!' but someone kicks me hard. I wake up screaming. I wake up screaming every night."
"Is this exactly what your mother told you about what happened to her?"
"Yes, exactly. . . except, well, except that she was not a tiny child, and in my dream, I'm a tiny child."
"That's so terrifying. "When you wake up screaming from the dream, what do you do?"
"I get up and walk around my apartment. I turn on all the lights, and I touch things. I touch my big couch and the soft draperies. I touch the numbers on my kitchen phone, all like that. I need things to bring me back to the here and now, or something. The dream is so real. And after I've done that for a while, I think I start to get really numb. Not frightened by the dream anymore-instead I get, well, kind of feeling-less. I wake up on the couch a lot in the mornings."
Magda was tormented by this dream every night of her life, and our progress in therapy was extremely slow.
While she was still quite young, she had made a vow never to become a mother herself. During one session, when I asked her why, she answered without hesitation that the world was just too dangerous for children.
"But you live in New England," I said, "and World War II was so long ago."
"You're right, of course," she replied. But then she looked away, and stared in silence at an empty chair across the room.