Archives for : Reviews of trauma books

Literary theory is not trauma theory

Literary theory is not trauma theory.

It may come as a surprise to some, but trauma theory has become a leading analytic framework through which to analyze literary texts.  Of course, literary theorists can and should use any framework they find useful.  The problem is the confusion that has developed between literary trauma and psychic trauma.  Theories of psychic trauma derived from literature have been applied to real trauma in an attempt to make sense of the suffering of real people. The result is confusion and misunderstanding about how real trauma might be healed.  Trauma is healed through care and love, values that have no place in literary trauma theory.

My account of this phenomenon draws heavily on a book edited by Roger Kurtz, Trauma and Literature, a reader that Amazon markets as a textbook.  Offering few new ideas, the book represents the state of the discipline and its players.

Cathy Caruth, a major player, is a literary critic who, drawing on the work of the litterateur Paul de Man, has influenced many who have sought to understand trauma in real life.   Often overlooked is that Caruth’s claims are not just literary, but empirical.  They can be tested against real trauma.  I conclude with an example drawn from the testimony of Holocaust survivors.  Some of this testimony was given in 1946, some twenty-five years later.  The testimony given shortly after the liberation of the concentration camps was as narratively competent as that given a quarter-century later.  Knowing this makes a difference in how we use literary theory to understand psychic trauma.

What Caruth claims

Caruth argues that traumatic events are unavailable to the conscious memory of the traumatized in the normal form in which memory operates, as narratives about events.  Instead, trauma is experienced in terms of flashbacks, overwhelming feelings of anxiety, nightmares, physical tension, and physical illness.  Trauma is experienced in symptoms rather than stories.  These symptoms repeat themselves, as though the original trauma can never be put into the past. 

Trauma is experienced as symptoms because it is too intense, and generally too sudden, to be understood as though it were an ordinary experience.  Absent understanding, it can only be experienced and re-experienced, time after time. In this regard, trauma is like language, which according to poststructuralists, as they are called, claim that the signifier (the word) is always unable to properly designate the signified, that is the world.

For poststructuralists, there is a break between word and world; for trauma theorists, there is a break between word and wound . . . . For Caruth, the nonreferential quality of words and wounds renders the former appropriate for communicating the latter: “On this view, language succeeds in testifying to the traumatic horror only when the referential function of words begins to break down.” (Kurtz, p 100; internal quote from Leys, p 268)

Words can’t capture an overwhelming experience that lies beyond or beneath words.  The words that come closest are the tropes of literary fiction, representing absence, indirection, and repetition.  In both traumatized memory and narrative, lacunae serve as markers of traumatic experience (Kurtz, p 101). 

More recent criticism of Caruth et al.

What if literary critics spent less time on modernist and postmodern texts, such as Caruth’s writing on Resnais and Dorfman, or Shoshana Felman’s on Celan? (p 106).  Consider instead, says Stef Craps, Aminatta Forna’s Memory of Love, a realist trauma narrative.*

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Peter Levine goes further than Bessel van der Kolk on the importance of body memory

Peter LevinePeter Levine goes further than Bessel van der Kolk on the importance of body memory.

Peter Levine’s work on body memory of trauma has a devoted following.  His is a more practical, methodical, and focused version of Bessel van der Kolk’s speculations about trauma’s embeddedness in the body.  Van der Kolk wrote the forward to Levine’s Trauma and Memory: Brain and Body in a Search for the Living Past.  It reads,

For well over a century we have understood that the imprints of trauma are stored not as narratives about bad things that happened sometime in the past, but as physical sensations that are experienced as immediate life threats — right now. (loc 90)

Or as Levine puts it,

It is crucial to appreciate that emotional memories are experienced in the body as physical sensations. (p 22)

The practice

Levine works by observing the position and attitude of the body, seeing where the tension lies, and working on that body part almost like a physical therapist, helping it to relax.   “Expand” is his term. The difference is that Levine does this body work while talking with his patient about the trauma he or she experienced.  It’s a good idea: talk about your trauma while your therapist works on your body to help it relax.  In this way, psyche and soma and integrated.  In practice, it doesn’t work so well, primarily because Levine focuses entirely on trauma confined to a single event manifested in a particular bodily contraction, as he calls it. 

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Kandel, The disordered mind. Or was Descartes wrong?

Kandel, The disordered mind.  Or was Descartes wrong? 

It’s become almost commonplace today, at least among those impressed by the latest results of neuroscience, to say that Descartes got it backward.  Not “I think therefore I am,” but “I am therefore I think.” The mind is composed of body.  The brain makes mind possible.

