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).

Brute facts and history

Bohleber is a German born in 1942.  The Holocaust is always hovering in the background in his account of trauma.  In some ways Bohleber’s claim about brute facts is helpful in reminding us to focus on the sources of emotional suffering, especially when they are human, as they so often are.  On the other hand, much trauma is actually quite subtle, such as a parent’s emotional absence or lack of attunement with her child. This does not mean that trauma is not an objective reality, only that it may be invisible to others, and does not exist independently of the relationship between subjects.  The latter statement is true even about the trauma inflicted by natural disasters.  Whether the disaster is experienced as a lasting trauma largely depends upon the community’s response. 

Bohleber’s chief concern is that psychoanalysis is in danger of devaluing history. 

Psychoanalysis, originally undertaken in order to discover repressed childhood memories, is now in danger of becoming a treatment technique that actually fades out history. (p. 109)

Psychoanalysis risks devaluing history when it focuses exclusively on the here and now within the transference/countertransference.  More generally, psychoanalysis devalues history when mental models of object relationships are its sole concern.  Helping the analysand remember and make sense of his or her experience becomes secondary.

Trauma destroys meaning

From the perspective of experience, trauma is best understood as the destruction of meaning.  One can call this the loss of the good object, but it makes more sense (that is to say, it comes closer to experienced reality) to say that trauma traumatizes because it destroys belief in a stable and predictable world.  Trauma destroys belief in a world that is not fundamentally hostile to human happiness.  For the traumatized, everything worthwhile can be annihilated in a moment, or slowly over years.  In either case the damage feels irreparable.  Sometimes it is.  Trauma is an existential crisis, the destruction of the meaning of existence. 

Sometimes this meaning rests on a relationship to a person, other times to an idea, to a place, to an image of oneself.  Sometimes it rests on nothing more, or less, than a belief that this world is a worthwhile place in which to live.  Trauma comes in all shapes and sizes, but this is its common core. 

Attachment theory

The claim that trauma is best understood as the lost of existential meaning—that is, the loss of the meaning of existence—fits well with attachment theory.  Indeed, they may be the same thing.  Attachment theory holds that

We survive by forming relationships, and adapting to the minds of others. Relationships are the remedy for fear—of loss, of annihilation, of psychic emptiness—and offer us the deepest expression of our humanity. (Slade, p. 41)

From the perspective of attachment theory, the loss of attachment is the loss of meaning and vice-versa.  Most people hold that attachment theory, founded by John Bowlby, and developed further by Mary Ainsworth and Mary Main is psychoanalytic; some don’t.  I think it is, but the question is not very important.  Important is the insight that we live and thrive only by virtue of our attachments to others: primarily other people, but also values, beliefs, ideas, and places.  Trauma destroys attachment.

Dissociation and the loss of meaning

From the loss of meaning perspective, dissociation is the result of trauma, not its cause.  A great deal of effort has been put into the attempt to characterize the experience of trauma as itself dissociative, an experience in which

excessive arousal in a traumatic situation significantly alters processes of encoding, storing, and, later, consolidating a memory and its recall . . . . A dissociated state of self emerges in the process, whereby the traumatic memories are encapsulated and isolated from the remaining flow of consciousness.  (pp. 129-130)

Bohleber says this.  Evidently he believes this statement is compatible with Freud and object relations theory.  I think it is incompatible with Freud’s account of trauma in terms of Nachträglichkeit, or afterwardness.  As Jean Laplanche puts it,

It is not the first act which is traumatic; it is the internal reviviscence of this memory hat becomes traumatic. That’s Freud’s  theory.(http://pmc.iath.virginia.edu/text-only/issue.101/11.2caruth.txt.) 

Dissociation is the result of the loss of meaning, not its cause.  Dissociation is not a quality of the original experience of trauma, which is what Bohleber, along with many others, such as Cathy Caruth, claim.  Indeed, it is very hard to know how people originally experience trauma.  What we know is how they talk about it afterwards, often long afterwards, and many have difficulty telling a story about what happened.  Sights, sounds, feelings, are recollected in detail.  The way they fit together to tell a story is often a struggle.  This is evidence of dissociation.  It is not evidence that trauma is itself dissociative.  Dissociative is the loss of meaning that follows trauma. Trauma doesn’t cause dissociation.  The loss of meaning that accompanies trauma causes dissociation. 

An exception and a story about a young girl

There is at least one exception to my claim about dissociation.  Victims of child abuse, frequently but not exclusively sexual abuse, seem to use dissociation as a defense against an unbearable and inescapable situation.  So many victims of child abuse testify to feeling as if they were outside their bodies in some way, experiencing the abuse as something happening to somebody else, that it is hard to avoid the conclusion that dissociation is a defense against trauma activated at the time of the original trauma (Herman, pp. 102-103). 

