thoughts from the inside 27: the dimension of trauma between event and structure

We have always known that what happens sets the table of reality's personal dimension of what appears to be real.

If reality doesn't need to be grasped since it already possesses the inconvenient characteristic of existing, what is real is a space and time (a space-time, as Einstein would say) inhabited without a perception of its physical dimension as classically understood.

The set of events that constitute what is commonly defined as reality is, in fact, as quantum physics teaches us, a more or less shared approximation of what is perceived. The 'more or less' does not depend on reality in and of itself, but on how each person perceives it, and, consequently, gives meaning to it.

Likewise, there is no single and absolute time, but rather several, which are the moments in which an interaction, whatever that interaction may be, develops.

Likewise, there is no single and absolute space, but several, to the extent that they indicate the correlation between bodies and events. 

By the same logic, there is no such thing as "the" emptyness, but rather an apparent lack of that something that is signaled and that we notice by its lacking.

Just as there is no single and absolute reality, what appears to be real is itself a dimension that everyone represents without actually knowing what they're talking about.

Quantum physics has always been fertile ground for me, offering wonderful metaphorical definitions and using it to navigate slippery terrain, including when talking about reality and the real.

In the first case, as Heisenberg (1) implied with his uncertainty principle, we can never objectively describe what we call 'reality'. At most, we can express probabilities of getting close to it, since motions and positions can never be defined simultaneously, and our mere observation of them is already a transformative movement.

In the second case, as Niels Bohr (2) wrote, "everything we call real is made up of things that cannot be considered real."

Carlo Rovelli (3) unites the images of these two instances, connects them, and frees them from the imperative of absoluteness: “The resulting image of reality is disconcerting. It is not supported by anything: every fact is only a fact relative to something else, and even the fact that a fact is relative to something is itself relative. None of this prevents us from describing the world from a perspective, our own. … We can also ask ourselves how we appear from someone else’s perspective. Nothing could be easier: just ask them. But it makes no sense to ask what the world is independently of a perspective… it teaches us nothing useful about the world, since we are a perspective.”

This lengthy introduction, with its fascination with the interrelational connection between physics and psychoanalysis, risks taking me elsewhere, but it seemed necessary to try to explain how the dimension of trauma is situated on a continuum between being an event and a structure.

Trauma, a term often used and abused, derives from the Greek "τραῦμα," literally "piercing," "perforation." Whatever the event, it pierces, perforates. 

It enters within: "trauma is not what happens to you, but what happens inside you as a response to what happens to you," as Gabor Maté writes (4).

It is within the body, in our internal world, that reality takes on the semblance of real and moves us from the unconscious into the steps that define the dimension of trauma. As Lara Sheehi so aptly explained in her recent essay (5), the healing process begins when the trauma can be recounted in its entirety, truthfully and without compromise. But when trauma is endless, its truth is never complete, just like a wound that is continually reopened. Then it emerges from the dimension of "event" to define itself as a dimension of "structure."

Systemic violence, protracted over time without any possibility of respite, makes it impossible to inhabit reality, since, in its systemic and continuous nature, violence does not allow a speakable truth to emerge. When the wound bleeds, it is not time for words; it is time for pain and tears. A time for a desperation that structurally transforms what appears real.

In its 2025 report on data collected in 2024, the War Child UK Alliance reveals that 96% of children living under siege in Palestine perceive their death as imminent, and nearly 50% have expressed a clear desire to die. 92% of them "cannot accept reality," 79% suffer from recurring nightmares, and 73% exhibit obvious symptoms of aggression, uncontrolled anger, and impulsive behavior.

The percentages we collected over 20 years ago (6) in Gaza and the West Bank have more than doubled.

When the context in which one lives is dominated by violence and systematic oppression aimed at the total annihilation of the individual, the marks, in addition to being indelible scars on the body, become excruciating wounds within the body. 

Therefore, not only marks "on" the body, but "in" the body. Sometimes invisible from the outside, terribly felt within.

It can be difficult for a westerner to make sense of what happens, but one can try to leave one's own perspective behind to question the perspective of others.

Let's take our body as a metaphorical ground, and imagine what happens in the case of a skiing accident. The fall may be severe without being devastating. In this case, the trauma caused by the fall will be limited, with only a few broken bones. A painful period of treatment will follow, the duration of which will be a direct reflection of the severity of the fall. This will be followed by a period of rehabilitation, physiotherapy, kinesiotherapy, and swimming, in which the suffering and duration will depend both on the traumatic nature of the fall and on the physical and bodily responsiveness of the person involved.

If the fall is not only severe but devastating, the trauma may be localized to a level of severity that allows for treatment, but will not be capable of achieving healing or recovering from the disabling nature of the trauma itself. A fracture of one of the upper vertebrae can cause quadriplegia. From a treatment perspective, there may be a recovery of many functions, but the disabling nature will not be overcome, which consequently becomes structural.

This doesn't only happen to the body. Some events produce trauma that remains in the state of the event and are therefore recoverable, albeit through a strenuous and painful process. Where traumatic events are repeated continuously over time and/or of such intensity, they can take on a structural form.

When trauma becomes structural, just as it does in the body, it will be possible to undergo a healing process that will at most reduce the damage, without allowing the structural form of individual existence to find any particular further steps.

In this second case, the dimension of trauma as structure is defined by its presentation as a condition of a loss, more or less partial, more or less complete, of the existential dimension of being able to exist.

This loss can have the same characteristics as a slow death, deferred over time, rooted in the no longer existing in everyday life, as in the profound desire to have the grace of no longer living, as Palestinian boys and girls describe.

