I will not attempt to deny it in any way. This last year has been rough for most of us. Lately, to escape from the grim news and to practice some self-care, I have intentionally avoided any kind of entertainment that reminded me of loss, tragedy, mourning. I was doing quite well with my resolution until I stumbled across " "Pieces of a woman", a Netflix film from Hungarian director Kornél Mundruczó starring Vanessa Kirby and Shia LaBeouf, produced by Martin Scorsese.
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I certainly knew what the plot of "Pieces of a Woman" was about , but nevertheless I decided to watch it, despite my resolutions. It is the story of a couple, Martha and Sean, whose baby dies shortly after a home birth. Please, if you have not seen the movie yet and/or hate spoilers, do not go further and come back at a later time!
Let me be quite frank: it is excruciatingly painful. The viewers find themselves nearly breathless from the beginning of the movie . We are quickly led to a 24 minutes single take scene which follows the labour from the first contractions to the tragedy. We watch with anguish and horror the signs of birth going atrociously wrong , we cannot help shouting "Why, why aren't they calling 911 right now??", we finally hear the crying of the baby and the joy of the parents.. and then we hear the silence, that cry fading away, the ambulance arriving too late. It comes really close to torture for the viewers. I personally was in physical pain. And I wondered "why am I doing this to myself??".
But all in all, I am grateful for this movie.
I am grateful for Vanessa Kirby's performance and portrayal of a woman who has been shattered into pieces. As a woman and as a mother, I can hardly imagine anything worse: a woman who holds her full-term baby born, hears her crying and then loses her after a few minutes. It is Trauma with a capital T. And this is what I found the most interesting about this movie, how it led me to many reflections on Trauma and the beliefs and expectations people inevitably hold on trauma survivors.
For someone who has experienced a great loss and is completely involved in processing grief and mourning, there is an added stress factor: having to interact with others. Partners, parents, colleagues, friends. Each of them will unconsciously have a scheme of how the trauma survivor should react, what they should be doing to survive and eventually overcome the pain. To put it simple, they have expectations which often prove to be inflexible and unhelpful. Although their intention is to be supportive, they can cause even more feelings of pain and alienation to the trauma survivor.
This is portrayed so well in the movie. Martha does not want a funeral for the baby, she does not want to sue the midwife, she does not cry, she does not overtly show her pain. She probably never talks about her grief to anyone, she wants to clear the nursery up, at a superficial level it may look like she has removed the painful memory from her mind and just wants to get on with her life. All of the above causes disbelief and worry in her mother, a holocaust survivor, who has a pretty clear idea of how her daughter should face her loss.
On the other hand, her partner witnesses her becoming every day more inaccessible, their pain which is likely to be so similar is impossible to be shared with one another. While he expresses his pain outwards, with aggression, she withdraws. They both try to fill that emptiness by having sex together, and eventually with casual partners, but it does not work and it pushes them even more apart. This is what Trauma does to relationships, what it does to individuals: it isolates them, it creates a void that sucks them in, with the risk of becoming completely cut-off.
And from the outside we are left wondering: why do trauma survivors seem to be at war with themselves? Why do they push their beloved ones away? Most of us have probably cared for someone who has been traumatised by a tragedy or a loss and most likely we have realised how hard and frustrating it can be to reach them. How can we help? How can we let them know they are not alone?
It may be good to slow down a minute and think about the meaning of trauma. What do we mean when we say "trauma"?
The definition of trauma by the DSM IV TR (Diagnostic and Statistic Manual of Mental Disorders) is: " direct personal experience of an event that involves actual or threatened death or serious injury; threat to one's physical integrity, witnessing an event that involves the above experience, learning about unexpected or violent death, serious harm, or threat of death, or injury experienced by a family member or close associate. "
According to Wikipedia, Psychological trauma is the "damage to a person's mind as a result of one or more distressing events which caused overwhelming amounts of stress that exceeded the person's ability to cope or integrate the emotions involved". While I personally do not 100% agree with the word "damage" as it sounds irrecoverable, I think the key part of this definition is " exceeded the person's ability to cope or integrate the emotions involved".