This is the argument of Eric R. Kandel, author of The Disordered Mind and Nobel Prize winner for his research on memory storage in neurons.  The reader need not be intimidated.  Kandel clearly explains recent developments in neuroscience for the non-specialist.  He tries, but fails, to put together the neuroscience of the injured brain with the experience of emotional distress.  He knows one is incomplete without the other, he calls for a “new scientific humanism,” but all he ever says is that both brain and experience need to be taken into account.  Sometimes that’s enough, but about some experiences, such as PTSD, he cannot get out of the brain.    

I feel therefore I am

It’s absolutely true that brain makes mind, and yet this is not how we experience ourselves.  “I feel therefore I am” is probably the first and fundamental experience of self, and it would not be wrong to say that feeling is at least as body-based as it is mind-based.  The fundamental experience, or at least the experience that makes life worth living, is the feeling of being alive, filled with the vitality of existence.* 

Neuroscience doesn’t capture the feeling of being human.  It’s about neurochemical events responsible for this feeling, but it doesn’t capture the experience of being alive, sad, happy, depressed, in love, etc.  The question is how much this matters, and how the neurological explanation can be made useful without diminishing the experience of life.

Thus, we now know that psychiatric illnesses, like neurological disorders, arise from abnormalities in the brain. (p 41)

It’s not true, at least not when stated like this.  These “abnormalities,” which exist, may be the brain’s normal reaction to an abnormal environment. What goes on in the brain is caused by the environment we live in, not just autonomous neurochemical events in the brain itself.  Everything I experience changes my brain.  But that doesn’t mean that all, or even most, psychiatric diseases arise from abnormalities in the brain.  Some do, some don’t, and many are a mix.  Besides, the term “arise” is too vague. 

Kandel talks about PTSD at some length, and I’ll get to that shortly.  His treatment of the topic is disturbing, but the scope of the book is broader and worth considering. 

A “new scientific humanism”?

As research into the brain and mind advances, it appears increasingly likely that there are actually no profound differences between neurological and psychiatric illnesses and that as we understand them better more and more similarities will emerge. (p 43)

This convergence will contribute to the new, scientific humanism. (p 43)

I have only a scant idea of what Kandel means by “the new scientific humanism.”  It would have helped had he defined “humanism” to begin with.  I think he means that experience still matters, particularly one’s own experience of events such as depression.

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Judith Herman’s new book, Truth and Repair is disappointing

Judith Herman’s new book, Truth and Repair is disappointing

A review in the New York Times calls Judith Herman’s recently published Truth and Repair, “a beautiful, profound and important book.” (Kenneally)  In some ways that may be true.  What it’s not is a “blazing bookend” to Trauma and Recovery (1992).  Not only is this just about the silliest phrase I’ve ever read in a review, but it’s wrong.  Truth and Repair never deals with the internal changes necessary to overcome the wounds of trauma, above all the experiences of dissociation and the constant presence of the past.  The books between the bookends never touch.  The inner world of trauma is lost to reflections on tyranny, enlightenment, and justice. 

Recognition and justice, what truth and repair look like to Herman, may help the traumatized woman integrate her inner self.  But it’s also possible that this integration will remain superficial, social not psychological.  Social integration may drive psychological disintegration further underground.  Herman fails to address this complexity.   

Trauma isolates

Because trauma isolates and shames, says Herman, recovery must be social. 

If traumatic disorders are afflictions of the powerless, then empowerment must be a central principle of recovery. If trauma shames and isolates, then recovery must take place in community. These are the central therapeutic insights of my work. (p 7)

Tracing the recovery of survivors over time a large body of research has now documented facts that make intuitive sense: social support is a powerful predictor of good recovery, while social isolation is toxic. People cannot feel safe alone, and they cannot mourn and make meaning alone. (p 8)

Herman is concerned with only two types of trauma, the sexual abuse of children and the domination of women by force.  This is no criticism, and it allows her to see trauma as continuous with tyranny, and tyranny as continuous with patriarchy, the original tyranny.  But these are political categories, and while the trauma of sexual and marital abuse takes place in a political environment, its suffering is not necessarily resolved by rendering it social.  I worry when psychic trauma is seen from a political point of view.  Not because trauma isn’t political, but because a political point of view tends to treat the inside as a mirror of the outside. 

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Trauma is the disruption of the ability to maintain relationships. Psychoanalysis can help.

PsychoanalysisTrauma is the disruption of the ability to maintain relationships. Psychoanalysis can help. Stephen Mitchell tells how. Unfortunately, the cure takes time and money.  A lot of time and money.  Here I’m going to lay out what I think it would take, and roughly how it would work.  Those uninterested in psychoanalysis may be tempted to skip this post, but I think laying out an ideal, a utopian treatment plan, shows us how far we are from an ideal, as well as directing our next steps, even if the pathway is currently blocked for most people.

