Last week, we made a start with a review of Viktor Frankl’s ‘Man’s Search For Meaning’ and discussed what was dealt with in Part 1 of the book. Different aspects of finding meaning are the topic of Part 2 of the book, where logotherapy is discussed in a nutshell.

Logotherapy is sometimes called the Third Viennese School of Psychotherapy. Where Sigmund Freud focused on ‘the will to pleasure’ (psychoanalysis) and Alfred Adler on ‘the will to power’ (individual psychology), Viktor Frankl focused on ‘the will to  meaning’ (logotherapy), as meaning in life turns out to be the primary motivational force for most people. This is also what the increasingly mainstream concept of Positive Health notices. Of its six dimensions (Bodily Functions, Mental Functions & Perceptions, Spiritual Dimension, Quality of life, Social & Societal Participation, and Daily Functioning) the spiritual aspects turn out to be most often mentioned as what really matters. People can have chronic health issues, but as long as those are fairly well dealt with and they have meaning and purpose in life, they generally consider themselves healthy. If physical health is overall good, but meaning is missing, people give much more despondent descriptions of how they are. The more meaning people can discern in their lives, the bigger the chances that health and happiness flow from that. Those are then not goals in themselves, but the consequence of having found meaning and purpose in life and of being able to contribute to something bigger than one’s own life. In Nietzsche’s words, quoted by Frankl: ‘He who has a why to live for, can bear almost any how’ (p.109, author’s italics).

Without such a sense of meaning, Frankl writes, people can experience ‘existential frustration’. Not feeling challenged, but bored and useless, is understandably hard, he maintains, and deserves attention, instead of medication:

Existential frustration is in itself neither pathological nor pathogenic. A man’s concern, even his despair, over the worthwhileness of life is an existential distress but by no means a mental disease. It may well be that interpreting the first in terms of the latter motivates a doctor to bury his patient’s existential despair under a heap of tranquilizing drugs (p.108, author’s italics).

In other words: healthcare providers should take the worries of their patients seriously when it comes to them not seeing enough or even any meaning in life anymore. Frankl sees three different layers of meaning in life: ‘1) by creating a work or doing a deed (work); 2) by experiencing something or encountering someone (love); and 3) by the attitude we take toward unavoidable suffering (mental strength)’ (p.115). The sense of meaninglessness, ‘resulting from a frustration of our existential needs which (…) has become a universal phenomenon in our industrial societies’ (p.141) can create an ‘existential vacuum’, often more widespread in places where spiritual, ceremonial, professional and familial traditions have gone lost. This can lead people ‘to do what other people do (conformism) or (…) what other people wish [them] to do (totalitarianism)’ (p.111).
Logotherapy’s aim is ‘neither teaching nor preaching’ (p.114), but to help people broaden their views and find their own meaning in life and thus the logotherapist ‘will never permit the patient to pass to the doctor the responsibility of judging’. A beautiful explanation is this one: ‘A painter tries to convey to us a picture of the world as he sees it; an ophthalmologist tries to enable us to see the world as it really is’ (p.114,115). Logotherapy encourages clients to find the potential meaning of their life and Frankl terms this ‘the self-transcendence of human existence’. Only when we can truly feel and see this, we will be able to reach self-actualisation, ‘as a side-effect of self-transcendence’ (p. 115). This especially applies to difficult circumstances, when things look hopeless.

For what then [when fate cannot be changed] matters is to bear witness to the uniquely human potential at its best, which is to transform a personal tragedy into a triumph, to turn one’s predicament into a human achievement. When we are no longer able to change a situation (…) we are challenged to change ourselves (p.116).

