PTSD and the death drive

Freud’s speculations about the death drive (Todestrieb) are no longer  accepted by most psychoanalysts. /1/ Yet, Freud’s thoughts about the death drive are worth considering from the perspective of trauma theory, since Freud regarded the inability of the traumatized to let their trauma pass into memory as the strongest evidence in favor of the death drives (he almost always used the plural). A version of the repetition compulsion, Andre Green calls the death drive the “murder of time.” Embeddedness in temporality is the mark of human existence. The murder of time is the murder of lived life.

Freud first posited the death drive in Beyond the Pleasure Principle (1920). His English translator, James Strachey, made the mistake of translating two German words, Trieb and Instinkt, with the same term, instinct. There is no death instinct. A drive is a motivation directed by a physical need. A drive is culturally and psychologically mutable within limits. /2/

If people seek pleasure above all else, as Freud had previously assumed, why would a traumatized person hold fast to a terrible memory of trauma, repeating the experience again and again, not just in memory but in the physical sensations accompanying that memory?

Freud’s first answer was that repetition is an attempt to master an experience that was originally too immediate, too intense, or simply too difficult to bear, such as the abandonment of a child by its mother. Freud comments on his grandson’s fort/da game in which the child threw a spool of string away and then reeled it back in during his mother’s absence. Or more frequently, he just threw his toys away, as though to say, “See, I don’t need you anymore. You’re not leaving. I’m sending you away.”  

Freud seems unsatisfied with his own answer, for Freud was never comfortable with the idea of an independent instinct or drive for mastery or control (Beyond, p. 54). Not mastery but the death drive is Freud’s explanation of life beyond the pleasure principle. Trauma incites the death drive, the urge of the organism to return to an original inorganic state. One sees this in Freud’s speculation about the Nirvana principle, which he interprets as the longing for the cessation of stimulation and tension (Beyond, p. 95). We desire our own deaths, but only in our own time and in our own way. If we are fortunate, we savor the journey that takes us from nothingness to nothingness, Nirvana. Trauma may make life so unbearable that a shortcut is tempting (Beyond, pp. 61, 95). To die and so end the constant intrusion of stimuli may seem like liberation from the burden of being.

Freud believed that the psychic drives are conservative. “Their goal is the restoration of a previous state of non-tension, calm, inertia.” This is what Freud means with his remarkable statement, “the aim of life is death.” (Freud, 1920, p 224) In its original formulation, the death drive.  

Has nothing to do with aggressiveness . . . and Freud always refused to recognize the existence of a destructive autonomous energy. (Valdrè, p 24)

Why drives are conservative can be explained by considering the original German title of Beyond the Pleasure Principle, Jenseits des Lustprinzips. Jenseits doesn’t mean “beyond” so much as it means the other side of pleasure, the pleasure of no tension. It is another type of pleasure, the pleasure of not having to be, to do, or respond. In the language of psychoanalysis, it is a pure narcissistic pleasure. In the language of Green and Lacan (that is, the French tradition, in which speech takes the place of experience), it is the pleasure of not having to represent oneself in language.

Some years ago, Christopher Lasch wrote The Culture of Narcissism. It turned out to be surprisingly popular considering its detailed study of psychoanalytic theory.  Lasch suggests that it was Freud’s growing interest in narcissism, seen most clearly in his essay “On Narcissism: An Introduction,” that led him to the Nirvana principle. The unalloyed narcissist takes him or herself as love object. Not other people, but the self is the true object of desire.

The death drive is prior to object-relatedness, attachment, and all the other things that have come to characterize psychoanalysis since Freud. It is prior to the destructiveness that is so often equated with the death drive, such as that Freud witnessed in World War One.  Whether civilization will survive the destructive desires of its citizens depends upon the ability of Eros to bind Thanatos, as the death drive came to be called by followers. The result is that the death drive has come to be equated with destructiveness. It may be constructive annihilation, as when we transform the natural landscape to fit our needs, or the destruction of war. But in this recapitulation of Freud (1930), which is accurate as far as it goes, the longing for Nirvana is lost.

What if it were true?

What if it were true that humans seek death, not through destruction, but in the sense that the drives are conservative? “Their goal is the restoration of a previous state of non-tension, calm, inertia.” (1920, p 224) That is, “the aim of life is death.”

For Herbert Marcuse, this means that Eros and narcissism are not so far apart, from which he concludes that the destructiveness of the death drive is not built-in but the result of the frustration of the desire to participate in aspects of Nirvana in this world, such as a deep and death-like sleep (Eros and Civilization, p 149; Alford, Narcissism, p 141). In terms of trauma theory, we can surmise that the repetition of traumatic experience, the inability to move on, is not only evidence of the death drive but also the spoiling of a life that longs for peace. PTSD is the opposite of what the ego seeks: not to be intruded upon. In this sense, PTSD is the destruction of the deepest source of satisfaction in life: the opportunity to just be without having to respond to stimuli.

The longing for Nirvana comes close to what Winnicott called the true self. The true self is expressed in spontaneity, above all the spontaneous gesture, and is cultured in an environment in which the infant does not have to react to external impingement, “the only state in which the self can begin to be.” (“Birth Memories,” p. 183) Like the true self, the experience of Nirvana is the experience of just being. Nirvana is not just realized in the movement toward death but in a life in which the individual is free, not just of the intrusion of traumatic memories but even of the constant press of reality. Quiet, stillness, night. Living without the constant need for self-assertion. These are dimensions of experience less available to us in the developed world than ever before. They are totally unavailable to the traumatized.