We often talk about trauma when- at least temporarily- our mind and body feels too overwhelmed to cope and process the painful emotions triggered by the traumatising event. As a result, part of these emotions are not integrated in our experience. Often they are very hard to identify. The trauma survivor does not recognise herself anymore, there is an alienation from the self. Emotions are compartmentalised, on a superficial level the person's functioning appears to be normal (day to day routine, work, habits) but what prevails is a shattering feeling of numbness. In a way it is like their mind has frozen to avoid having to cope with the emotions attached to the loss.
There seems to be a fault in the memory system; somehow the memories of the traumatic event are split into fragments, into pictures and body sensations.
Unprocessed emotions can get trapped in the body causing physical symptoms and a vulnerability to illnesses, both physical and psychological.
We can find some interesting explanations in the "Structural Dissociation Model" of van der Hart, Nijenius and Steele (2004) which contends that the division of the brain in two separate hemispheres facilitates left-bright brain disconnection when we are under threat (Fisher, 2017). They hypothesized that the disconnected left side of the brain orients the individual towards the daily functioning, the achievement of tasks, while the right side of the brain keeps the person in a survival mode, fight/flight or freeze. These two sides of the personality may be in conflict and flip from one to to the other in trauma survivors without integration.
As a result, because of the non integration of the two "brains" and unawareness of feelings of sadness, anger, fear despair, trauma survivors may struggle to recognise that they may need support and reach out for help.
While all the above may be true, it is also very important to bear in mind that trauma does not necessarily cause long-lasting concerning responses.
Pieces of a Woman underlines how a deeply traumatic event may trigger reactions that considerably differ from individual to individual. There is not one way to survive trauma and to process it. As I mentioned earlier, it may look like Martha is not processing her loss in the "right" way and her behaviour, the absence of overt display of grief may baffle her family. We see her going to the office three weeks after her loss, attending work parties, avoiding talking with her family and oddly sniffing and compulsively buying apples.
Towards the end of the movie - for me the most touching moment of the film- we understand that she tries to find the smell of her baby in every apple because in the short moments spent with her, one of the very few memories she holds of her girl is how her baby smelled for her: of apples. And her collection of apples seeds has a deep meaning: she wants to sprout them. Her coping strategy, at least at that phase of the mourning, is to try to grow apples and maybe reconnect with that smell again.
A key factor in psychological trauma is time. As for pretty much all psychological difficulties and disorders, times plays a crucial role in differentiating "normal" reactions from concerning responses. How long does the self-alienation and numbness last? How long does the apathy persist?
It takes time to integrate those painful emotions into the personality and until that starts to happen, the trauma survivor cannot really move on and heal.
To go back to my initial question. How do we help and understand trauma survivors? There is no simple answer. Some may display lasting symptoms which can be only addressed with psychological therapy and in some cases psychiatric help and medication. Others may just require their space and time to go through the different steps of grief in their own terms and at their own pace. Indeed, Martha needed to find her own coping strategies, some of which may have looked dysfunctional and inappropriate. She needed space from her ex partner and family and eventually, she needed to finally see her baby's pictures to be able to start the journey of healing. According to trauma expert Janina Fisher, everything changes when trauma survivors clients can move from a phase of self-alienation and disconnection to self-compassion, when the hurt, lonely and lost parts are accepted and cared for.
Supporting beloved ones who have been victims of trauma is one of the hardest tasks we are called upon to carry out in our life. It can cause feelings of hopelessness and despair in the whole family system.
While reaching and encouraging trauma survivors is essential in order for them to feel they are contained by safe relationships and deep connections, it is also critical to remind ourselves of the importance of being patient and flexible in our expectations of the trauma survivor's behaviours, pace, emotional reactions and coping strategies.
After all, all trauma responses are to be seen as an attempt of adaptation to the new reality.
Therapy can definitely help unlocking unprocessed emotions so that they are not trapped anymore, stopping causing illnesses to the mind and body.
Like the bridge that is eventually built in Boston in one of the last scenes of Pieces of a Woman, therapy can help build the bridge between those left and right brain modes, letting the healing begin.