The Silent Scream

My continuing search for telltale characteristics of adult victims of infant surgery without anesthesia suggests two that are expressed in literature and art. These adults seem to live “a life of quiet desperation” as quoted from Thoreau’s Walden (1854) and descriptive of the person’s unconscious (nonverbal) dire expectancy of doom. The second relates to the painting “The Scream” by Edvard Munch. That was one victim’s description of her invariable reaction to stress; a silent scream. Others have endorsed this description as applying to their inner echo of perennial pain. I understand these two experiences as arising from the dissociated infant self, frozen in the trauma of surgical pain.

How Can You Treat The Trauma Of Infant Surgery ?
The processing of any trauma requires the processing of two memories, the verbal memory and the nonverbal. The verbal memory of infant surgery is a reconstruction of what-must-have-been, elicited by known facts, imagination, and guided imagery to form a narrative with beginning, middle, and end. The nonverbal memory is the body’s experience of survival instincts (startle, flight/fight, freeze, submission, and repair). The verbal memory must convey narrative truth but not necessarily historical truth. The nonverbal memory is known to the therapist as the instinctual trauma response, which is the same for all traumas at all ages. The narrative construction is assisted by guided imagery that develops a believable story of the traumatic event. The verbal story and nonverbal sensations are merged into a graphic narrative, which the patient draws. The therapist pins up the pictures and “re-presents” the story to the patient as the audience. This makes it possible for the person to experience closure and to finally regard the trauma as past tense and finished.

Louis Tinnin, MD