Trauma is the loss of relationality

Trauma is the loss of relationality to self and to others.  By relationality I mean the ability to participate in relationships.  Trauma is the loss of access to sources of vitality deep within oneself, sources that are brought to life in spontaneous and authentic relations with others, from families to strangers. 

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Dori Laub has a bad trauma theory, but he has still made a contribution

Dori Laub has a bad trauma theory, but he has still made a contribution.

Laub concludes an autobiographical essay, “On leaving home and the flight from trauma,” with the following lines.

Perhaps it is only through resisting the temptation and the pressures of becoming the same that he [the therapist] can listen to the patients as they really are, without succumbing to the generalizing effects of theory and the homogenizing produced by fashion and by political correctness. (2013a, pp 579-580)

Laub has adopted some of the most fashionable theories of trauma.  At the same time, it is hard to imagine that he is not a good therapist to the traumatized.  I conclude this from the way he writes about his patients, as well as having seen him interview survivors for the Fortunoff Video Archive for Holocaust Testimony at Yale University.

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Are PTSD and C-PTSD dissociative disorders? Does it matter?

art-1699977_1920Are PTSD and C-PTSD dissociative disorders?  Yes, but it’s more important to remember that they are first of all about terror.

It appears that PTSD and C-PTSD may be grouped under the dissociative disorders in the next edition of the DSM (Diagnostic and Statistical Manual of Mental Disorders).  As Matthew Friedman points out, the new DSM-5 category of trauma and stress related disorders was intentionally placed next to the dissociative disorders in order to suggest their similarity (p. 549).  Whether this is a good direction to be heading is another question. 

A quick definition: dissociation is the division of parts of the self.  Dissociation occurs when the parts of the self that know and feel traumatic experience no longer communicate with the rest of the self.  Dissociation is generally seen on a continuum, more or less.   

What’s dissociative about PTSD and C-PTSD?  

I’ll get to C-PTSD (complex PTSD) in a minute. 

It’s easy enough to interpret the leading symptoms of PTSD in terms of dissociation.  The flashback is a dissociative symptom, a failure to prevent intrusion of unwanted and painful experience.

PTSD criteria read like a short laundry list of dissociative isolative and exclusionary processes (intrusion, numbing, and avoidance). (Chefetz, p. 28)

The dissociation associated with PTSD is characterized by an alteration between hyperarousal and numbing or constriction.  The dialectic of trauma moves between intrusion and numbing.   

Judith Herman (pp. 47-49) and others have argued that the experience of trauma generally moves from early hyperarousal to later numbing and constriction.  Others, such as Richard Chefetz see no progression, just the dominance of one position or another. 

Some people with PTSD present with flooding, and others are so emotionally shutdown that they present as emotionally flat, detached, with active dissociative process.  (p. 80)

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The best trauma narrative I know is Aftermath

fear-1131143_1280The best trauma narrative I know is Aftermath: Violence and the Remaking of the Self, by Susan Brison.  It’s an account of her rape and attempted murder.  I call it the best trauma narrative because it combines philosophy, trauma theory, and narrative.  Alice Sebold’s Lucky, probably the most well known rape narrative (reviewed in this blog), is better written, and makes a more compelling story.  But Susan Brison is a distinguished philosopher, and she approaches her trauma, and trauma theory in general, from a perspective that combines philosophy and experience.    

Actually, Brison doesn’t think being a philosopher did her much good.  Rape and trauma challenge philosophy because they reveal how embodied we all are.  Before we are minds, even before we are body-minds, we are body.  Philosophy is generally not comfortable with bodies.  Philosophy is practiced by questioning the obvious, asking questions such as “what is time?”  But when confronted with an experience that is overwhelmingly obvious, her rape and near murder, Brison found no comfort in philosophy. 

But now, when I was confronted with the utterly strange and paradoxical, philosophy was of no use. (p. x)

 

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Testimony creates the trauma it discovers

zen-178992_1920Testimony can create the trauma it discovers.

Trauma theory and testimony grew up together, beginning in about 1980.  By this I mean that trauma theory and Holocaust testimony emerged as socially and historically significant at about the same time.  It’s worthwhile thinking about their relationship.  If we take the limits of testimony seriously, then much of current trauma theory, especially Cathy Caruth’s account of the “missing moment,” is mistaken. 

It is, of course, not literally true that trauma theory emerged in 1980.  Freud built much of psychoanalysis on his reinterpretation of his patients’ trauma almost a hundred years earlier.  Shell shock, as PTSD was then known, emerged with the First World War.  What happened beginning in the early 1980’s was the inclusion of PTSD in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM III) for the first time.  The introduction of PTSD coincided with the “narrative turn” in the humanities and social sciences.  At about the same time, the Fortunoff Archive for Holocaust Testimony was established at Yale University. 

