trauma & recovery
(1992) by Judith Herman [https://en.wikipedia.org/wiki/Judith_Lewis_Herman]
found it.. intro’d to book here:
Céline Keller (@krustelkram) tweeted at 5:34 AM – 26 Sep 2018 :
“…this complex array of mental maneuvers, at once conscious & unconscious.”
“Alterations in time sense begin with the obliteration of the future but eventually progress to the obliteration of the past.”
doublethink & the end of history
(Judith Lewis Herman/Trauma & Recovery) https://t.co/McEKU6rQH4 (http://twitter.com/krustelkram/status/1044913199030706176?s=17)
Céline Keller (@krustelkram) tweeted at 5:55 AM – 26 Sep 2018 :
“The prisoner no longer thinks of how to escape, but rather of how to stay alive, or how to make captivity more bearable.” https://t.co/TCjKAfnSCn (http://twitter.com/krustelkram/status/1044918432779698176?s=17)
the ordinary response to atrocities is to banish them from consciousness.. certain violations of the social compact are too terrible to utter aloud: this is the meaning of the word unspeakable..
atrocities, however, refuse to be buried..
the conflict between the will to deny horrible events and the will to proclaim them aloud is the central dialectic(discussion, debate, reasoning) of psychological trauma.. people who have survived atrocities often tell their stories in a highly emotional contradictory, and fragmented manner which undermines their credibility and thereby serves the twin imperatives of truth telling and secrecy. when the truth is finally recognized, survivors can begin their recovery. but far too often secrecy prevails, and the story of the traumatic even surfaces not as a verbal narrative but as a symptom..
they psychological distress symptoms of traumatized people simultaneously call attention to the existence of an unspeakable secret and deflect attention from it.. this si most apparent in the way traumatized people alternate between feel numb and reliving he event..
witnesses as well as victims are subject to the dialectic of trauma.. it is difficult for an observer to remain clearheaded and calm, to see more than a few fragments of the picture at one time, to retain all the pieces, and to fit them together. it is even more difficult to find language that conveys fully and persuasively what one has seen.. those who attempt to describe the atrocities that they have witnessed also risk their own credibility. to speak publicly about one’s knowledge of atrocities is to invite the stigma that attaches to victims
it is a book about commonalities: between rape survivors and combat vets, between battered women and political prisoners, between the survivors of vast concentration camps created by tyrants who rule nations and the survivors of small, hidden concentration camps created by tyrants who rule their homes.. t
p 1 – traumatic disorders
1 – a forgotten history
the study of psychological trauma does not languish for lack of interest.. rather, the subject provokes such intense controversy that it periodically becomes anathema..
when the events are natural disasters or ‘acts of god’ those who bear witness sympathize readily w the victim. but when the traumatic events are of human design, those who bear witness are caught in the conflict between victim and perpetrator. it is morally impossible to remain neutral in this conflict. the bystander is forced to take sides..
it is very tempting to take the side of the perpetrator. all the perpetrator asks is that the bystander do nothing..t.. he appeals to the universal desire to see, hear, and speak no evil. the victim, on the contrary , asks the bystander to share the burden of pain.. the victim demands action..engagement.. remembering
in order to escape accountability for his crimes, the perpetrator does everything in his power to promote forgetting.. secrecy and silence are the perpetrator’s first line of defense.. if secrecy fails, the perpetrator attacks the credibility of his victim.. if he cannot silence her absolutely , he tries to make sure that no one listens..t
w/o a supportive social environ the bystander usually succumbs to the temptation to look the other way. this is true even when the victim is an idealized and valued member of society. soldiers in every war, even those who have been regarded as heroes, complain bitterly that no one wants to know the real truth about war..t when the victim is already devalued (a woman, a child), she may find that the most traumatic events of her life take place outside the realm of socially validated reality. her experience becomes unspeakable..t
the study of psych trauma must constantly contend w this tendency to discredit the victim or to render her invisible.. throughout the history of the field, dispute has raged over whether patients w post-traumatic conditions are entitled to care and respect or deserving of contempt, whether they are genuinely suffering or malingering, whether their histories are true or false and if false, whether imagined or maliciously fabricated.. in spite of a vast literature documenting the phenomena of psychological trauma, debate still centers on the basic question of whether these phenomena are credible and real..t
it is not only the patients but also the investigator of post traumatic conditions whose credibility is repeatedly challenged. clinicians who listen too long and too carefully to traumatized patients often become suspect among their colleagues.. as though contaminated by contact.. investigators who purse the field too far beyond the bounds of conventional belief are often subjected to a kind of professional isolations.
