Archives for : February2016

What I learned about PTSD from the University of Google

childineyeThe Urban Dictionary says that the “University of Google” refers to a major ignoramus who pretends to be an intellectual. Well, I decided to attend the University of Google for a few days to see what I could learn about PTSD. It’s pretty depressing. So-called reputable sites were the worst. There are a couple of interesting exceptions.

I looked at every site listed on the first three pages of my Google search “PTSD.” This was over the days February 18-22, 2016. The top sites changed every day (sometimes every hour), but not by much, and I included sites that paid to be listed first. Since I’ve done a lot of trauma searches with Google on my computer, my rankings were not quite the same as on my wife’s computer, my i-pad, and my school computer, which I rarely use. Google customizes (that is, markets) its information. Nevertheless, the overlap was considerable.

After a while, the sites started to sound the same. There were a couple of exceptions.

Wiki disappoints

Wikipedia’s entry on PTSD was disappointing. “Psychotherapy is the ‘gold standard’ of treatment for PTSD.” A promising start, but under psychotherapy Wiki includes prolonged exposure therapy (PE), cognitive behavioral therapy (CBT), and eye movement desensitization and reprocessing (EMDR). I expected more from Wiki; I’m not sure why.

Rats, mice, ecstasy, and dogs

A surprising number of sites reported on research with mice and rats, and several report the results of delivering electric shocks to people. In one, people with PTSD show heightened brain activity in areas thought to be associated with stress when shown pictures of frightened face when shocked and not shocked (that is, no difference), while people without PTSD show more anxiety when shocked. The significance of this is left unclear.

The same site, The Brain and Behavior Research Foundation, summarizes a study which shows that MDMA — also known as the rave drug Ecstasy — can treat symptoms of post-traumatic stress disorder in mice. At: https://bbrfoundation.org/ptsd?gclid=CIrI-YnshssCFclkhgodKkIKew. Don’t try this at home.

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What if Bessel van der Kolk is right about trauma?

B0000757Bessel van der Kolk (vdK) is probably the world’s most well known trauma theorist. I reviewed his recent book, The Body Keeps the Score, in an earlier post. Since then I’ve read more of his work and listened to him speak for hours (he is all over youtube). The best way I’ve figured out to think seriously about his work is to ask what difference it would make if he were right.

What he says

Asked about how he treats the victims of acute trauma, vdK says

Holding them, rocking them, giving them massages, calming their bodies down is a critical issue. I am probably the minority among my colleagues in that I am much more focused on bodily state than on articulating what’s going on. I think that words are not really the core issue here. It is the state of being, of tenseness, of arousal, and of numbing, and that people need to learn again to be safely in their bodies. (http://www.medscape.com/viewarticle/408691)

Think about this for a minute. One might expect a trauma therapist to say something like “I try to create a safe environment in which my patients can put words to unspeakable experiences. I try to help them remember an experience so they don’t have to constantly relive it.” This makes sense, for trauma is a disorder of time, in which the past is never past but is constantly intruding upon the present.

VdK would have no difficulty with the last sentence, and yet his treatment program (or rather programs) has little to do with the past, and everything to do with the present. Trauma is when the past colonizes the present. Its treatment depends on reappropriating the present, and one does that not through understanding the past, but coming to live in the present, and the best way to do this is to bring the body into the present.

Behind vdK’s approach is his view that PTSD and related traumatic disorders, particularly developmental trauma (childhood abuse and neglect), are disorders of the limbic system, one of the oldest parts of the brain, the one we share with all mammals. In the limbic system, threat is experienced as sensation, and the impulse to fight or flee. Threat turns into trauma when we can neither fight nor flee, when we are trapped, and the stress is turned against the self. Trauma is embedded in the body-mind, a single entity.

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Levinas, trauma, and God: Does Emmanuel Levinas idealize trauma?

IMG_1140,colorcurve,autocolor,crop2Emmanuel Levinas was an unlikely combination of Talmudic scholar and postmodern philosopher. Or at least he was adopted by postmoderns, such as Jacques Derrida, who wrote a book about him, Adieu to Emmanuel Levinas.

Levinas struggled with what a modern experience of God might actually be like. He ended up describing the experience in terms of trauma. The idea that an encounter with God is traumatic has a venerable history, going back to Moses, from whom God concealed His face, lest Moses be struck dead (Exodus 33.22). But Levinas is dealing with a postmodern God, whom we experience through an encounter with Infinity.

Cathy Caruth and trauma

An encounter with infinity is traumatic enough, and the terms in which Levinas describes this trauma come remarkably close to Cathy Caruth’s account of trauma. Caruth is probably the most influential figure in literary trauma theory today. For Caruth, the traumatic experience cannot be represented because it occurred before its recipient was prepared to know it. Or as Caruth puts it, deeply traumatic experiences are events without witnesses, experienced a moment too late, before the self was there to mediate it. As a result, the trauma remains unsymbolized, unintegrated into normal memory.

Unlike Freud, Caruth’s is not a developmental claim but a temporal one. Extreme trauma is inscribed upon an otherwise-mature subject who was not there, because the experience was so far beyond the normal it could not be prepared for, categorized, or shared. The traumatized, says Caruth,

carry an impossible history within them, or they become themselves the symptom of a history that they cannot entirely possess (p. 5).

In a sense, the traumatized are their trauma until they are able to integrate it, almost always with the help of another who hears what the traumatized are unable know.

Levinas

Levinas sounds remarkably like Caruth. For Levinas, the experience of the Infinite is traumatic because it slips into me before I am ready, “despite the taut weave of consciousness.” The experience of the infinite is “a trauma (traumatisme) that surprises me absolutely, always already passed in a past that was never present.” (1987, p. 75) The past was never present because it remains stuck in traumatic time, the past that occupies the present without being subject to it. If the past were subject to the present, it could be repressed.

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