I have come to believe that Holocaust testimony leads to a misunderstanding of trauma, especially if one does not understand testimony’s limits.  I have published three books on trauma that draw on Holocaust testimonies in the Fortunoff Archive.  I think I understand the limits of testimony better now.  My instructor, so to speak, is Henry Greenspan, author of On Listening to Holocaust Survivors.  I also draw on some more recent papers of his.  In place of testimony, Greenspan has engaged in extended conversations with survivors.  Some of these conversations have lasted decades.  Out of these conversations comes a different way of thinking about testimony and trauma. 

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Trauma destroys meaning. Psychoanalysis is not always helpful.

crow, croppedTrauma destroys meaning, and psychoanalysis is not the best way to understand how this happens.  Destructiveness, Intersubjectivity and Trauma: The Identity Crisis of Modern Psychoanalysis, by Werner Bohleber helped me reach this conclusion, which is not his.  Bohleber is a former president of the German Psychoanalytic Association, and editor of Psyche.

Bohleber holds that the psychoanalytic theory of trauma needs two models:

  • the Freudian psycho-economic model, and
  • the hermeneutic object relations model, as he calls it. 

The “economic” model captures the experience of being overwhelmed by an excess of violence, anxiety, and stimulation that cannot be mentally bound, largely because the ego was unprepared.  The term economic, in this context, refers to currency of mental energy, or libido. 

The object relations model explains the feelings of abandonment, including the destruction of emotional bonds with others, as well as the inability to connect with good objects, or feelings, in oneself, associated with trauma.  (pp. 97-98)

But even using both models, the psychoanalytic account faces a fundamental problem, “the almost complete separation of psychic and external realities within psychoanalytic reality.”  External reality is often devalued by psychoanalysts because it challenges the primacy of unconscious experience (p. 102).  The most important thing to know about trauma, says Bohleber, is that it is a “brute fact” that takes place in historical time (p. 109).

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The imitation of trauma by those who study it

abstract-art-516337_1920The transference is always active between the scholar and what he or she studies.  This is especially so when the subject is trauma.  So Dominick LaCapra argues, and I think he’s right. What does the transference mean in the case of trauma?  For LaCapra it means that “at some level you always have a tendency to repeat the problems you are studying.” (p. 142)         

More generally,

by transference I mean primarily . . . the tendency to repeat in one’s own discourse or practice tendencies active in, or projected into, the other or object [of study]. (P. xv)

In the case of trauma, those writing about it often write as though they have been traumatized.  The writing of Cathy Caruth and Shoshana Felman is frequently in “unmodulated, orphic, cryptic, indirect allusive form” that is designed to transmit the disorientation of trauma.  (LaCapra, p. 106)  This may be suitable for trauma fiction, as it is sometimes called (though I have questioned that in another post), but it is unnecessary and counterproductive when trying to explain trauma. 

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Review of Stolorow’s Trauma and Human Existence, with remarks on his use of Heidegger

cropped-cropped-IMG_0531_editedblack-2_edited-11.jpgRobert Stolorow’s Trauma and Human Existence represents the kind of book trauma theory needs more of, a book that connects the psychology of trauma with a philosophy of human existence.  Connecting trauma to the philosophy of existence is at least as useful as connecting trauma to neuroscience, the current wave.  In this sense, Stolorow’s is an old fashioned book, and that’s a compliment.  

The trouble is the philosophy Stolorow chooses, that of Martin Heidegger.  For Heidegger does not fit well with Stolorow’s relational account of trauma.  For Stolorow, trauma is the loss of attachment, particularly the inability of parents and others to attune themselves to their children’s moods.  His case studies are mostly about patients who experienced troubled childhoods.  He uses a well-known quote from D. W. Winnicott as an epigraph to his second chapter, “there is no such thing as an infant.”  There is only the relationship between mother and child. 

His book could have been just about what is called today developmental trauma disorder (DTD).  Except that he bravely writes at length about his horror at finding his wife of many years dead in bed beside him, so cold and alien he couldn’t touch her. 

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Dori Laub, trauma, and a Holocaust without witnesses

faces-986236_1920Dori Laub puzzles me.  A child survivor of the Holocaust, and co-founder of the Fortunoff Archive for Holocaust Testimony at Yale University, both he and his achievements are admirable.  I’ve spent over 300 hours viewing testimony in an Archive that would not have existed, at least not in its present form, without Laub’s effort.  More than any other person, Laub created the format in which the testimonies were given, one in which the interviewer asks few questions, allowing the witness to speak for long periods without interruption.   Laub is a psychoanalyst, and the format psychoanalytically inspired. 