to hold traumatic reality in consciousness requires a social context that affirms and protects the victim and that joins victim and witness in a common alliance. for the individual victim, this social context is created by relationships w friends, lovers, and family. for the large society, the social context is created by political movements that *give voice to the disempowered..
less about *giving voice.. (to trauma or what change could be – because often that doesn’t get to the root.. not to mention that no one is voiceless).. but more about listening to every voice.. first thing.. everyday.. tech as it could be.. ie: 2 convers as infra
perhaps via cure ios city
the systematic study of psych trauma therefore depends on the support of a political movement..
for 2 decades in the late 19th cent, the disorder called hysteria became a major focus of serious inquiry. the term hysteria as so commonly understood at the time that no one had actually taken the trouble to define it systematically.. m most physicians believed it to be a disease roper to women and originating in the uterus.. as another historian explained, hysteria was ‘a dramatic medical metaphor for everything that men found mysterious or unmanageable in the opposite sex’
by the md 1890s these investigators had discovered that hysterical symptoms could be alleviated when the traumatic memories, as well as the intense feelings that accompanied them, were recovered and put into words.. this method of treatment became the basis of modern psychotherapy.. .. janet and freud called it ‘psychological analysis’ breuer and freud called it ‘catharsis’ .. but the simplest and perhaps best name was invented y one of breurer’ patients.. the ‘talking cure’
self-talk as data – perhaps reflective.. but maybe even more so.. initiative.. reset ness.. getting a new start/go.. everyday..
the collaborations between dr and patient took on the quality of a quest, in which the solution to the mystery of hysteria could be found in the painstaking reconstruction of the patient’s past.. breuer: ‘following back the thread of memory’
freud decided to listen to women’s stories.. comes to conclusion and writes the aetiology of hysteria.. that it is all traced childhood sexual abuse.. w/in a year he repudiated it.. saying.. hysteria so common among women that if his patients’ stories were true, and if his theory were correct, he would be forced to conclude that what he called ‘perverted acts against children’ were endemic,..t.. not only among the proletariat of paris, where he first studied hysteria, but also among the respectable bourgeois families of vienna, where he had established his practice.. this idea was simply unacceptable. it was beyond credibility.
faced w this dilemma, freud stopped listening to his female patients.. ending w dora – who he refused to validate her feelings of outrage and humiliation (father had offered her to his friends a s asexual toy).. instead, he insisted upon exploring her feelings of erotic excitement, as if the exploitative situation wer e fulfillment of her desire.. in an act that freud viewed as revenge, dora broke off the treatment..
the breach of their alliance marked the bitter end of an era of collab between investigators and hysterical patients… for close to a century.. these patients would again be scorned and silenced.
by first decade of 20th cent.. w/o ever offering any clinical documentation of false complaints, freud had concluded that his hysterical patients’ accounts of childhood sexual abuse were untrue: ‘i was at last obliged to recognize that these scenes of seduction had never taken place, and that they were only fantasies which my patients had made up’..t
while these men of science saw themselves as benevolent rescuers, uplifting women from their degraded condition, they never for a moment envisioned a condition of social equality between women and men.. women were to be the objects of study and humane care, not subjects in their own right..
w/in a few years after the end of the war, medical interest in the subject to psychological trauma faded once again. though numerous men w long lasting psychiatric disabilities crowded the back wards of veterans’ hospitals, their presence had become an embarrassment to civilian societies eager to forget
kardiner.. recognized that war neuroses represented a form of hysteria.. but he also realized that the term had once again become so pejorative that its very use discredited patients: ‘when the word ‘hysterical’ is used, its social meaning is that the subject is a predatory individual, trying to get something for nothing. the victim of such a neurosis is, therefore, w/o sympathy in court and .. w/o sympathy from his physicians.. who often take ‘hysterical’ to mean that the individual is suffering from some persistent form of wickedness, perversity, or weakness of will’
two american psychiatrist, jw appel and gw beebe, concluded that 200-240 days in combat would suffice to break even the strongest soldier: ‘there is no such thing as ‘getting used to combat’.. each moment of combat imposes a strain so great that men will break down in direct relation to the intensity and duration of their exposure.. thus psychiatric casualties are as inevitable as gunshot and shrapnel wounds in warfare’
american psychiatrists focused their energy on identifying those factors that might protect against acute breakdown or lead to rapid recovery. they discovered once again what rivers had demo’d in his treatment of sassoon: the power of emotional attachments among fighting men. in 1947 kardiner revised his classic text in collab w herbert spiegel, a psychiatrist who had just returned from treating men at the front. kardiner and spiegel argued that the strongest protection against overwhelming terror was the degree of relatedness between the soldier, his immediate fighting unit, and their leader.. similar findings.. roy grinker and john spiegel who noted that the situation of constant danger led soldiers to develop extreme emotional dependency upon their peer group and leaders.. strongest protection… against psych breakdown was morale and leadership of the small fighting unit..
