Inside the Dreaded Moment

by Dr. Selena Sermeno

“The doctor just biopsied the lymph nodes, and they are positive,” my twenty year-old daughter said, her voice eerily calm over the speaker phone. This gut punch came after months of swollen lymph nodes, odd symptoms, multiple doctors’ visits, and many emotional roller coasters. No matter how near I had lived to loss and to trauma, when it came to my only child, this news felt like the blow of all blows. 

I am a Salvadoran-born psychologist. I left my country at the onset of a long and brutal civil war. I know trauma personally and professionally. My own father was tragically, brutally, and unjustly taken by gang-related violence. My tiny country, tropical paradise and surfers’ heaven, earned the title of most violent country in the world just a few months ago. 

A great deal of my work has been with trauma survivors. Earlier in my career, I worked with recently diagnosed cancer patients. In the arch of my life, I have also worked through my own traumatic history. No matter how common tragic circumstances are on a global scale, we seldom have language to speak of or write about deep pain while we ourselves are actually feeling it, especially when such pain is of a traumatic nature. It is easier for the journalist to describe the collapse of an exhausted Syrian mother than for the mother to put into words her own traumatic experiences as they unfold.

There is a place in all of us not reachable by words. Science tells us trauma hits us at a non-verbal level on the first blow, and, therefore, we need the distancing effects of time and safe spaces to work through it. Within the acute experience of trauma, a wider, wiser perspective seems impossible. When I have found myself in such deep, dark moments, I have yearned for a flashlight—a beam in the form of those unafraid to witness my chaos or in the form of calming words from people who have gone through similar challenges before me. 

I like to think of God as a composite of the forces that intersect to form a safe haven to carry me at times when I feel lost and petrified.

I like to think of God as a composite of the forces that intersect to form a safe haven to carry me at times when I feel lost and petrified. The late Argentinian writer Maria Elena Walsh writes in the poem-song “Como La Cigarra- Like The Cicada” about the descent into the womb of terrifying, unimaginable experiences. While she never quite says it, she is speaking of the terror of survivors of the Argentinian dictatorship. Beautifully and poignantly, without gore or graphic detail, she speaks of the fact that life may “kill” us many times and that “many nights” will be spent in quiet desperation. She uses the metaphor of a cicada coming back to life and seeking the sun after a year underground. She speaks of how she must remember that when the shipwreck happens, someone or something has always brought her back to life. Her lyrics have given me the deep breath I have often needed to keep me from fainting.  

The best metaphor for dealing with my own frightening experiences is that of surrender into paradox. As my beloved teacher Parker Palmer teaches, it is the both/and of life that I must remember in these moments. The terror and the calm, the joy and the sorrow, the hope and the resignation—these parts of life are all true and can actually co-exist. I can survive their seemingly contradictory natures. 

Following my daughter’s surgery, I stood at a local pharmacy trying to select thank-you cards to give to those who had been supporting me. I was immediately struck by how the thank-you cards were placed next to the condolence and get-well cards. How ironic, paradoxical, and true that gratitude, fragility, and loss live together—not only at Walgreens but also in our hearts and experiences. 

There is something to our industrialized, rapid-paced culture that resists this paradox.

There is something to our industrialized, rapid-paced culture that resists this paradox. We often believe we must have absolute faith that all will be well. We beat ourselves up for not being faithful enough. To be doubtful or skeptical can be seen as a weakness rather than a humble not-knowing. 

“I want certainty not probability,” my own daughter said when in the midst of her despair. Even as she was told she would make a full recovery and had an excellent prognosis, she wanted 100% assurance. Who could blame her? I wanted certainty as well. 

I have learned a great deal from living out of my own heartbreak. Living the journey of traumatic loss and recently my own child’s diagnosis is quite different from teaching about it, researching the subject matter, or guiding others through it in one-hour sessions. I have always given myself wholeheartedly to my professional work. Yet, the humility, patience, and compassion needed for a deep connection have come more from my own dreaded moments, courageously explored, than from a Ph.D. 

In the moment my daughter cried out in search of certainty, I felt the same yearning, and I simultaneously felt gratitude that my relationship with her allowed for unedited vulnerability, for love and connection amidst uncertainty, and for hope in our not-knowing. I have found that we too often make failure out of the human condition, binding ourselves into feeling successful when beating the odds but feeling weak when giving into the unavoidable vulnerability of being alive. I fear that such attitudes minimize those who suffer in spite of their perseverance and efforts to change their circumstances. 

Science has grown in its understanding of trauma. Resilience can be deeply misunderstood. There is a high price to pay for survivorship, no matter how exemplary one’s healing appears. Post-traumatic growth or the idea that we can all grow after trauma is, of course, worth striving for, but we must also remember that eventually anyone can crumble in the face of pain and misfortune. Death, illness, or the accumulation of multiple traumas are not individual failures but rather elements of our collective experience as one human family. Resilience is not the psychological grit of an individual—it is rather a more subtle quality of presence cultivated in connection to life. Resilience is having a deep sense of hope and interconnectedness rather than stubborn optimism.

It is only in living within the paradox principle that we can discover and experience the company and power of deep spirit as we strive to work through our pain. It is in the agony of feeling abandoned and still hoping for a better day. It is in the moments of severe illness that we slow down enough to be cared for but still aim for health. It is in surrendering to the inevitable and often ongoing fight that we often find victory. 

In a matter of a day, my daughter accumulated a medical bill much higher than her college tuition. I was scared to sign up for a username and password on the insurance company’s website. And yet, I logged in, looked at the figure, and called the company. On the phone, something led me to tell the insurance agent who answered the phone that the figure felt like a second injury. I told her that it was hard enough to confront the fact that my daughter had a cancer diagnosis at 20. I shared this without blame. I said it with wholehearted honesty. The comment was not planned or thought out, but it was simply my most congruent response to my feeling of shock. The agent listened and found herself speechless. She said she was sorry and that at least she could help me understand how the insurance worked. There it was: another paradox. It is true that we need not pour our hearts out to strangers, and it is also true that sometimes we need to let ourselves be heard. It is true that kind words do not pay bills, but it is also true that when spoken, such words can sometimes soften the blow. 

By living inside the painful moments I have so often dreaded, I have found strength; I have caught my second wind; I have found champions of friendship and birthed myself into new families. It is inside these dreaded moments that I have found God in the form of my next breath and the ability to live fully present to what is unfolding within and around me.

This paradoxical living has not been possible without fearless companions. I have only been able descend into the depths of uncertainty because of the witnessing power of those who love me even when I feel that I have nothing left to give and that I will never be able to reciprocate their selfless generosity. 

When my daughter was recovering from her surgery, I washed her thick, long hair for the first time in 15 years. It was a tender and deeply intimate moment—one that would have been difficult to experience in its poignancy during healthier times. Though I was still trying to accept the diagnosis, as I lathered and rinsed her hair, I prayed and wished for her complete health. 

Living with this deep sense of paradox—frightened and hopeful, tired and wholeheartedly committed—has become my constant. In the end, I am humbly grateful for every heart courageous enough to come along with me, not only as I faithfully accompany my daughter but also as I step up to all that is and will inevitably be asked of me. §




Dr. Selena Sermeno is a bilingual psychologist, an organizational consultant, and a social science educator who has devoted her career to helping young people learn and grow from adversity.  She has worked with organizations worldwide, focusing on children, youth, and families in the most vulnerable of human conditions. Selena is a native of El Salvador, a resident of the Durango, Colorado community, and a global citizen.