We are called upon, however, to relieve suffering if possible, because to ‘suffer unnecessarily is masochistic rather than heroic’ (p. 117). What is needed for this is to find the ‘super-meaning’, not ‘to endure the meaninglessness of life, but rather to bear [the] incapacity to grasp its unconditional meaningfulness in rational terms. Logos is deeper than logic’ (p.122, author’s italics).
We can never be fully free from difficult conditions, so true freedom, in Frankl’s view, is the ‘freedom to take a stand toward the conditions’ (p.132), a route towards self-determination. This is typically human, because: ‘Man is capable of changing the world for the better if possible, and of changing himself for the better if necessary’ (p.133). If meaninglessness drives us crazy, it merely proves our humanness, Frankl says. This ties in with a quote from Krishnamurti’s work: ‘It is no sign of health to be well-adjusted to a profoundly sick society.’  That is not to say it is always easy. We can, for many different reasons, fall prey to ‘give-up-itis’ (p.141), losing all hope because we no longer focus on the remaining meaningfulness of life. Thus, we may lose all ability to deal with the suffering.
There is, however, a ‘difference between being valuable in the sense of dignity and being valuable in the sense of usefulness’ (p.152). Bearing whatever fate with dignity means rising above and growing beyond ourselves and thus increasing peace and wellbeing in the world.

That is hopeful, indeed. Compassionately exploring with people who grieve and suffer, the things that still make their life worthwhile may support them in finding the way back to their purpose and happiness. Seeing all this so impressively well laid-out by someone with a history like Frankl’s, is a humbling read.

A little booklet it is, in its 2004 paperback version, but a crucial message it contains and so a classic it became. Originally, the book was written and published in 1946 with the title ‘Ein Psycholog erlebt das Konzentrationslager’ (‘A Psychologist Survives the Concentration Camp’) and then in 1978, with the English translation, it got its new title, that aptly summarises the book: how to find meaning in even the most ghastly plights.
Viktor Frankl was born in Vienna in 1905 and died there in 1997. He studied Medicine there, specialising in neurology and psychiatry. He focused on depression and suicide and the knowledge and insights this brought him, he took with him when he was deported first to Theresienstadt (1942) and later to Auschwitz and Dachau (1944). The book basically consists of two parts. Part 1 is an account of his stay and travails in the concentration camps and Part 2 is an explanation of ‘logotherapy’, the psychotherapeutic method he developed already before the Second World War, but that he meticulously described and practised post-war after his return to Vienna.

Logotherapy is sometimes called the ‘Theory of Meaning’, because at its core it deals with the question of how to find meaning (logos meaning ‘word’ or ‘meaning’), to remain resilient in the face of adversity and injustice. There may be many reasons to lose hope and faith, and one may be robbed of personal freedom, but there is one freedom, in Frankl’s view, that cannot be taken away from any person: the choice to decide how to respond to external circumstances. In the context of ACEs this is quite relevant, seeing that the essence of trauma is losing the connection to one’s true self. If there are ways to nurture that connection and remain authentic, it is important to share those with people who have (had) to go through dire circumstances.
At first, Frankl wanted to write the book anonymously, but he changed his mind and felt he had to ‘have the courage to state [his] convictions openly’ (p.20).

His first-hand description of the proceedings in the camps is impressive. Most readers will have something of a general knowledge about what these tragic places were like, but the clarity with which Frankl looks back at it, is admirable. Those circumstances were so dreadful that he writes one can hardly blame people ‘for trying to dope themselves’ (p.24), either with alcohol or by any other possible means.
He describes the phases people would go through upon entering the camp: shock (at first paired with painful emotions like longing, pity, horror, and disgust), apathy (emotional death, not caring anymore, an attempt at self-protection), and lastly the psychological response after liberation.
This third and last stage was difficult in the sense that joy had to be ‘relearned’: ‘The pressure which had been on [the prisoner’s] mind for years was released at last [and] his desire to speak was irresistible’ (p.96). Frankl describes this process as ‘from that war of nerves to mental peace’ again (p.97). Ideally this is done very slowly, step by step, so as to prevent ‘moral deformity’ in the form of revenge being taken and doing harm to (properties of) offenders.
We can see a parallel here with other kinds of trauma: feeling happy again, letting go of pain and loss, can be difficult, if those have been your developmental habitat for a lifetime.

The biggest part of the book, however, is focused on the second stage, that of apathy and how to either deal with or prevent it. Some people were able to achieve ‘spiritual life to deepen’ (p.47), Frankl writes:

They were able to retreat from their terrible surroundings to a life of inner riches and spiritual freedom. Only in this way can one explain the apparent paradox that some prisoners of a less hardy make-up often seemed to survive camp life better than did those of a robust nature (p.47).