also why they have trouble when they come home and don’t have a tribe like that.. also why they go in the first place.. none of us question ie: war.. because we don’t have a tribe.. instead we have holes we need to fill.. so war’s pr is ever so inviting..
they found that artificially induced altered states could be used to gain access to traumatic memories.. as in the earlier work on hysteria, the focus of the ‘talking cure’
how to change mind
little attention was paid to the fate of these men once they returned to active duty, let alone after they returned home from the way.. as long as they could function on a minimal level, they were thought to have recovered..
in 1970 while the vietnam war was at its height, two psychiatrists, robert jay lifton and chaim shatanm met w reps of a new org called vietnam veterans against the war.. for vets to org against their own war while it was still ongoing was virtually unprecedented.. this small group of soldiers, many of whom had distinguished themselves for bravery, returned their medals and offered public testimony of their war crimes.. their presence contributed moral credibility to a growing antiwar movement.. ‘exposed their country’s counterfeit claim of a just war’
‘a lot of them were ‘hurting’ as they put it.. but they didn’t want to go the vet’s admin for help.. they needed something that would take place on their own turf, where they were in charge..’
in 1980 for the first time, the chaacteristic syndrome of psych trauma became a ‘real’ diagnosis.. in that year the america psych assoc included it in its official manual of mental disorders a new category called ‘ptsd’
the late 19th cent studies of hysteria foundered on the question of sexual trauma.. at the time of these investigations there was no awareness that violence is a routine part of women’s sexual and domestic lives.. freud glimpsed this truth and retreated in horror.. for most of the 20th cent it was the study of combat vets that led to the development of a body of knowledge about traumatic disorders.
not until the women’s’ lib movement of the 70s was it recognized that the most common post traumatic disorders are those not of men in war but of women civilian life..t
the real conditions of women’s lives were hidden in the sphere of the personal in private life. the cherished value of privacy created a powerful barrier to consciousness and rendered women’s reality practically invisible.. t.. to speak about experiences in sexual or domestic life was to invite public humiliation, ridicule and disbelief.. women were silenced by fear and shame, and the silence of women gave license to every form of sexual and domestic exploitation..t
in the protected environ of the consulting room, women had dared to speak of rape, but the learned men of science had not believed them.. in the protected environ of consciousness raising groups, women spoke of rape and other women believed them..
though the methods of consciousness raising were analogous to those of psychotherapy their purpose was to effect social rather than individual change. a feminist understanding of sexual assault empowered victims to break the barriers of privacy .. to support one another.. and to take collective action.. consciousness raising was also an empirical methods of inquiry.. kathie sarachild, one of the originators of consciousness raising, described it as a challenge to the prevailing intellectual orthodoxy: ‘the decision to emphasize our own feelings and experiences as women and to test all generalization and reading we did by our own experience was actually the scientific method of research . we were in effect repeating the 17th cent challenge of science to scholasticism:’study nature, not books’ and put all theories to the test of living practice and action..
huge.. otherwise we’re studying whales in sea world
the results of these investigations confirmed the reality of women’s experiences that freud had dismissed as fantasies a century before. sexual assaults against women and children were shown to be pervasive and endemic in our culture..
over 900 women, chose by random sampling .. were interviewed in depths.. the results were horrifying.. 1 in 4 had been raped.. 1 in 3 had been sexually abused in childhood
susan brownmiller: ‘man’s discovery that his genitalia could serve as a weapon to generate fear must rank as one of the most important discoveries of prehistoric times, along w the use of fire and the first crude stone axe.. from prehistoric times to present, i believe, rape has played a critical function.. it is nothing more or less than a conscious process of intimidation by which all men keep all women in a state of fear’
(study of rape) .. and they commented that some of the victims’ symptoms resembled those previously described in combat vets
my own initial descriptions of the psychology of incest survivors essentially recapitulated the late 19th cent observation of hysteria
only after 1980 when the efforts of combat vets had legitimated the concept of ptsd, did it become clear that the psych syndrome seen in survivor of rape domestic battery m, and incest was essentially the same as the syndrome seen in survivors of war.
the implications of this insight are as horrifying in the present as they were a century ago: the subordinate condition of women is maintained and enforced by the hidden violence of men. there is war between the sexes. rape victims, battered women and sexually abused children are its casualties.. hysteria is the combat neurosis of the sex war
2 – terror
traumatic symptoms have a tendency to become disconnected from their source and to take on a life of their own.. this kind of fragmentation, whereby trauma tears apart a complex system of self protection that normally functions in an integrated fashion, is central to the historic observation so on ptsd..
