Archives for : Mini Essay on trauma

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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Affect Theory and Trauma Theory

railway-station-1363771_1920Affect theory is coming to trauma theory.  In fact it’s already here.  The best account I’ve read is Ruth Leys “Trauma and the Turn to Affect.”  A historian of science, Leys is the author of the highly regarded Trauma: A Genealogy.  This post is indebted to her work. 

The main thing to understand about affect theory is that it has nothing to do with affect–that is, feeling and emotion.  According to affect theorists, affect is a

pre-subjective force that operates independently of consciousness or the phenomenological concept of subjectivity. (Leys, 2012) 

Affect is a mental state, separate from belief and desire, the affect program system as it is called.  Affect is the body acting on itself, free of cognition and emotion on the one hand, the quality of the stimulus, or stressor, on the other.  If this sounds weird, stick with me. 

As Patricia Clough puts it,

Trauma is the engulfment of the ego in memory. But memory might be better understood not as unconscious memory so much as memory without consciousness and therefore, incorporated, body memory, or cellular memory. (p. 6)

 

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Trauma and the pleasure principle

manhandstoheadMany who study trauma from a psychoanalytic perspective turn to Freud’s Beyond the Pleasure Principle (1920) in order to make sense of the apparent desire of people to repeat unpleasant experiences.  Why, the sensible person wonders, would a traumatized person keep repeating a horrible experience, whether it be war-time trauma, or the trauma of an abusive childhood?  In this context, the term “repeating” covers multiple forms of repetition, from flashbacks and nightmares, to acting-out an original trauma, in which, for example, a woman who was abused as a young girl continues to choose abusive partners.

Freud begins Beyond the Pleasure Principle with what he calls the traumatic neuroses, brought about by accidents and wartime trauma.  However, he quickly turns from “the dark and dismal topic of traumatic neurosis,” to children’s play (pp. 50-52).  The reader is at first disappointed.  Should not Freud have paid more than passing attention to the psychological suffering of so many who had just returned from a war that inflicted immense psychic suffering on its combatants?  He does, but one has to search for it.  Or create it. 

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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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Moral injury in civilian life: a new category of trauma

DSC00286To live in the United States today is to be constantly exposed to moral injury. Moral injury is not, however, equally distributed. Some people are vastly more injured than others, and some are not injured at all. Some people inflict moral injury on others. Lots of people are morally injured, and it is not always obvious.

One might argue that such a grand category, applying to so many, must result in pathologizing a normal experience. Moral injury may be normal, but it’s not good. The lives of the morally injured manifest in chronic sadness and despair, overlaying a rage that occasionally becomes dramatic.

From military trauma to everyday moral injury

Moral injury has become something of a hot topic among those who write about the trauma experienced by soldiers at war. So far, I can find nothing written about moral injury that applies to the experiences of civilians in everyday life. Yet, there is no reason it shouldn’t, particularly if it is interpreted properly.  Moral injury is the result of the use of  political power to deny the experiences of others. There is no more pernicious political power than this.

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Depoliticizing moral injury

B0000904Moral injury is a relatively new and puzzling category to the Department of Veterans Affairs, National Center for PTSD. Lots of researchers seem to recognize that it exists, but nobody can categorize it (Maugen and Litz). Or figure out an effective therapy for it, one that is evidence based, as they say, such as cognitive behavioral therapy (CBT), or prolonged exposure therapy (PE). The practical irrelevance of these therapies when dealing with moral injury makes moral injury a challenging category. 

Events are considered morally injurious if they “transgress deeply held moral beliefs and expectations,” as one of the first academic papers sponsored by the VA put it (Litz, et al., pp. 696, 700). A moral injury occurs when an act shatters the moral and ethical expectations of soldiers and others, including expectations about fairness, the value of life, and that leaders will tell the truth.