He describes it as the ‘survival of the sensitive’. What under normal circumstances might be described as dissociation could under severe adversity be seen as identification with the riches of inner life by drawing on previous experiences such as love and joy and gratitude, humour and curiosity. All of this is what we could see as ‘the wisdom of trauma’, using the mind’s abilities to survive the unbearable present. It also means that the more abundant those previous positive experiences are, the greater the likelihood of people being able to draw on them, or, put differently, to manifest resilience. Frankl says: ‘An abnormal reaction to an abnormal situation is normal behavior’ (p.32). In line with this were prisoners’ efforts to disappear in the crowd, so as not to draw attention to themselves, whereas in normal life, people may love to be seen and recognised for their unique individuality. Tiny pockets of privacy and solitude were considered pure luxury, moments to connect to Self again (p.61).

Yet, humans are not merely the product of biopsychosocial factors, Frankl states, pointing to the emotional, spiritual dimension of mankind. Throughout all of life, ‘everything can be taken from a man, but one thing: the last of the human freedoms – to choose one’s attitude in any given set of circumstance, to choose one’s own way. (…) It is this spiritual freedom – which cannot be taken away – that makes life meaningful and purposeful’ (p.75,76). Remaining ‘brave, dignified and unselfish’ (p. 76) within the suffering, while nurturing hope and faith for better times to come, can give a deeper meaning to life. It can even lead a person to reach immense personal and spiritual growth.

Next week, we will discuss Part 2 of the book.

We recently read the book ‘Ikigai – The Japanese Secret to a Long and Happy Life’, written by Héctor García and Francesc Miralles. The term can be described in different ways: meaningfulness, ‘raison d’être’, the reason why you get out of bed in the morning.

It is an important theme, meaningfulness. When there is trauma or piercing loss, fearfulness and dark thoughts and feelings can take the upper hand in such a way that it becomes difficult to see the meaning of life. Sometimes it is good to carefully discover again what gives joy and which elements feel like a blessing for the body. With small steps you can then work towards a situation in which larger goals can also be given a place for daily motivation once more. Meaning also has a crucial place in the Positive Health-view. When people are asked about the six pillars of the spider web (bodily functions, mental well-being, meaningfulness, quality of life, participation, and daily functioning), ‘meaningfulness’ appears to be the most important component for many. We want to feel that we are making a meaningful contribution to a greater whole. This may not be the same topic for everyone, but we do share that need for meaningfulness. This book aims to provide more insight for such a salutogenetic approach, a view in which you do not avoid things so that you do not get sick, but in which you proactively seek out things that make you happy and give meaning to your existence.

After an introductory Chapter I, Chapter II follows with an overview of the little things that add up to make a big contribution to a long and happy life. Consider, for example, the Latin proverb “mens sana in corpore sano” – a healthy mind in a healthy body. An open, flexible attitude of mind helps you to keep feeling young, even as the body ages. One of the key points of trauma is that you lose an essential part of your flexibility when you have to structurally deploy your survival strategies. Stress promotes cell aging by weakening telomeres, cell structures that affect how cells regenerate and how they age (p. 23). You can lower the stress level of your life with the help of meditation, breathing exercises and yoga, for example. Ensuring sufficient exercise and sufficient sleep is also important to keep body and mind healthy.

Chapter III discusses how finding your ‘ikigai’, your purpose in life, helps you stay healthy. It opens with a pithy question from Austrian neurologist, psychiatrist, and former Auschwitz prisoner Viktor Frankl (1905-1997), who reportedly presented his patients with this dilemma: “Why don’t you kill yourself?” (p. 37). He saw this as a way to forcefully confront people with the fact that in most cases they did see aspects that made life worth living. Feelings of emptiness, frustration and fear, Frankl believed, usually stem from the deep need for a meaningful life. The chapter then provides a nice overview of the difference between psychoanalysis and Frankl’s logotherapy, the method in which patients are encouraged to consciously discover the meaning and purpose of their lives. That is helpful because then they can really do what suits their personal life destiny. Frankl makes a distinction between ‘being mentally ill’ and ‘experiencing spiritual suffering’ (p. 40): without meaning, the soul suffers. That is not a disease, but a logical consequence of an unfulfilled, inherent human need. The task for every human being is not to create meaning, but to discover the meaning that lies deep within us. By looking at situations in which we are deeply focused and ‘in flow’, where everything seems to go by itself, we can gain insight into that life purpose.