When trauma becomes structural in the body, the capacity and possibility for self-determination on an existential level may no longer exist, and the person may, at that point, undergo a process that is more or less accelerated compared to the condition of slow death.

That is, they may progressively deprive themselves of vital sustenance, for example by radically diminishing their capacity to care for their own physical dimensions, whether through food deprivation, which is not anorexia, or a lack of hygiene and cleanliness, which is not a stumble in self-care: it is a radical doing without them when what is being done away with is the self.

Whether it's the population of Gaza or the West Bank, Sudan, or a refugee who has traveled the Balkan or Libyan routes, nothing amazes me more than how profound the point of resilience is, that is, the moment of rupture due to excessive existential torsion.

"Care of one's self" is an interesting expression, in which the disappearance of a part of it signals the dimension of the trauma, whether more on the side of the event or the structure.

If the preposition that functions as a specification is missing, the conditional dimension of a "care... self (perhaps)" remains. If the dimension of care is missing, a possibility of structure remains that speaks "... of the self." But if the self is missing, the "care of..." remains an open expression, essentially devoid of meaning and horizons.

What transference dynamics teach is that, in the face of pervasive anxiety, places, times, and spaces lacking meaning and horizon can be occupied by the caregiver, who in that moment takes the place of the subject of care, thus ousting that subject, simply to defend themselves from their own anguish at witnessing the slow death, the slow fading of a trauma-stricken existence.

In her book "Psychoanalysis under Occupation," Lara Sheehi recounts the story of M., a promising young writer who committed suicide by asphyxiation in 2017. It was his third attempt. In his short 22 years, the denial of life prospects linked to the Israeli siege of Gaza and M.'s father represented "a parallel process in which they replicate each other, each identifiable as a distinctly suffocating force."

Ahmed Abu-Tawahina, former director of the Gaza Mental Health Program, aptly expresses how the idea of ​​"trauma can make sense in Geneva, where there is security, stability, and routine." But due to an excess of distance, which Fanon would say denotes an implicit colonialist paternalism rather than a geographical dimension, westerners still struggle to fully understand how trauma, once it has become a structure, can superimpose the end of pain and anguish on the end of life, and how this is understandable for those who live a daily life of constant and infinite fear that their violent end might occur at their very next step.

In a context pervaded by violence and death, suicide appears to be something more profound than a simple acting-out, being at the same time both an act of desperation and suffering and the a radical attempt of "voluntary disobedience" from a devastating fate suffered by others.

It's not a matter of romanticizing, celebrating, or apologizing for suicide, but of meaning it by attempting to sense the profound power of experiencing it as an act of radical subjectivation that allows an escape from the yoke of siege, genocide, torture, or slavery.

As Baudrillard wrote (8), "against the senseless illusion of the living that they want to be alive to the exclusion of the dead, against the illusion of reducing life to an absolute surplus value by suppressing death, the indestructible logic of symbolic exchange reestablishes the equivalence of life and death."

To care for life, to bear witness to it, we must allow ourselves to grasp the discourse of dying, to recognize, through its grammar, its dignity.

Through the most radical act in existence, there is the enunciation of a speaking subject, a Lacanian subject of enunciation, a desiring self that cannot be silenced even when annihilated by life.

While in the case of M. the act is timely, in others it can be delayed, as it happened to S., a mature Afghan man who reaches Europe after a journey through violence and torture that leaves deep scars, visible even on his body. Having achieved the goal of being granted refugee status appears to have healed the scars. Well-groomed and proactive, he soon obtains a permanent employment contract. When the company moves to another city, he is fired for just cause, something incomprehensible to him: "The cause is just if I make mistakes."

This event, which may seem trivial in light of S. previous experiences, has an implicit meaning: the meaninglessness of behaviors endured without any justifiable cause. Thus, paranoid and persecutory experiences begin again, silently exploding when the house built for relatives back home is razed to the ground by an earthquake.

Silently, his internal world collapses, becoming dark and slow, and he stops washing. One day, he calls the operator asking to visit him at home. There, washed and dressed in his best clothes, he hands the operator his most precious personal belongings, asking to keep them, as he was about to kill himself. The operator calls an ambulance, which is followed by several hospitalizations in psychiatric facilities, and pharmacological treatment with antidepressant and antipsychotic drugs. Returning to the shelter, S. asks the operator, with childlike candor, "Why did you do this to me?" 

S. returned to a place he could recognize as shelter. He returned and had the space to speak out.

The act of encountering one another, of regaining a channel through which to seek meaning, becomes a fundamental space for providing care, a care based on small gestures, yet transcending the confines of the clinic, and presenting itself as a political space offering a glimmer of hope in which to recover the alienating exhilaration of the mirror; a liberated space, which must be vacated so that we can return to existing as individuals, as members of a community, as a people, as human beings. Recovery implies existence.

...

References:

1. Werner Karl Heisenberg, The Physical Principles of Quantum Theory, 1930

2. Niels Bohr, The Philosophical Writings, 1987

3. Carlo Rovelli, On the Equality of All Things, 2025

4. Gabor Maté, The Myth of Normality, 2023

5. Lara Sheehi, Psychoanalysis under Occupation, 2023

6. In early 2000, we collected the opinions of young men and women in Gaza and the West Bank: "The percentage of young men and women who declared they were permanently afraid of leaving their homes was close to 30%. Anxiety, phobias, and panic attacks were already widespread, over 50%. Then there was claustrophobia, difficulty sleeping and dreaming. Bedwetting. Full article: https://www.paolobrusa.it/2024/04/i-pensieri-del-dentro-19-una-garza-da.html 

7. Jean Baudrillard, Symbolic Exchange and Death, 1979