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Little Earthquakes

Little Earthquakes

A Memoir
by Sarah Mandel 2023 288 pages
4.17
100+ ratings
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Key Takeaways

1. Trauma can shatter our sense of safety and identity

Like a hammer to glass, trauma shatters our previously held assumptions that the "world is basically safe," that "extremely bad things won't happen to me," and "I'll be able to cope with any problems that come my way."

Trauma disrupts our worldview. When we experience a traumatic event, it can completely upend our understanding of ourselves and the world around us. The beliefs and assumptions we once held about safety, justice, and our ability to handle challenges are called into question. This can lead to feelings of intense vulnerability, confusion, and a loss of meaning.

Identity is often destabilized. Trauma survivors may feel like strangers to themselves as they struggle to reconcile their pre-trauma identity with their new reality. This can manifest as:

  • Feeling disconnected from one's body
  • Difficulty recognizing oneself in the mirror
  • A sense that life has been divided into "before" and "after"
  • Questioning long-held beliefs and values

The process of rebuilding one's sense of self and safety after trauma is gradual. It requires patience, self-compassion, and often professional support to integrate the traumatic experience into a new understanding of oneself and the world.

2. The body's fight-flight-freeze response is a natural reaction to trauma

According to the fifth edition of The Diagnostic and Statistical Manual of Mental Disorders (DSM-V), psychological trauma involves an "exposure to actual or threatened death, serious injury, or sexual violence."

Our bodies are wired for survival. When faced with a threat, our nervous system automatically activates the fight-flight-freeze response. This involuntary physiological reaction prepares us to defend ourselves, escape danger, or, when neither is possible, enter a state of immobilization.

Key aspects of the fight-flight-freeze response include:

  • Increased heart rate and breathing
  • Heightened alertness and focus
  • Release of stress hormones like adrenaline and cortisol
  • Redirection of blood flow to major muscle groups
  • Suppression of non-essential functions like digestion

While this response is adaptive in the moment of trauma, problems can arise when it remains chronically activated long after the threat has passed. This can lead to symptoms of post-traumatic stress disorder (PTSD) such as hypervigilance, intrusive memories, and emotional numbing. Understanding that these reactions are normal biological responses, rather than personal failings, can be an important step in trauma recovery.

3. Cancer diagnosis and treatment can be a profoundly traumatic experience

I was now starting a new kind of life. The precancer days were forever gone.

A cancer diagnosis is life-altering. It thrusts a person into a world of uncertainty, fear, and physical suffering. The trauma of cancer extends beyond the initial shock of diagnosis to encompass the entire treatment journey and its aftermath.

Key aspects of cancer-related trauma may include:

  • Confronting mortality and existential fears
  • Loss of control over one's body and future
  • Physical pain and side effects of treatment
  • Changes in appearance and bodily functions
  • Disruption of roles and relationships
  • Financial stress and career impacts

The experience of cancer can shatter a person's sense of invulnerability and force a reevaluation of priorities and identity. Even after successful treatment, survivors may struggle with the fear of recurrence and the challenge of integrating their cancer experience into their life narrative. Recognizing cancer as a potential source of trauma can help patients and their loved ones better understand and address the psychological impacts of the disease.

4. Writing and storytelling can be powerful tools for processing trauma

Word by word, my story broke free from the haze of my traumatized mind.

Narrative therapy facilitates healing. Writing about traumatic experiences can help survivors make sense of what happened to them and integrate fragmented memories into a coherent story. This process of externalization allows individuals to gain some distance from their trauma and begin to see it as something that happened to them, rather than something that defines them.

Benefits of writing about trauma include:

  • Organizing chaotic thoughts and memories
  • Reducing the intensity of emotional reactions
  • Identifying patterns and gaining new insights
  • Reclaiming a sense of agency and control
  • Creating meaning from suffering

The act of sharing one's story, whether through writing, art, or verbal communication, can also help combat the isolation often experienced by trauma survivors. It provides an opportunity for validation and connection with others who may have had similar experiences. However, it's important to approach trauma writing with care and support, as revisiting painful memories can be emotionally challenging.

5. Physical movement and yoga can help reconnect mind and body after trauma

Yoga is my playground. I'm building up my calluses. Every time I practice yoga I experience novelty; I am learning something new, inching my body toward new boundaries, and taking risks.

Embodied practices promote healing. Trauma can lead to a profound disconnection from one's body, as survivors often dissociate to cope with overwhelming experiences. Gentle, mindful movement practices like yoga can help individuals safely reconnect with their physical sensations and emotions.

Key benefits of yoga and movement for trauma recovery:

  • Increased body awareness and interoception
  • Regulation of the nervous system
  • Release of tension and stored trauma
  • Cultivation of present-moment awareness
  • Building a sense of strength and agency
  • Creating new, positive associations with the body

The author's journey with yoga, particularly her experience learning headstands, illustrates how challenging physical practices can become metaphors for broader healing. By gradually confronting fear and instability in a controlled environment, trauma survivors can build confidence in their ability to handle difficult situations in other areas of life.

6. Relationships and community support are crucial for trauma recovery

Having a newborn can be an isolating experience. Fighting a life-threatening, physically debilitating, and energy-tapping illness can be an isolating experience. But I felt far from alone—I was cloaked in the warmth of my supportive community.