Chapters 5 through 8 provide the experiences of a group of very old people in Japan and how they look at what brought them here, what views, diets and physical exercises helped.
Chapter 9 discusses three concepts that indicate how a person, thing or organisation responds to adversity. When something happens and damage easily occurs, we speak of ‘fragility’. When something happens and it can be endured without weakening, we speak of ‘resilience’. And a third concept describes the situation in which violent influences or even damages occur and the person, thing or organisation does not become weaker, but rather stronger. We can then speak of ‘antifragility’ (p. 174). The book offers three strategies for becoming antifragile: create more options (with not one but several jobs or clients you are less dependent on one source of income), be careful in certain areas and take lots of small risks in others (small risks can bring big results without exposing ourselves to big dangers), get rid of things that make you fragile (don’t snack too much, pay off your debts, don’t spend time with toxic people) and also remember that every setback offers an opportunity for growth (p. 176-179). More on this concept, the authors say, can be found in Nassim Nicholas Taleb’s book ‘Antifragile’. Coincidentally, that book is also here – a small 500 finely printed pages thick. 😉

The epilogue summarizes the main points of the book:

1. Stay active; don’t retire.
2. Take it slow.
3. Don’t fill your stomach (but only 80%).
4. Surround yourself with good friends.
5. Get in shape for your next birthday.
6. Smile.
7. Reconnect with nature.
8. Give thanks.
9. Live in the moment.
10. Follow your ikigai.

This book offers great starting points to look for your life purpose. What seems to receive not so much attention is that in the case of early childhood trauma, the brain is ‘wired’ in such a way that the physiology makes all kinds of aspects of life (more) difficult. Few words are also devoted to the role social factors play in this. It is mainly focused on what you could do yourself within your own context. If you want to know more about that, this is a wonderfully handy, easy-to-read little reference work!

Last week, we posted Part 4 in this blog series and this week we finish the sequence by sharing our thoughts on the fifth part of the book, called ‘Pathways to Wholeness’. This part of the book is full of beautiful personal stories of healing. Again, Gabor does not elude his own difficulties in walking the healing path and from his explicit vulnerability, we can all gain courage: even when you have a lot of knowledge in your head, it can be quite a challenge to first hear and then follow the call of your heart.

Chapter 25 speaks about ‘healing’, how it is not a destination, but a direction, aimed ad “self-retrieval”, finding back the lost connections to ourselves. The authors make an important distinction between ‘being healed’ and ‘being cured’. If we are being cured, our physical issues have been dealt with and the disease is gone, whereas being healed is much more about finding wholeness and being at peace with everything inside us, our qualities, our possibilities, and “the truth of our lives” (p. 362, 363). Sometimes we ‘suffer ourselves into healing’, meaning that we first need serious setbacks before feeling the urgency of finding a way out of the darkness and step back into the light. In other instances, the healing process comes as a calling. Some people may feel that healing is attainable for everyone, except themselves, which only shows how deep the pain can be etched into your being.
Then again: “Anyone, no matter their history, can begin to hear wholeness beckoning, whether in a shout or whisper, and resolve to move in its direction. With the heart as a guide and the mind as a willing and curious partner, we follow whatever path most resonates with that call” (p. 373).

Chapter 26 deals with a number of healing principles, among which are four important qualities:
1. Authenticity: we fully accept ourselves and learn to notice when we stray from it.
2. Agency: we exercise “response ability” (p. 377), have choice and take control of our own healing.
3. Anger: we are able to feel and express healthy anger as “a boundary defense” to protect our integrity and equilibrium (p. 378, 379), and do not suppress or judge, nor nourish it.
4. Acceptance: we recognise that right now, things can only be as they are and “we endeavour to just be with it” (p. 381), which is very different from tolerating the untolerable (e.g injustice).