Though the publications of the VA recognize the existence of moral injury, it is not a currently accepted diagnostic category. One can receive recompense and treatment for PTSD, but not for moral injury, except on an experimental basis. Shame, guilt, and anger at the self or others’ betrayal of basic human values are central to moral injury. These emotions may occur with PTSD, but they are not key to its definition. PTSD is generally regarded as a fear-based disorder (in spite of DSM-5’s currently grouping it with dissociative disorders). Moral injury is guilt and shame based (Maguen and Litz, p. 2).

As I explain below, I think the VA has depoliticized what was originally a political concept.

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Trauma theory and Melanie Klein

B0000766Melanie Klein’s clinical researches on early childhood led her to postulate that the traumatic pathogenic situation par excellence is the overriding triumph of the death instinct. (Hernandez)

Trauma theory poses a problem for Melanie Klein, and Melanie Klein poses a problem for trauma theory. From a Kleinian perspective, the traumatic experience is not traumatic in itself. The traumatic experience is traumatic to the degree that it activates the fear of annihilation and destruction that is always waiting within, the haunting presence of the death instinct. The death instinct, in turn, gives rise to primitive defenses. Fearing death, the traumatized person projects his fear outward into persecutory objects and people, who then come back to haunt him.

A Kleinian theory of trauma in effect blames the victim. It is as though the Kleinian therapist said

Getting run over, almost dying, and spending six months in the hospital recovering isn’t the real source of your trauma. The real source of your trauma is the hate and aggression you feel toward what we call good objects, the people who really care for you. Your PTSD is so extreme right now because you fear you cannot protect the good from your own anger and hate.

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

DSC00267_edited-2b&wThe 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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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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Winnicott and the vastness of trauma

B0000969What would we do with a trauma so vague and vast that we have no name for it? I think there is such a trauma, and the British Psychoanalyst D. W. Winnicott identified it over half a century ago. Winnicott (1989) wrote specifically about trauma, but I’m not going to write about that. I’m going to write about the implications of his work in general.

The trauma identified by Winnicott doesn’t fit the definition of PTSD. Nor does it fit any of the categories by which experts think about developmental trauma, such as DESNOS (disorders of extreme stress not otherwise specified), C-PTSD (chronic or complex PTSD) or DTD (developmental trauma disorder).

All these categories, with the exception of PTSD, are traumas that primarily affect the developing child, though they may occur in any long term abusive situation, such as wife abuse. With children C-PTSD is generally the result of physical or sexual abuse or obvious neglect. A website explaining C-PTSD begins this way.

As a child, Olivia, who never knew the identity of her father, was consistently abused and neglected by her mother. Her mother’s emotional temperament was highly variable—shifting from dark moods during which she was verbally and physically abusive to her daughter, and manic periods during which she left Olivia to fend for herself for days at a time. (http://www.elementsbehavioralhealth.com/mental-health/what-are-the-symptoms-of-complex-ptsd/)

There are differences between C-PTSD and DESNOS, but they are primarily terminological (see my post http://www.traumatheory.com/?p=178).  DTD is identical to C-PTSD. The Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-5) does not officially recognize C-PTSD, but its new subcategories of dissociative and pre-school subtypes of PTSD come close. The International Classification of Diseases (ICD-11) will include C-PTSD.

A trauma so vague and vast we have no name for it

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Whatever happened to DESNOS?

IMG_0319_edited-2DESNOS stands for Disorders of Extreme Stress Not Otherwise Specified, about as clumsy a diagnosis as one could imagine, and an only slightly better acronym. It owes its existence to the persistence of Judith Herman, who in her classic Trauma and Recovery, argued for a special category of trauma she called complex PTSD (C-PTSD). C-PTSD = DESNOS for all practical purposes.

It has long been recognized that there are different types of trauma, but no one has figured out what to do about it as far as PTSD is concerned. Rape, a serious car accident, most wartime trauma takes place during a specified period of time, and often results in the familiar symptoms of PTSD, such as flashbacks, nightmares, sleeplessness, hypervigilance, and a gradual retreat into a smaller world in which the victim is less likely to encounter situations reminding him or her of the original trauma.

