When the world won’t hold us
Written by Gabor Maté, MD
Published byPsychotherapy Networker
Last updated: 02/22/2023
Finding agency in the suffering
As the pandemic rages on, and we wrestle with the horrors of racial injustice, I’ve been hearing people say, “We’re all in this together.” But are we? “We’re all in this together” may be a call to action and awareness, but it’s not an accurate description of reality.
While it’s true that human beings are ultimately in this life together, it’s not true that we’re in it together in the same way. Clearly, while I’m sitting in my comfortable, leafy neighborhood in Vancouver, I’m not experiencing this situation in the same way as a person in San Francisco who’s living on the street, or someone in downtown Vancouver who’s struggling with a drug addiction. I’m not experiencing it the same way as somebody who’s stressed, burdened, isolated—all of which may be exacerbated right now.
We are our beginnings
A lot of us carry a great deal of anxiety that we usually cover up or distract ourselves from through work, relationships, going to the pub, watching sports, or exercising. Some of these are good things to do, but they can also function as a way of binding or diverting our anxieties.
Now that there are fewer of those options for coping, people’s anxieties are rising, and that’s showing up in their behavior. It’s important to remember that anxiety was not born of the COVID-19 pandemic. It was there before, and in almost every case it goes back to people’s earliest experiences. However we’re responding to this situation, whatever we’re experiencing these days—including panic, grief, inspiration, connection—is part of our beginnings.
How we perceive ourselves as being held by the world reflects how we were held in the beginning. Did our earliest caregivers have a presence of awareness, self-knowledge, attunement, and lack of stress? Right now, while the world may not be holding us in those qualities, we have an opportunity to feel into what it may have been like for us at the start—and to try to heal it for ourselves and for those around us.
Because of the crises facing us, some of us may be experiencing what D. W. Winnicott calls “primitive agony.” We have an opportunity to get in touch with this agony in the present, to see it for what it is, and to create the awareness around it that can hold it, so it doesn’t control us or drag us down.
I’ve struggled all my life not to fall into that well of sadness in multiple dysfunctional ways, and I’ve worked with many people at the edge of despair. But I’ve learned that, though we fight the well of sadness, we have no reason to be afraid of feeling it. It’s not an absolute void; there’s something in it, and it doesn’t have to swallow us whole.
I’ve spoken with the hockey player Theo Fleury, who was making millions playing for the New York Rangers in the NHL. He’s a 5-foot-6 guy in a land of giants, an effective scorer, and a tough man. He also drank and did drugs and almost destroyed his life. At one point, he was sitting with a gun in his mouth, ready to put an end to it all. But something shifted in him, and he surrendered—not to the suicidal urge, but to the sadness—and his life hasn’t been the same since. He’s now an author and motivational speaker on healing from trauma and addiction.
I have no idea how to do this kind of surrender. I can’t advise people about it. But I do know that if you surrender to your sadness, you’re not necessarily going to drown in it or be stuck in it for the rest of your life.
So what can we do about that primitive agony that’s ingrained in our nervous systems? We can notice that it’s there. We can allow it to be there. We don’t have to run away from it. We don’t have to turn on the TV set. Or if we do, let’s do it consciously, and say, “Right now, I’m so perturbed I need a break. I’m gonna watch the junk consciously and enjoy it.”
We have agency
As we consider all of this, let’s be conscious that suffering and trauma are not the same thing. Let’s not assume that we’ve all been or will be traumatized by the circumstances right now. Trauma is not the same as pain. Trauma is not the same as fear. Those are natural responses to events.
Trauma is when we get stuck around those events and their impact on us. Trauma, in some ways, is a resistance to grief. Genuine grieving is the opposite of trauma.
I do see a lot of burgeoning awareness in the world right now. The people out there who are marching, demonstrating, and taking action—or supporting those who do—they won’t necessarily be traumatized, because they’re responding actively to something painful, cruel, and very unjust. If you respond with that sense of agency, this will not have to be traumatic.
But if this time triggers a deeply held sense of helplessness and a primordial sense of isolation, then it can reinforce the trauma that already lives in us. So the first thing to realize is that—while it may not be accessible to all of us at all times—the capacity to act with a sense of agency is there.
The question for therapists is, how do we support our clients and the people who are relying on us? How do we support their capacity to choose? That depends on how we cultivate our own capacity to choose. When I train people in my Compassionate Inquiry model, it’s all about the self first. How do we inquire into ourselves, so that we can show up as active agents in our own lives when we deal with our clients?
In this way, we are all in this together.
Gabor Maté, MD, is the author of four bestselling books, including “When the Body Says No: Exploring the Stress-Disease Connection” and “In the Realm of Hungry Ghosts: Close Encounters with Addiction.”
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For nearly 50 years, the Psychotherapy Networker magazine has been celebrated for its incisive and heartfelt articles on the challenges of clinical practice, the therapeutic innovations shaping the field, and the extraordinary experience of being a therapist.
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