But if the man and his creation are admirable, his claims about trauma and the Holocaust are troubling.  The Holocaust, he says was an

event that produced no witnesses. . . . One  might say that there was, thus, historically no witness to the Holocaust either from outside or from inside the event. (Laub, An event, pp. 80-81, his emphasis)

Elsewhere Laub says

The Holocaust created in this way a world in which one could not bear witness to oneself. (Laub, Truth, p. 66, his emphasis)

What Laub means is that in order to experience an event, one must communicate it to an “inner Thou,” the addressee with whom inner dialogue takes place.  Without the “internal Thou,” an event cannot be symbolized, and hence cannot be known, even as it exerts a continuous pressure which expresses itself in trauma. 

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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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The lesson of trauma comes from its content, not form

B0000871The Sorrow of War: A Novel of North Vietnam, by Bao Ninh, is an important but not particularly well known literary trauma narrative.*  Ninh was a North Vietnamese soldier during the war.

The question I want to ask is what difference all the literary devices make, the devices that are supposed to make us feel the narrator’s trauma. Jane Robinett says they make all the difference in the world. I don’t think they make any difference at all. It’s an interesting question because much writing about literary trauma fiction focuses on the form, not the content, as though it is through the form that we can feel what the narrator feels.

Form or content?

Consider the following passage by Ninh, followed by its interpretation by Robinett.

Often in the middle of a busy street in broad daylight I become lost in a daydream. On smelling the stink of rotten meat I’ve suddenly imagined I was back crossing Hamburger Hill in 1972, walking over strewn corpses. The stench of death is often so overpowering I have to stop in the middle of the pavement, holding my nose, while startled, suspicious people step around me avoiding my mad stare. (Ninh, 46)

Robinett interprets.

The subtle shift in tenses (from present perfect to past and abruptly into present) in the middle of the paragraph moves readers directly into the experience just as the narrator abruptly finds himself reliving it. (Robinett, 297)

When I read the passage by Ninh it’s the content that counts, the way in which trauma intrudes on his postwar life. The shift in tenses doesn’t add much.

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Did literary trauma theory encourage the Iraq War?

B0000955Contemporary American Trauma Narratives, by Alan Gibbs (2014) is a fascinating book. Most provocative is Gibbs’ claim that a trauma theory perspective on 9/11 actually supported the Bush administration’s invasions of Iraq and Afghanistan. But I’ll get to that later.

The idea of analyzing literature from the perspective of trauma theory is still a little strange to me, even if I have analyzed narratives of the traumatized countless times. See my last post on Alice Sebold’s Lucky, an account of her rape. If I have been misled by Gibbs, or my own ignorance, I hope readers will correct me. *

Second hand trauma

A particularly troubling tendency in literary trauma theory is its claim that “authentic trauma fiction” enlists its

readers to become witnesses to these kinds of stories through the unconventional narrative translations of traumatic experience and memory that give them a different kind of access to the past than conventional frameworks . . . . when readers absorb these stories [like Beloved] through the division of voice . . . they experience something analogous to splitting. (Vickroy, 20, 27-28)

This makes no sense at all. There is no such thing as “something analogous to splitting.” With this claim we have entered the realm of “second-hand trauma.” (Gibbs, 29)

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The Trauma of Rape Can Be Told

B0000782I just finished reading Lucky, by Alice Sebold. It’s an account of her rape when she was a 19 year old freshman at Syracuse University. The book has really caused me to rethink trauma theory, for there is nothing theoretical about Lucky. She describes her rape in horrifying detail. Even more troubling, at least in some respects, is the response of those around her.

I was now on the other side of something they could not understand. I didn’t understand it myself. (p. 27)

This isn’t a review of the book, which was published in 1999. It has been often reviewed. It even has its own Wikipedia entry. Sebold subsequently published The Lovely Bones, which was made into a movie. She is a good writer.

This post is about my embarrassment at writing about trauma theory after reading Sebold’s book. Not that there is anything wrong with trauma theory, but there is something so real about Sebold’s account that it makes the theory of trauma seem an overly intellectual exercise. At least for me, at least for a little while.

Nevertheless, it’s not so simple, for trauma theory helped Sebold, who says that she learned that a short passage from her book had been published in Judith Herman’s classic work, Trauma and Recovery. Sebold said she decided not just to keep Herman’s book as a memento, but to actually read it. It may not have changed her life, Sebold did that for herself, but it helped her make sense of her experience.

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Cognitive behavioral therapy is a terrible way to treat trauma. And it’s government approved.

IMG_0525_editedblack-1_edited-1The Department of Veterans Affairs may today deliver the worst trauma treatment known to man or woman.