The chapter continues with five forms of compassion: human compassion, compassion of curiosity and understanding, of recognition, of truth, and of possibility, all with their own characteristics and foci. It also contains a quote from A.H. Almaas, often cited by Gabor: “Only when compassion is present, do people allow themselves to see the truth.” This is a very beautiful citation; it somehow invites all of us to listen with compassion, because the other person will have a hard time diving into their deepest insecurities and life questions, if we as a listener do not have compassion for whatever it is they might come up with.

Chapter 27 broaches a tough topic: disease as teacher, as an opportunity for learning and growth. Some people tell that their disease felt as a wake-up call: “Symptoms and illness are the body’s way of letting us know when we have strayed from that [authentic] core” (p. 393). Several cases of serious disease are discussed and the ways people dealt with them. Often, people somehow sensed that their ‘dis-ease’ was a factor in the genesis of their disease, but in general, both many healthcare providers and many lay people may find this a difficult topic to deal with. This chapter tells how some people are not cured, but healed nevertheless, dissolving the fragmentation felt earlier in their lives.

Chapter 28 provides a compassionate inquiry exercise, a way to learn an attitude of compassionately inquiring about yourself and the choices you make in life. Do they support your authenticity or do they stimulate self-hatred and pushing the body and its physiology across unhealthy boundaries? The exercise consists of answering six questions on a very regular, preferably daily basis. Part of the exercise, in fact, is the discipline of doing it regularly. I read this exercise a while ago and felt like starting, but initially postponed doing so, despite my conviction that it would, indeed, be truly helpful. It is about the stories we believe in and how they are “neither objective nor accurate, [but] always internally consistent with our behavior and our experience” (p. 418). These stories are learned very early in life and may stifle our authentic expression. The creativity in us must, however, be able to come out, “otherwise we may explode at the wrong places or become hopelessly hemmed in by frustrations” (p. 421).

Chapter 29 explains how we might work through these self-limiting stories that make us believe we are not enough. To achieve this, five processes are described: relabel, reattribute, refocus, revalue, and re-create. To do this may require self-discipline, courage, and determination. The authors see much potential in them, however: “The more you relabel, reattribute, refocus, and revalue, the freer you will be to re-create”, both in the sense of ‘creating anew’ and of ‘playfully relax’ (p. 429).

Chapter 30 acknowledges the fact that our healing journey will not always be smooth. Moving away from “I’m unworthy” and “I am defective” is hard, because convictions like these are stored in the body’s neurophysiology. This is where the approach of unhealthy beliefs and practices deserves a compassionate inquiry: “The question thus shifts from ‘How do I get rid of this?’ to ‘What is this for? Why is this here?’ (…,) to turn these [aspects] from foes to friends”, once we realise that they are there for a reason (p. 431). They helped us through the hard times and deserve our compassion. The whole chapter deals with all kinds of obstacles to healing and about the importance of becoming aware of them. Unhealthy beliefs arose for the purpose of harm reduction in the first place, despite the harm they may cause later on, when something triggers us (a very descriptive word for what truly happens).

Chapter 31 is a powerful, gripping story of Gabor’s personal experience with the use of psychedelics, and also about him always working to help others in their healing, but deep down inside believing that he himself was “beyond all hope of healing” (p. 371, Chapter 25) – an amazing story.

Chapter 32 elaborates on this experience of spirituality and what it taught him, part of which is the fact that, again, psychedelics show the mindbody unity: “what happens to the body reflects what is happening in the mind and the spirit” (p. 474). This spirit, which is aeons old, has mythical proportions and the authors state that being more open to myth, more in the sense of ‘mystical’, “as a fount of knowledge, a portal to spirit, and one of the fundaments of any healthy culture” would do our societies really well (p. 478).

Chapter 33, the last one, leaves us with a number of suggestions for how to create trauma-conscious societies, in medicine and the law as well as in education, so that “the adult community [can] hold space for the development of the young” (p. 491). This chapter is filled with intriguing thoughts and comments about the “malignant normality” of present practices and convictions and the way young people pay the price for this “toxic culture” (p. 495), created and maintained by “the barbarians of civilization”. In such a setting, “it is often individuals who defy conventional normality who are the healthy ones” (p. 496). This, once over, requires authenticity, the strength to stay true to one’s inner truths and to a purpose bigger than ourselves. The challenge the book ends with is to wake up and become aware of what has to be done: “Shedding toxic myths of disconnection from ourselves, from one another, and from the planet, we can bring what is normal and what is natural, bit by bit, closer together” (p. 497).

