Invisible Countries

Traveling with others through their stories of trauma

by Susan Palwick

In the medical world, the word trauma refers to very specific classes of life-threatening injury. The hospital where I volunteer isn’t a trauma center, which means that—except for a few rare cases where trauma patients arrive under their own power, and even rarer mass casualty incidents—we don’t see people who’ve been shot, stabbed, severely burned, or involved in serious auto accidents. If patients in those categories come to our ER, they’re stabilized and transported by ambulance or helicopter to a facility with the resources to help them.

But that doesn’t mean that we don’t see traumatized patients. It just means that their trauma is less immediate and less obvious.

In one sense, any ER visit is inherently traumatic. But when I use the word trauma as a spiritual-care volunteer, I’m speaking not simply of upsetting or painful events, but of those that threaten meaning and undo human connection. In my ten years of doing this work, I’ve become alert to two sentences that almost always signal the presence of such trauma.

“You really, really don’t want to hear this story.”
“You can’t understand if you haven’t been through it.”

I’ve heard both of these sentences more times than I can count. My response to the first is always, “Yes, I do want to hear it, if you want to tell it. Listening is what I’m here for.” My response to the second is, “I know I can’t understand, but I want to try. Will you tell me?”

Patients who speak these sentences—who admit to the presence of the unspeakable—are warning me. “You are standing at the border of a country I carry within me, one most people can’t see and would never want to visit. Here are terrors, demons, dragons. Proceed at your own risk.” But once I acknowledge the warning and signal my willingness to go forward anyway, they almost always tell me the story.

And the stories are terrible. I’ve heard tales of combat, assault, horrific abuse, unfathomable loss. I’ve listened to people still haunted by impossible choices they were forced to make years before, still suffering from them, often ill directly because of them. I’ve sat with middle-aged people with schizophrenia who describe decades of torture, nonstop ridicule from voices demanding that they die, voices no one else can hear. I’ve met patients so scarred by tragedy that they are convinced they must be cursed and that anyone who gets close to them will die.

I can’t understand what it is like to go through any of those experiences. All I can do is listen, stay quiet, contain my own emotional reaction so it doesn’t derail the story.

What I have come to believe, and what research on trauma demonstrates, is that telling the story often helps. Simply by choosing which words to use, the speaker exerts control and agency, despite having no control over the event when it happened. Trauma destroys, but storytelling is always creative; trauma threatens life and undoes meaning, but speaking the story reaffirms life and begins to seek meaning in pain. Traumatic events are always present and always internalized—think of the veteran who hears a car backfiring and is instantly transported back to the battlefield—but sharing the narrative with someone else externalizes it, putting it in a shared space where it can begin to be seen as part of the past. Trauma is invisible, isolating, incommunicable; the attempt to tell it makes it visible to at least one other person, however partially, and in doing so points to the hope of community.

The listener to a trauma story may not be able to understand what it felt like to live that story, but now someone else is standing on the road to the invisible country. Even if the terrain is too rough for this new companion to journey very far, the border is a little more open than it was when no one came alongside. I can’t fix what happened. The only healing I can offer is to serve in some small way as a reminder of the God who cannot spare us from suffering, but is always present with us through it.

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