Implications for the treatment of PTSD

If one of the implications of the death drive is that life longs to return to an inorganic state, but only in its own time and its own way, then the most popular treatments of trauma only encourage the traumatized to take a shortcut to non-being. The desire for Nirvana is not the only implication of the death drive, but it is not just a vagary of destructiveness either. Treatment of PTSD should take this into account.

The most popular treatments of PTSD, cognitive behavioral therapy (CBT) and prolonged exposure therapy (PE) are the opposite of how PTSD should be approached. They are the opposite of Nirvana. So too is EMDR (eye movement desensitization and reprogramming), which combines elements of CBT with the stimulation of eye movement, which is thoought to be therapeutuc. /3/ The best approaches focus not on the traumatic past, but on promoting an enjoyable experience of being, of living in the now.  The work of Bessel van der Kolk is helpful here, especially his emphasis on body work, such as massage. Or bathing in a warm salt-water pool (my experience). The body is the foundation of the enjoyment of being, and a sense of physical aliveness supports a healthy narcissism. Reigniting the capacity for physical pleasure is the first and most important step in dealing with PTSD.

Talk therapy has so many varieties that it’s hard to draw many conclusions. The best therapy is one which understands that what Winnicott calls the “true self” has been terribly intruded upon so that the capacity for spontaneous gesture is destroyed. The therapist will be careful not to impinge, not to “get to the bottom of things,” but to provide a supportive and responsive holding environment. There is no reason a sensitive LCSW-C couldn’t do this. But talk therapy like this takes time, money, and compassion. All are in short supply.

Of course, it is not primarily the treatment of PTSD that makes the temptation to take a shortcut to non-being so tempting. It is PTSD itself. An existence filled with fear, unable to leave the original experience of trauma behind, leads to the longing to take a shortcut to nonbeing. Not just suicide, but a constrained, motionless, static existence, frozen in time, is a version of non-being. Therapy should address this, not worsen it, but even bad therapy should not take the bulk of the blame. PTSD is a problem in the world. Nevertheless, we should be concerned when therapy mimics the problem  in the guise of helping to resolve it.

Notes

1.  Jacques Lacan is the most well-known among those few to have taken the Todestrieb seriously. Andre Green is another.

2.  The four essays where Freud mentions the death drive are “Beyond the Pleasure Principle” (1920), “The Economic Problem of Masochism” (1924), Civilization and its Discontents (1930), and “An Outline of Psychoanalysis” (1938). The first and third are the most important.

3.  CBT (cognitive behavioral therapy) mimics the problem by intruding upon the patient’s ability to feel his or her experience, encouraging “rational” thinking.  Prolonged exposure therapy (PE) forces the traumatized person to relive an original experience in order to eventually extinguish the intense response. EMDR (eye movement desensitization and reprogramming) seeks to substitute positive beliefs for negative ones.  The back and forth movement of the eyes as they follow a pointer is thought to aid this reprogramming.  Like the other two approaches, EMDR aims to impose a new experience on an original one.  Both CBT and PE are manualized therapies, meaning they can be used by technicians with limited training.  For this reason they are especially popular with the Veterans Administration and other large organizations.  EMDR can cure even complex traumas in eight to twelve sessions, according to the Clevland Clinic.   I’m not sure why reputatable organizations like the Cleveland Clinic endorse questionable treatments, especially ones that seem like miracle cures. 

References

C. Fred Alford, Narcissism: Socrates, the Frankfurt School, and Psychoanalytic Theory. Yale, 1988.

Sigmund Freud, “On Narcissism: An Introduction,” The Standard Edition (1914), vol. 14: 67-102.

Sigmund Freud, “Beyond the Pleasure Principle,” The Standard Edition (1920), vol. 18: 7-64.

Sigmund Freud, “The Economic Problem of Masochism,” The Standard Edition (1924), vol. 19: 155-170.

Sigmund Freud, “Civilization and its Discontents,” The Standard Edition, vol. 21 (1930): 57-146.

Sigmund Freud, “An Outline of Psychoanalysis,” The Standard Edition, vol. 23 (1938): 139-208.

Sigmund Freud, “On Narcissism: An Introduction,” The Standard Edition, vol. 14: 67-102.

Andre Green, Illusions and Disillusions of Psychoanalytic Work, translated by Andrew Weller. Routledge, 2011.

Andre Green, On the Destruction and Death Drives, with an introduction by Howard Levine. Phoenix, 2023.

Lacan, Jaques. Écrits: The First Complete Edition in English, translated by Bruce Fink. W. W. Norton, 2006.

Christopher Lasch, The Culture of Narcissism: American Life in an Age of Diminishing Expectations. W. W. Norton, 2018 [reissue].

Herbert Marcuse, Eros and Civilization: A Philosophical Inquiry into Freud. Beacon Press, 1974.

Rossella Valdrè, Psychoanalytic Reflections on the Freudian Death Drive. Routledge, 2019.

Bessel van der Kolk, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Penguin, 2015 (reprint).

D. W. Winnicott, “Birth Memories, Birth Trauma, and Anxiety,” in Collected Papers: Through Pediatrics to Psychoanalysis, 174-193. Basic Books, 1958.

D. W. Winnicott, “Ego Distortion in Terms of True and False Self,” in The Maturational Processes and the Facilitating Environment, 140-152. Karnac Books, 1990.  

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