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Our daily interactions with one another make us vulnerable, more than we may typically be able to register. According to Crastnopol (2015) in Micro-trauma: A Psychoanalytic Understanding of Cumulative Psychic Injury, the subtlest and most banal of these interactions can add up without warning—unacknowledged, unnoticed, denied, dismissed, excused—and gradually leave wounds. This book is both a nuanced description of these sub-traumatic experiences and an argument for closer clinical attention to them in our clients' daily lives.
Crastnopol's intervention usefully builds on psychoanalytic conceptualizations of traumatic misattunement in childhood, in particular Khan's (1963) study of “cumulative trauma” in early childhood, although she also draws on her readings of Kris, Fairbairn, Winnicott, Sullivan, Laing, Kohut, Bromberg, Stern, and Mitchell. Crastnopol repeatedly makes the point that micro-traumas need not build on or refer back to traumatic experiences in childhood. Although cumulative injuries may indeed stem from the past, they can also begin to accumulate at any point in life without an early history, like the gradual onset of carpal tunnel syndrome after years of computer use in adulthood. Regardless of the etiology, Crastnopol further builds on Mitchell's (1984) “developmental tilt” to demonstrate that a clinician's attempt to make sense of the injury in only historical terms risks avoiding and even invalidating the pain in the present, repeating the injury.
In the following chapters, Crastnopol names seven examples of micro-traumas, elaborating each with reference to personal and professional anecdotes, fiction and poetry, and clinical case material. The first example is the micro-trauma of “unkind cutting back”—the precipitous but almost imperceptible, easily denied withdrawal of affection and attention. The person experiencing the withdrawal may find it very difficult to name the new distance, in particular in the context of family. Clinicians may cut back