The diagnosis of PTSD is an outgrowth of the protests over the Vietnam War. Distraught and disillusioned Vietnam veterans, together with psychiatrists such as Robert Jay Lifton and Chaim Shatan, developed the “rap groups” that provided psychological support in a community of other vets who had undergone similar experiences. Rap groups worked because they provided a place to share common experiences, including terror and remorse. Rap groups provided community and social support.

The effectiveness of rap groups eventually convinced the American Psychiatric Association to include Post Traumatic Stress Disorder in the third edition of its Diagnostic and Statistical Manual, though this is a long and convoluted story (see http://traumatheory.com/whats-going-on-with-dsm-5/ for more details). For some time, rap groups were employed by the VA, often with reluctance, for their members were not always easily managed (Sonnenberg, Blank, Talbott).

No more. David Morris’ recent account of his experience with cognitive behavioral therapy at the San Diego VA tells of a sign on the wall of a waiting room for a small group of vets who were about to enter therapy (p. 195).

PLEASE REFRAIN FROM TELLING WAR STORIES. YOUR STORY COULD BE A “TRIGGER” FOR SOMEONE ELSE.

If the traumatized cannot talk with each other, but only through a therapist, even in a group, then therapy is no longer about creating a community of support for those who suffer. It’s about isolating those who suffer from each other, so they can be processed individually, their trauma chopped into bits.

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From a trauma perspective, Freud’s fort-da game replaces Oedipus

B0000852This post is largely based on re-reading Freud’s Beyond the Pleasure Principle (1920). If one reads the book from a trauma perspective, the fort-da game he describes is more important than the Oedipus complex in the formation of character.

Readers familiar with Freud will recall his puzzlement over the existence of traumatic nightmares. Freud was surprised because he believed that the mind is organized around the pleasure principle, which would imply that dreams are a variety of wish fulfillment. But, what pleasure could there be to the recurrence of a traumatic experience in a dream, what wish could a nightmare fulfill? “People,” says Freud, “have shown far too little surprise at this phenomenon.” (p. 51)

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The assumptive world theory of trauma

DSC00481This post is a review of The Loss of the Assumptive World: A Theory of Traumatic Loss, edited by Jeffrey Kauffman. The approach is popular among a group of clinicians, though I think its thesis is widely, if tacitly, held. It’s a good theory with a remarkable flaw.

The assumptive world

The assumptive world is the only world we know and it includes everything we know or think we know. It includes our interpretation of the past and our expectations of the future, our plans and our prejudices. (Tom Attig, quoting Parkes, p. 55)

Robert J. Lifton and Irvin Yalom play pretty big roles in assumptive world theory, which could be called existential crisis theory. Trauma happens when our basic assumptions about the world are shattered. These assumptions are as fundamental as “I will continue to live,” “I will not be alone and isolated for the rest of my life,” and “my life has meaning and purpose.”

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Does it mean anything to claim that trauma is “aporetic”? No.

trauma is aporeticThe first time I read that trauma is aporetic I rushed to my dictionary. An aporia is from the Greek, referring to an impasse, and generally refers to a paradox or perplexity that cannot be resolved. The term is frequently used in rhetoric; a Texan declaring that all Texans are liars would be a rhetorical aporia. Aporetic is the adjective, describing the condition of being caught in a paradox or contradiction.

Many, perhaps most, who have written about trauma from a literary perspective have seen trauma as aporetic. My comments are informed by Roger Luckhurst’s The Trauma Question, though mine is not so much a review as an appreciation of the issues he raises. It’s a good book.

For Cathy Caruth, doyenne of literary trauma theory, trauma is paradoxical or aporetic because its truth cannot be known at the time of its experience. Not just the traumatic event, but the trauma itself can only be understood after the fact, as it “returns to haunt the survivor later on.” (p. 4) Shoshana Felman and Dori Laub call this a crisis of history and truth, in which the most privileged observers of their own experience are unable to recount it. “The necessity of testimony . . . derives, paradoxically enough from the impossibility of testimony.” (p. 224, their emphasis).

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Review of a really good article on “memory envy” and the limits of literary trauma theory

I want to tell you about a really good article about trauma theory. The article is organized around this statement. “With improved conceptual precision we can differentiate between trauma and the culture of trauma, or, put differently, between trauma and entertainment.” (p. 195).

cropped-IMG_0402-1-1-e1421442766650.jpgThe article is “Genealogy of a Category Mistake: A Critical Intellectual History of the Cultural Trauma Metaphor,” by Wulf Kansteiner. It’s not new (2004), but it generates a provocative criticism of the application of trauma theory to literature. Nevertheless, Kansteiner’s conclusion is wrong, for he thinks that to take trauma seriously we must limit it to extreme events.

For literary or cultural trauma theory, the Holocaust is the ur-trauma, and the problem is that it soon becomes an abstraction. Though Kansteiner sees this tendency in Horkheimer and Adorno’s Dialectic of Enlightenment, it becomes a real problem only in Lyotard.

