Laurence Gonzales knows the world of survival—the stories, the science, the survivors themselves—as well as anyone alive today. His latest book, Surviving Survival (W.W. Norton), tells the stories of people who've been through hell, how it affected them, and how they came back. (Click here to read an excerpt from the book).
Everyone loves survival stories. There's nothing more extreme—and there are no higher stakes—than someone almost losing their life. But it seems that the aftermath for the survivor can be very different than we'd imagine. Rather than a feeling of euphoria and triumph, there's something more serious, even alienating, about it. What is that?
Major trauma physically rewires the brain. One person goes into the survival situation, and a different person comes out. This isn't metaphorical. It represents real physical changes, the creation of new proteins in the brain and new synapses. So coming back from trauma, you see things differently, you feel different, even your relatives and loved ones appear a bit strange. Your friends may tell you to snap out of it, but you can't. You have to get to know your environment all over again. It's not a simple process, but it's a natural process. You are not crazy! It's very real. This book is about how that works in the brain and how you can cope with it.
Is that sense of alienation the same as PTSD? Is it a physical or psychological effect? Or both?
As I mentioned, it is a real physical change. And psychology--which is coming to be an almost outmoded word due to advances in neuroscience--grows out of the physical stuff of which we're made, the brain and body. But that sense of alienation can be part of a host of responses that are known as Post Traumatic Stress Disorder. What we're learning is that it's not a disorder. It's a very natural reaction. It's what animals do when you expose them to trauma.
What—and who—makes a good long-term survivor? Is it your attitude, your personality, your preparation? Or is it all of the above?
Definitely all of the above. And you can change all three. You can eliminate some of the effects of surprise by learning that yes, life is going to whack you at some point. You can develop a personality that meets adversity with the idea that you can make the most of it. You can do something about it, and do something with it. And you can prepare by constantly learning new things--skills, hobbies, disciplines, languages, almost anything. A learning brain is a resilient brain. After all, why have a brain if not to learn? The brain really doesn't do anything else. In fact, the relentless learning is what bedevils us in the wake of trauma. The brain can't forget, so you teach it to cope. And coping means doing.
What can people do to recover from trauma more successfully?
Richard Mollica is a psychiatrist at Harvard who specializes in recovery from trauma. And his mantra is, "Work, work, work." Find that activity that will put your brain in a state of calm. For one of the people I write about in Surviving Survial, it's knitting. For a World War II veteran with bad PTSD, it was golf. For a woman suffering from cancer, it was learning Hindi, a very difficult task for the Western brain, but that very difficulty took her out of her suffering. Find something that works for you and pursue it with passion.
Is there a difference between being attacked—say by an animal, or another person—and getting into a natural predicament such as an avalanche or getting wedged into a canyon, like Aron Ralston? Is surviving violence different from surviving an accident?
Where the brain is concerned, all of these events are pretty similar and the differences become matters of degree. For a human to be attacked by a human is a very powerful stressor, because it violates so many of our assumptions about the world. But having your arm nearly torn off by a shark is right up there on the stress meter. So I would have to say that you can treat all of these traumas in much the same way. You just have to have respect for the notion that attacks by living creatures, especially people, rate very high on the scale of trauma.
What goes on in the brain that makes us keep suffering after the event is over? Wouldn't it make more sense in terms of evolution if we could just forget it and get on with our lives?
Think of Pavlov's dog. Pavlov rang a bell and then fed the dog, so the dog learned to salivate when Pavlov rang a bell, even if no food was forthcoming. What do bells have to do with food? Nothing. But that's how our brains work. In Surviving Survival, I write about a woman who is attacked by a bear. Shortly before the attack, she sits down to rest and breaks some pine needles to smell, because pine is one of her favorite smells. After the attack, the smell of pine sends her into a panic attack. She can't stand the smell of pine. The brain is constantly making these nonsensical associations, because statistically, over millions of years, that tended to keep us alive longer. It was a simple system to get you running away from a predator. The fact that it was often wrong didn't matter. Better to run away and not need to than to need to and not run away. And this evolutionary process doesn't care if you're unhappy. It cares only if you live long enough to reproduce. Then the trait is passed on, and that's what we have today: Lasting misery following trauma to make us paranoid enough to survive.
What's it like to have a flashback? Is it all that bad, or is it just that you're remembering the trauma? Why can't you just think about something else?
A true flashback is an all-out assault of the emotional system that takes control of your senses and your behavior and can wipe your memory clean. One Vietnam vet returned home and then came out of a flashback standing in a forest in Ohio wearing battle fatigues. He had no idea how he got there. Another vet was walking along a street in Boston and came out of a flashback in a motel room in Texas. In the book I wrote about Micki Glenn, who was attacked by a shark and nearly killed. Her experiences were virtually identical to those of the Vietnam vets. She was sitting in a restaurant waiting to pick up a pizza when she found herself curled up in a ball on the floorboard of her truck with no memory of how she got there.
In the book you talk about a phenomenon called "extinguishing" that can help get rid of some of these associations. What's that about?
Not long after the shark attack, Micki was watching a James Bond film when a shark appeared on the screen in close-up. She completely flipped out, blubbering and running around like mad. She completely came unglued. Her husband happened to have taken a photograph of the shark that attacked her, and he now put it on her computer as a screen saver. At first Micki would come into her study and freak out. But after repeated exposures, she simply built a new set of associations with the image of a shark. She no longer felt that she was being attacked. The shark melted into the background of her life. That's what "extinguishing" means.
You recommend taking up a goal-oriented hobby or activity that is systematic and patterned. In particular, you talk about a woman whose life was ruined when her five-year-old daughter died, and she said that learning to knit saved her life. How does that work?
In order to answer that question, I need to tell you a little bit about how the brain works. And to do that, I'll use the example of a cat. A regular house cat. Suppose you step on your cat's tail. We all know what happens. The cat screams and struggles and fights and bares its teeth and claws. Why does that happen? It happens because of a circuit in the brain called The Rage Circuit. All animals have it. But the cat can engage in another activity that is familiar: Stalking. When a cat is stalking prey, it must be methodical, quiet, and goal-oriented. It has to take things step by step and be very careful. This behavior is mediated by the so-called Seeking Circuit. It turns out that those two circuits use some of the same areas of the brain and cannot function at the same time. If you are stalking, you cannot be in a rage. If you are in a rage, you cannot be stalking. Trauma causes the rage circuit to go off over and over, giving you what we know as PTSD. But in humans, many activities can activate the Seeking Circuit. They are activities that, like actual stalking, are methodical, step-by-step, and goal-oriented. Knitting is one of those activities. Sports, music, languages fall into that category, too. That's why I say to find something that works for you, that activates your seeking circuit, and pursue it with passion.
For more about Laurence Gonzales and his work, visit LaurenceGonzales.com.