Childhood abuse, particularly sexual abuse is not as rare as once supposed.  More common is the trauma described by a woman looking back on a childhood hospitalization.  Her mother had not prepared her for the long separation, lying to her that she would visit her daily.  She didn’t.

When she was discharged from the hospital, she said, the image had been “engraved” in her of going down the stairs and thinking, “now everything’s different.” (Bohleber, p. 139)

At the age of six the meaning of a child’s world had changed forever.  There is no need to believe that this is exactly what the child said to herself at age six.  She may, or this may have been a reworking of the meaning of the experience in the years after.  It doesn’t matter.  The point is that trauma is about meaning.  For children, and for adults.   

Conclusion

That trauma is about meaning doesn’t mean that psychoanalysis has nothing to contribute to our understanding of trauma.  Dissociation reveals that the loss of meaning is a complex experience, which a psychoanalytic concept can help clarify.  Nevertheless, it is the phenomenology of trauma, the experienced meaning that is so important to preserve, especially in a field coming to be dominated by neuroscience. 

By the way, just because trauma is about the loss of meaning doesn’t mean that its treatment must be limited to talk about meaning.  Meaning is also embedded in the body, as the phenomenologist Maurice Merleau-Ponty taught.  The physical therapies recommended by Bessel van der Kolk, from meditation to yoga to massage, among others, have their place together with talk therapy and community living.   

Bohleber insists on two points: the brute fact of trauma, and that trauma takes place in historical time.  Therefore, it is worthwhile to reconstruct the traumatic experience, and therapy should concern itself with that old fashioned task. 

Though I have questioned the “bruteness” of the fact of trauma, with Bohleber’s emphasis I agree.  Life is lived forward and understood backwards.  No more so is this true than in the case of trauma.  The belief that it is possible to make sense of the past is central to the restoration of meaning to traumatic experience.       

References

Werner Bohleber, Destructiveness, Intersubjectivity and Trauma: The Identity Crisis of Modern Psychoanalysis.  London: Karnac, 2010.   

John Bowlby, A Secure Base.  New York: Basic Books, 1988.

Judith Herman, Trauma and Recovery. New York: Basic Books, 1997.

Maurice Merleau-Ponty, The Primacy of Perception, trans. C. Smith.  London: Routledge and Kegan Paul, 1962.

Arietta Slade, Psychoanalysis: The fifteenth John Bowlby memorial lecture, in The John Bowlby Memorial Conference Monograph Series, ed. Judy Yellin and Orit Badouk-Epstein. London: Karnac Books, 2013.

Bessel van der Kolk, The Body Keeps the Score.  New York: Viking, 2014.

 

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Comment (1)

  1. John

    I am certain that Bohleber is only partially correct on this point. Psycho-dynamically informed practice may actually be the best method for making sense and meaning out of traumatic incidents and restoring trust in one’s place in the world. First, attending to the transference and the countertransference within the therapeutic relationship is one form of attunement. This form of attunement focuses on the present moment and on the traumatic antecedents that led the person to seek healing. In fact, not attending to the person’s transference reactions may be fragmenting and destabilizing to the person as might disavowing countertransference reactions on the part of the therapist. Noticed countertransference may be especially helpful to understanding dissociative episodes experienced by the person. Second, Freud abandoned his original seduction theory which held that traumatic stress reactions were a result of real traumata and abuse (interpersonal injury is always the worst). But, Sandor Ferenczi in The Confusion of Tongues (1933) continued this trust and belief in the experience of the person. Ferenczi advocated an empathic, validating, and active approach that would be familiar to many relational therapists, intersubjectivists, and subscribers to attachment theory (and actually may be reminiscent of van der Kolk’s ideas). In essence, what the Confusion of Tongues describes is moral injury (Shay’s betrayal theory, not Litz’s transgression theory). Having one’s narrative believed, one’s emotional reactions properly responded to, and one’s traumatic reactions validated can be especially helpful to healing. Finally, this point that trauma doesn’t always cause dissociation is an important one. It is only when one’s understanding of the goodness of the world and the goodness of others has been compromised that dissociation is likely to occur. Dissociation in a clinical sense involves extreme detachment from one’s sense of self and/or detachment from one’s environment. In a human sense, dissociation is unmooring and loss. Psycho-dynamically informed practice (relational, interpersonal, intersubjective, and attachment theory/practice) is increasingly being embraced by those frustrated by the incomplete and surface outcomes realized by cognitive-behavioral approaches as a better way to help those struggling with trauma to find connection to others and wholeness to self.

    Final Note (really): It doesn’t matter if it is Freud succumbing to societal pressures and re-labeling client’s recounted child sexual abuse as “fantasy, or trolling sexual assault victims at college campuses and military bases, or meeting military veteran’s disability claims for PTSD with skepticism. These examples are all forms of moral injury (betrayal) that can compound trauma.

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