LITTLE EARTHQUAKES

A clinical psychologist moves through the stages of trauma recovery to make sense of her cancer diagnosis.

In the third trimester of her second pregnancy, at age 36, Mandel was diagnosed with metastatic breast cancer. In her debut book, she builds on the trauma narrative therapy she undertook following her against-all-odds recovery. The first section is a relatively linear account of her diagnosis, metastasis, labor and delivery, and treatment and success. Across the remaining sections, Mandel positions a literary microscope over certain inflection points, including the symbolic complexity of cancer in the breasts, the management of chemotherapy’s harsh side effects, the guilt of survival, and how her near death has affected her roles as wife, mother, daughter, and therapist. Throughout, her clinical background and specialty in trauma therapy shape her personal memoir into a sort of motivational tale for others working to understand and move past trauma. She offers insights about the adaptive nature of fear, pain, the desire for control, and the instinct to emotionally detach, and she discusses the benefits of practices like mindfulness and yoga. Both her recovery and her access to resources—financial, informational, medical, and human—make Mandel an outlier (privileges that she acknowledges), and a deeper probing of the depression that spurred her to narrative therapy is veiled by a consistent, sometimes grating note of optimism and triumph. Still, in attempting to find order and meaning in her own experiences of frailty and frustration, the author provides a salient example of how to untangle isolated traumatic events from ongoing suffering and worries. By the end, the validation and empowerment that she seeks jump from the page even as her narrative reaches the period of pandemic shutdown. Mandel includes a guide to narrative therapy and a list of resources for readers seeking further help.

Sometimes overly rosy but nevertheless an encouraging story of trauma and how it affects one’s understanding of self.