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How to turn trauma into loss. It’s not easy.

B0000724This post is inspired by a not very recent and probably not very well known essay, “A Late Adventure of the Feelings: Loss, Trauma, and the Limits of Psychoanalysis,” by Gregg Horowitz. It’s in a collection titled The Trauma Controversy. I never did find out what the trauma controversy is. I thought there were only controversies.

Loss

Loss, says Horowitz, is the substance of our lives. And we never get over it. “The loss we never make good on, yet which we never leave behind, is the very texture of our ordinary lives.” (31) In loss the origin keeps happening over and over again. The main reason is because the loss is incomprehensible. Easy enough to grasp, impossible to believe. It sounds like trauma, but it’s not.

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The Book of Woe, and why NIMH said goodbye to DSM-5

IMG_1078This book review and comment are a little off my beat, for they are about DSM-5 in general, not just its diagnosis of trauma, which I addressed in my post of January 20, 2015, http://traumatheory.com/?p=86.

The full title of Gary Greenberg’s book is The Book of Woe: The DSM and the Unmaking of Psychiatry. Greenberg is a psychologist and journalist. Some of the juiciest pieces of this book appeared in The New Yorker between 2010 and 2013 (Google Greenberg + DSM + New Yorker; they are all there).

The book begins with a story about Sandy, one of Greenberg’s patients. When Greenberg first saw him Sandy could barely go out of his house. By the end of therapy, Sandy had a job, a girlfriend, and what most of us would call a life. Sandy and Greenberg exchanged emails after Sandy moved halfway across the country from Connecticut. Eventually, the emails stopped. A couple of years later Greenberg received a call from Sandy in the middle of the night. It ran something like this.

You’ve got to help me. They’ve sucked all the bones out of my body. I’m here in this hotel room and my bones are gone. My mother and my father and James. They’ve done this to me. And I don’t want to die. Please don’t let them kill me. You’re the only one who can help. Good-bye. Good-bye. (p. 9)

Greenberg tried to call Sandy back at the hotel he had called from, but there was no answer. He never heard from Sandy again.

The book turns on what to make of Sandy’s phone call.

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Should reading Maus feel cozy? On the 35th anniversary of the original publication of the graphic novel by Art Spiegelman

cropped-IMG_0531_editedblack-2_edited-11.jpgA friend who has been reading my posts and knows of my desire to reach a wider-audience suggested that I consider the Maus books by Art Spiegelman. I did, and told my friend that they were fun. I think my friend was a little put off, as though a comic book about the Holocaust could be fun. I think my reaction, while not well put, reflects something real going on in Maus, but first a little background on this Holocaust comic.

Maus is a graphic novel drawn and written by Art Spiegelman, the son of Holocaust survivors. Spiegelman first presented Maus in serial form in Raw, an adult comic book, from 1980-1991. Spiegelman had all along intended to write a graphic novel, and in 1986, after an enthusiastic review by The New York Times, the serialized installments were published by Pantheon. In 1992, Maus became the first graphic novel to win a Pulitzer Prize. By the way, Spiegelman objected when the New York Times located his book under the category of fiction on its best-seller list. The Times responded by listing the second volume as non-fiction. The Library of Congress considers the book non-fiction.

Maus is not so much the story of the Holocaust as it is the story of Artie’s attempt to come to terms with his difficult father, who along with his mother survived Auschwitz. It has the outward form of a fable, in which the Jews are mice, the Germans cats, the Poles pigs, and the Americans dogs. Unlike the traditional fable there is no moral of the story. Except perhaps that “suffering doesn’t make you better, it just makes you suffer,” as Art puts it about his father’s racism (Meta, p. 36). But while there is no moral to the story, there is a meaning. It resides in Artie’s use of the Holocaust as a way to meet his father. Vladek was so overwhelmed by the Holocaust that there could be no other ground on which to meet him.

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Cathy Caruth drives me crazy, thoughts while reading Caruth’s Listening to Trauma, conversations with leading trauma theorists.

IMG_2110,superliquidCathy Caruth drives me crazy because she glorifies the person who listens to the traumatized, making it seem as if though the listener to trauma is playing a heroic role: willingly becoming traumatized so that the truly traumatized person can testify. Dori Laub, child survivor, psychiatrist, and co-founder of the Fortunoff Archive for Holocaust Testimony at Yale University, is her co-conspirator.

Cathy Caruth is a big deal in trauma theory, probably the single most important person working at the intersection of literary theory and trauma theory, though Shoshana Felman should receive honorable mention. They share a lot, as the conversation between them published in Caruth’s recent Listening to Trauma: Conversations with Leaders in the Theory and Treatment of Catastrophic Experience, reveals. Together, along with people such as Geoffrey Hartman, also a co-founder of the Fortunoff Video Archive for Holocaust Testimony at Yale (and also interviewed by Caruth), they have helped transform testimony into an important literary genre.