Quite a journey it was, reading this 500 page book from cover to cover. What a wealth of wisdom we have encountered in it! The authors masterfully and beautifully incorporate a plethora of topics in order to illustrate what needs to change if we truly aim to prevent and heal trauma and illness. It succeeds in offering a genuinely holistic approach and shows beyond any doubt that depoliticization of health does no justice to the influence of the biopsychosocial context we all grow up in. As much as we may try, we cannot be healthy on our own, walled off from those around us. Their joy and their pain are contagious to our neurophysiology, our interpersonal biology. That means that the more we succeed in nurturing healthy connection to ourselves and others, the more healed and healing we can become. “It is our most daunting challenge and greatest possibility.”

Last week, we shared the blog about Part III of ‘The Myth of Normal’; this week, we turn to Part IV, called ‘The Toxicities of Our Culture’.

Chapter 19 dives straight into the biopsychosocial aspect of who we are as human beings: we are enormously influenced by our context and suffer more the bigger the inequalities are, as they cause such a lot of stress. We can depoliticise health and make it an individual responsibility, but the fact of the matter is that political decisions have a huge impact on personal life circumstances and thus also on the stresses people have to deal with in relation to income (in)security, lack of control over their own lives, and dependence on jobs that bring no fulfilment only to pay (part of) the bills. Combined with stress physiology, these circumstances go “from society to cell” (p. 278), from public routines and institutions to personal lives and bodies. Capitalism, with all its pollution and unemployment, has arrived at a point “where everything is acceptable and no one is accountable” (p. 283).
The chapter ends with a definition of ‘alienation’ that deserves a full quote, despite its length, as it also has core characteristics of trauma: “It is the cry of men who feel themselves the victims of blind economic forces beyond their control. It’s the frustration of ordinary people excluded from the processes of decision-making. The feeling of despair and hopelessness that pervades people who feel with justification that they have no real say in shaping or determining their own destinies” (p. 285). What if we look at this definition from the perspective of children…?

Chapter 20 is about the impact of social disconnection and the illness that can but ensue because of the loneliness, stress, and immune suppression caused by it: truly “a public health crisis” (p. 293). The “social dislocation”, people finding “themselves cut off from autonomy, relatedness, trust, and meaning (…) is a potent source of mental dysfunction, despair, addictions, and physical illness” (p. 289). Seeing that humans are innately meaning-making creatures, a life with no meaning is bound to cause problems. Competition, as a driving societal force, causes us to strongly rely on how we perform in comparison to others, instead of on our authenticity. Because of our “need for belonging” (p. 292), our sense of feeling seen and heard and valued thus becomes highly conditional and fragile.

Chapter 21, again, contains a lot of societal criticism, this time about “sociopathy as a strategy”, as the chapter’s title calls it. It speaks about the difference between pleasure (‘This feels good, I want more’) and happiness (‘This feels good, I am contented and complete’) and how the yearning for pleasure feeds into addictions and the short-term satisfaction of dopamine rushes. Businesses (ab)use this the search for pleasure through “neuromarketing (…) a deliberate corporate conspiracy to hook people on addictive junk foods, with no regard for health consequences” (p. 299). This is not a theory, the authors state, but realism, primarily aimed at the vulnerable, among whom children. In this context, the term ‘Coca-colonization’ (p. 301) is used, a contemporary capitalist form of preying on certain groups. Many people thus get addicted on all kinds of substances, such as unhealthy foods, alcohol, and nicotine, that are not forbidden in the name of health, but often heavily taxed by the government and then cause illness that is often treated with medication. This is seemingly normal and often not frowned upon. Illness is still seen by many as a matter of ‘bad luck’. The addiction to medication (profiting pharmaceutical companies) concerns much larger numbers, however, than the addiction to opioids and the like. That last form of addiction, however, is most certainly condemned and those falling for it, in their effort to self-medicate, are heavily punished and stigmatised. The chapter then makes a comparison between characteristics of sociopaths and large corporations, arguing that the latter should be given that same label.