Connection fosters resilience. While trauma can shatter one's sense of safety and trust in others, supportive relationships are essential for healing. The presence of caring, empathetic individuals can provide a secure base from which survivors can gradually rebuild their sense of self and connection to the world.

Key aspects of relational healing in trauma recovery:

  • Emotional validation and acceptance
  • Practical support and assistance
  • Opportunities for positive social experiences
  • Counteracting isolation and loneliness
  • Modeling of healthy coping strategies
  • Restoration of trust in human goodness

The author's experience with her "meal train" and visits from friends illustrates how community support can provide both tangible aid and emotional nourishment during times of crisis. While professional help is often necessary for trauma recovery, the power of everyday acts of kindness and connection should not be underestimated.

7. Trauma recovery is an ongoing process of integration and meaning-making

Trauma recovery is an ongoing process, one that never reaches the equivalent of a storybook's "The End."

Healing is non-linear. Rather than a straightforward journey from illness to health, trauma recovery is often characterized by periods of progress interspersed with setbacks and new challenges. The goal is not to erase the trauma or return to one's pre-trauma self, but to integrate the experience into a new, more complex understanding of oneself and the world.

Key aspects of the ongoing recovery process:

  • Gradual reduction in the intensity of trauma symptoms
  • Development of new coping skills and resilience
  • Redefining one's identity and life narrative
  • Finding meaning or purpose in the traumatic experience
  • Navigating triggers and anniversary reactions
  • Balancing acknowledgment of ongoing vulnerability with hope for the future

The author's journey illustrates how trauma recovery continues long after the initial crisis has passed. Her ongoing negotiation of cancer treatments, relationships, and identity shows that healing is a dynamic process of growth and adaptation rather than a fixed destination.

8. Living with uncertainty is challenging but can lead to greater presence

I think of that dragonfly often. Like that dragonfly, I was not sure of my physical limitations. For a long while, it was a game of trial and error to find out which movements I could engage in safely while remaining pain-free.

Embracing the unknown fosters growth. Chronic illness and trauma force individuals to confront the fundamental uncertainty of life. While this can be deeply unsettling, learning to live with ambiguity can paradoxically lead to a greater appreciation for the present moment and a deeper sense of aliveness.

Strategies for coping with uncertainty:

  • Practicing mindfulness and present-moment awareness
  • Focusing on what can be controlled rather than what cannot
  • Cultivating flexibility and adaptability
  • Finding meaning and purpose beyond physical health
  • Celebrating small victories and moments of joy
  • Developing a tolerance for discomfort and imperfection

The author's metaphor of the dragonfly illustrates the delicate balance between accepting limitations and exploring new possibilities. By approaching life with curiosity and openness, even in the face of ongoing challenges, individuals can discover unexpected sources of strength and resilience.

9. Self-compassion is essential when coping with chronic illness

I can honor my body's reactions, my tears, my joy and gratitude for being alive, my fear of not being around for my kids. I have a chronic illness, one I will be fighting for the rest of my life. I'm up for the fight.

Kindness towards oneself facilitates healing. Chronic illness and trauma can lead to intense self-criticism and feelings of failure or inadequacy. Cultivating self-compassion – treating oneself with the same kindness and understanding one would offer a good friend – is crucial for long-term well-being and resilience.

Key aspects of self-compassion in chronic illness:

  • Acknowledging the difficulty of one's situation without self-pity
  • Recognizing the common humanity in suffering
  • Balancing acceptance of limitations with gentle encouragement
  • Allowing space for all emotions, including fear and anger
  • Celebrating small victories and moments of joy
  • Prioritizing self-care without guilt

The author's statement reflects a compassionate stance towards her ongoing struggle with cancer. By acknowledging both her fears and her determination to keep fighting, she demonstrates a balanced approach that honors the full spectrum of her experience. This self-compassionate attitude can serve as a model for others facing chronic health challenges or the aftermath of trauma.

Last updated:

Review Summary

4.17 out of 5
Average of 100+ ratings from Goodreads and Amazon.

Little Earthquakes receives mostly positive reviews, with an average rating of 4.19/5. Readers praise Mandel's raw and honest account of her cancer diagnosis while pregnant, finding her writing vulnerable and insightful. Many appreciate her perspective as both a patient and psychologist, noting the book's value for those dealing with trauma. Some readers found the narrative style challenging, but most were moved by Mandel's resilience and bravery. The memoir is described as heartbreaking yet inspiring, offering a unique blend of personal experience and professional expertise in processing trauma.

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About the Author

Sarah Mandel is a clinical psychologist and author who wrote "Little Earthquakes" based on her personal experience with stage-four metastatic breast cancer. Diagnosed at 36 while pregnant with her second child, Mandel uses her expertise in narrative therapy to process her own trauma. Her book explores the emotional journey of diagnosis, treatment, and recovery, offering insights into the psychological aspects of facing a life-threatening illness. Mandel's work as a trauma psychologist informs her writing, providing a unique perspective on coping with cancer. Despite her challenging diagnosis, Mandel responded well to treatment and was considered a "super responder," with clean scans after three months of treatment.

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