Where Caruth goes wrong

Consider Caruth’s conversation with Robert Jay Lifton in Listening to Trauma: Conversations. Trying to summarize Lifton, Caruth says “there’s a double survivor situation, but a survivor and a proxy survivor, and it’s the meeting of those two that constitutes the witness.” (p. 18)

No! There is only one witness, and one listener. Together they do not make a witness. They make a team, one who tells the story and one who listens.

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Demystifying transgenerational trauma. Review of History Beyond Trauma and The Shell and the Kernel.

 

B0000722History Beyond Trauma, by Françoise Davoine and Jean-Max Gaudillière, has been well-received for over ten years. I could hardly find a negative review. But, in my view the book provides no evidence at all for its most fundamental claim: that historical and social trauma is the origin of madness (pp xxii-xxiii).

To be sure, intergenerational trauma exists. Parents inflict it on their children. Davoine and Gaudillière recognize this, but the message the book sends, and certainly this message has been widely received, is that historical traumas such as war are passed down the generations in ways that can’t be readily explained by the familiar experiences of children in troubled families.

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How the Holocaust Became Traumatic, Alexander

For some time I’ve been puzzled by the idea of collective or historical trauma. Only individuals can experience trauma, so what sense does it make sense to say that a society is traumatized? Literally it makes no sense, unless it is seen as some sort of additive statement, such as this person was traumatized, and this person was traumatized, and this person, and so forth. But society is not additive; it is an abstraction. How can an abstraction be traumatized?

Looking at Jeffrey Alexander’s account of how the Holocaust became traumatic helps to explain the process, as well as raising some questions.

Alexander holds that nothing is traumatic in itself. Trauma is made, or constructed, by the meaning we give events, a social process involving the representation of trauma, as well as the political and persuasive power of those who do the representing. It also requires the receptivity of the larger society.

The claim that nothing is traumatic in itself doesn’t sound very convincing if we think about the trauma suffered by those who survived the Holocaust. Did someone who was imprisoned in Auschwitz have any alternative but to construct his or her experience as traumatic? Even the term “construct” suggests an agency that was largely lacking. Just read Lawrence Langer’s Holocaust Testimonies: The Ruins of Memory.

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Bessel van der Kolk’s House of Trauma Has Many Mansions. Review of The Body Keeps the Score (2014)

 

IMG_0646,straitFor a man who was a leading defender of repressed memory syndrome in the early 1990’s, providing expert testimony in a number of high profile cases, Bessel van der Kolk has done remarkably well for himself. No matter that he seems to have lost his lab and his Harvard medical school affiliation as a result (New York Times). Some of the qualities that led him off the deep end of the repressed memory bandwagon have led him to write what an important, but flawed, book on trauma, The Body Keeps the Score (2014).

Van der Kolk (vdK) holds that the real problem with trauma is not in the past. The problem is that trauma keeps the sufferer from feeling alive in the present, and so able to enjoy everyday life. All the desensitization in the world isn’t going to do any good if a person can’t enjoy the everyday pleasures of life. The way to approach trauma is to work from body to mind. If you are traumatized, and talking isn’t helping, and you are picking the scabs on your body as a means of self-stimulation and soothing, go see a massage therapist. And while you do that we will continue to talk (pp. 88-89). This isn’t all he has to say, but it is at the core.

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Review of Crazy Like Us. With comments on its relationship to Herman’s Trauma and Recovery, and Empire of Trauma.

Crazy Like Us isn’t a recent book, and it is certainly not an academic one. But maybe that’s good, for Watters makes statements about the state of the global PTSD industry that an academic might hesitate to make, at least in plain English.

Crazy Like Us isn’t just about exporting PTSD. It’s about exporting anorexia nervosa to Hong Kong, and a medicalized diagnosis of depression to Japan. But the chapter on the tsunami that brought PTSD to Sri Lanka is the one I’m interested in here.

Watters isn’t anti-psychiatry (his wife is a psychiatrist), and he isn’t against the diagnosis of PTSD per se. His point is that psychiatric categories are cultural categories, and particularly responsive to social change. As the medical anthropologist Allan Young put it, a diagnosis of PTSD “can be real in a particular place and time, and yet not be true for all places and times.” (101-102).

His most important insight is that PTSD is a diagnosis that fits a modern Western world, in which people see themselves as autonomous individuals first, and members of groups and social networks second. In a so-called traditional culture, the diagnosis just doesn’t make sense. So much the worse for us, Watters seems to be saying, but perhaps it’s not so simple.

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