Chapter 22 and 23 discuss the dire consequences of the disadvantages certain classes and ‘races’ (some no longer want to use this word; see also p. 314) have to endure. Women are also routinely disadvantaged, their problems being compounded by their female sex added to race and class. This phenomenon can be called “biological embedding, (…) that our social environments and experiences (…) get under the skin early in life, shaping our biology and development” (p. 312). Another concept in this context is that of intersectionality, the idea that it is hard to clearly differentiate between certain factors as causal for hardship, because they are at play simultaneously, with the one often increasing the severity of the other. When you are constantly the target of ‘othering’, being treated as intrinsically different and alien, what may arise is an “assaulted sense of self” (p. 315), being defined by someone else’s negative ideas about you.

All these kinds of stressors and the way they get under the skin, are triggering for “inflammation-promoting genes” (p. 319), leading to a high allostatic load, toxifying the body and wearing it out. Different kinds of discrimination continuously trigger survival defenses, the basis of many diseases. This leads to much shorter life expectancies in the most underprivileged groups. Cited is anthropologist Ashley Montagu, who termed this “sociogenic brain damage”, with more recently a scientist calling poverty a “neurotoxin” (p. 326). All these factors are called social determinants of health (with a whole field of scientific study surrounding it, such as DOHaD, Developmental Origins of Health and Disease). A sobering example is given of how this would translate to healthcare advice. Instead of ‘Stop smoking’, practitioners would have to say ‘Don’t be poor’, ‘Don’t work in a stressful job’ or ‘Don’t live near a polluting factory’.

Chapter 23, on women as ‘shock absorbers’, adds another layer to all of this, namely patriarchy, bringing about toxic power dynamics. One effect is that women often resort to “self-silencing (…), the tendency to silence one’s thoughts and feelings to maintain safe relationships, particularly intimate relationships” (p. 333, 334). Anger building up inside, as expression would risk income or family security, in the long term leads to illness due to the never subsiding stress it causes. Women are often “the designated emotional caregivers” (p. 337), but they pay a price: it weakens their immune systems. There is still a huge male-oriented bias in many aspects of social life (wages, medicine, job positions). Men often feel very entitled, even to women’s care, which can have implications for children who may lose out on maternal attention. Women often decide to go along to get along, to “make sure everybody else is happy” (p. 340). This result of “toxic masculinity”, the authors say, such societal suppression of the feminine, is lethal, and in fact shows “male fragility” (p. 341, 342).
In this chapter, Gabor once again does not spare his own role within his marriage and family – a very brave way of showing the much needed vulnerability and accountability he advocates.

Chapter 24, the last of this part, deals with the way all of this seeps into our politics, with “the wounded electing the wounded, the traumatized leading the traumatized and inexorably, implementing policies that entrench traumatizing social conditions” (p. 344). The earlier described ‘social character’, a character that is very common and thus considered ‘normal’, is represented by politicians. The way they operate, maintaining established power patterns, leads to “toxic myths becom[ing] normalized truths” (p. 345). The authors refer to the way we build our worldview in the early years and how a closer examination of ‘troubled’ politicians shows that usually they did indeed have very troubled, traumatic childhoods, where harshness was not a stranger to the family dynamics. Once in power, these people often do not have much issue with creating their own reality: “there are plenty of congenial liars, but no congenital ones” (p. 350). This once again points to the fact that much of what we become later in life, is a consequence of how we were raised, whether in the early years our needs were met or not, and how we then may try to meet them after all, even if we will never succeed to obtain what we missed out on in the first place. Celebrating and encouraging such leaders and these leaders celebrating their own stern childhoods, the chapter says, is “a public celebration of trauma” (p. 352). These processes can also be recognised in the way other celebrities are pictured in the media and how they often portray themselves: “a fan base is the closest they can come to filling a life-long void of homegrown esteem” (p. 356). It can be hard to recognise this void as such, because we so want believe in the magic of their fame.

Next week, the final part of the book will be the topic of our blog. This Part V is called ‘Pathways to Wholeness’.