But, some trauma doesn’t fit this pattern, generally because it is prolonged, frequently happens at an early age, and often involves people with whom the victim has an intimate relationship. Child abuse is exemplary, but prolonged captivity and confinement of any type also fits the pattern. This includes emotional and physical abuse in marriage or other relationships.

The about to be released International Classification of Diseases, ICD-11, which serves as the DSM for the rest of the world, includes C-PTSD, but only if the victim first fulfills all the requirements of a diagnosis for PTSD. DSM-5 includes most of the symptoms of C-PTSD, achieved in part by enlarging the number of symptoms to twenty. In addition, it includes a dissociative subtype and a pre-school subtype. As with the ICD-11, the basic requirements of PTSD must first be met. DSM-5 does not officially recognize C-PTSD, but one professional’s comment on PTSD in DSM-5 gets it right, remarking that it has become more “DESNOS-ish.”

Here’s the problem

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How trauma works: by destroying the inner other (revised, 7/12)

How Trauma Happens

B00007701. Throughout our lives we need an inner other. We need someone with whom we can carry on an internal dialogue. An inner other is different from an internal object.

Unlike Melanie Klein’s internal object, the inner other is not a projection of innate love and hate, subsequently modified by the real world, before being reintrojected. The inner other reflects the need to be understood. The inner other is created in interaction with others. It is always already a relationship. In this regard it comes closer to John Bowlby’s “internal working model.” The inner other is a relationship, and a relationship takes two.

Unlike Heinz Kohut’s selfobject, the inner other is separate from the self. The inner other is not experienced, even as a young child, “as nonautonomous components of the self,” which exist to serve the self’s need to be mirrored. Nor does the inner other exist in order to be idealized. It exists in order to draw the child into the world. Without the otherness of the inner object the world would be empty of value and joy. See the quote from Daniel Stern below (number 3). The same principle applies to adults.

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Neuroimaging in trauma studies is bad science and worse understanding

DSC00633In his recent book, The Body Keeps the Score (2014), Bessel Van der Kolk writes about the first time he used neuroimaging in his work. He placed eight traumatized subjects in a scanner similar to the fMRI (functional MRI), which records in real time changes in the blood flow in the subject’s brain. With the subject in the scanner, an associate read back an account of the subject’s traumatic experience(s). All subjects experienced flashbacks while in the scanner.

I taped the scans up on the refrigerator in my kitchen, and for the next few months I stared at them every evening. It occurred to me that this was how early astronomers must have felt when they peered through a telescope at a new constellation. (van der Kolk, 2014, p. 42)

fMRI: the basics

Is neural imaging really is equivalent to the Galilean revolution? In order to answer that question, it will be useful to understand how neuroimaging works in practice in the study of psychic trauma.

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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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Do Holocaust survivors unconsciously want to kill their children?

B0000782Erik Hesse and Mary Main, leading attachment theorists, explain the process of second generation trauma this way. During the normal course of child rearing, traumatized parents will reexperience their original trauma, leading to episodes of parental detachment and confusion. This is the case even with good, generally competent, parents. Incapable of understanding the source of the parents’ distress, the child will either blame itself, or be drawn into compulsively trying to comfort the parent. Role reversal, the child comforting the parent, is a common attachment strategy undertaken by children of traumatized or disturbed parents. It is a leading marker of anxious or ambivalent attachment.

The next step: the internalized aggressor

Adah Sachs has taken this argument a step further, suggesting that the alien role the child is forced into is the result of the parents having internalized the aggressor, a consequence of helpless terror.

While most of these parents would have given their lives away to protect their offspring, they could not protect them from the messages of their traumatic introjects, and from the death threats that were carried and implied by them . . . . The survivors of the Holocaust continued to carry the terrifying introjects of the perpetrators and their murderous wishes, in a dissociated way      . . . . These children had to rely on the love of an attachment figure who had a murderous aggressor internalised. (p. 31)

The child senses this murderer in the parent, and lives to keep it inside the parent. The result is a very, very good child. Sachs calls the result “an infanticidal attachment pattern.” (p. 34)

This is a disturbing, scary, awful thought!

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