people w ptsd take longer to fall asleep, are more sensitive to noise, and awaken more frequently during the night than ordinary people. thus traumatic events appear to recondition the human nervous system..
play does not stop easily when it is traumatically inspired. and it may not change much over time. as opposed to ordinary child’s play, post traumatic play is obsessively repeated.. post traumatic play is so literal that if you spot it, you may be able to guess the trauma w few other clues..
in his use of language, janet implicitly recognized that helplessness constitutes the essential insult of trauma, and that restitution requires the restoration of a sense of efficacy and power..
the trauma is resolved only when the survivor develops a new mental ‘schema’ for understanding what has happened..
the helpless person escapes from her situation not by action in the real world but rather by altering her state of consciousness.. analogous states are observed in animals, who sometimes ‘freeze’ when they are attacked.. or stuck in glare of headlights..
3 – disconnection
combat and rape, the public and private forms of organized social violence, are primarily experiences of adolescence and early adult life. the us army enlists young men at 17; the avg age of the vietnam combat soldier was 19. in many other countries boys are conscripted for military service while barely in their teens. similarly, the period of highest risk for rape is in late adolescence. half of all victims are aged 20 or younger at the time they are raped; 3/4 are between 13-26 .. the period of greatest psych vulnerability is also in reality the period of greatest traumatic exposure, for both young men and young women.. rape and combat might thus be considered complementary social rites of initiation into the coercive violence at the foundation of adult society..t they are the paradigmatal forms of trauma for women and men respectively..
4 – captivity
a single traumatic event can occur almost anywhere. prolonged, repeated trauma, by contrast, occurs only in circumstances of captivity. when the victim is free to escape, she will not be abused a second time; repeated trauma occurs only when the victim is a prisoner, unable to flee, and under the control of the perpetrator.. such conditions obviously exist in prisons, concentration camps, and slave labor camps. these conditions may also exist in religious cults, in brothers and other institutions of organized sexual exploitation, and in families..
in most homes, even the most oppressive, there are no bars on the windows, no barbed wire fences.. women and children are not ordinarily chained..though even this occurs more often than one might think.. the barriers to escape are generally invisible.. children are rendered captive by their condition of dependency. women are rendered captive by economic, social, psychological, and legal subordination, as well as by physical force..
this idea is deeply disturbing to most people. how much more comforting it would be if the perpetrator were easily recognizable, obviously deviant or disturbed. but he is not. the legal scholar hannah arendt created a scandal when she reported that adolf eichmann, a man who committed unfathomable crimes against humanity, had been certified by half a dozen psychiatrists as normal: .. ‘this normality was much more terrifying than all the atrocities put together’
a study of prisoner relationships in these (nazi) cams found that the overwhelming majority of survivors became part of a ‘stable pari’.. a loyal buddy relationship of mutual sharing and protection, leading to the conclusion that the pair, rather than the individual, was the ‘basic unit of survival’
in isolated prisoners, however.. pair bonding may occur between victim and perpetrator.. relationship may come to feel liked the ‘basic unit of survival’.. traumatic bonding.. that occurs in hostages, who come to view their captors as their saviors and to fear and hate their rescuers.. psychological infantilism – which compels victims to cling to very person who is endangering their life..
same between battered woman and her abuser
even after escape.. no ordinary relationship offers same degree o f intensity as the pathological boned w abuser
in every encounter, basic trust is in question.. which side are you on?.. the victim’s greatest contempt is often reserved, not for the perpetrator, but for the passive bystander.. ‘most people don’t know how hard i judge them because i don’t say anything.. all i do is cross them off the list.. forever.. these men had their change to help me and they didn’t respond..
same bitterness and sense of abandonment expressed by political prisoner timerman: ‘the holocaust will be understood not so much for the number of victims as of the magnitude of the silence. and what obsesses me most is the repetition of silence’
prolonged captivity disrupts all human relationships and amplifies the dialectic of trauma.. the survivor oscillates between intense attachment sand terrified withdrawal…
over time, as most people fail the survivor’s exacting tests of trust worthiness, she tends to withdraw from relationships. the isolation of the survivor thus persists even after she is free..
also profound alterations in victims’ id.. ie: patricia hearst was rebaptised tania, the revolution; lind bormena was renamed linda lovelace, the whore..
victims contaminated id.. maybe be preoccupied w shame, self loathing and a sense of failure..
while majority of his patients (from holocaust) complained, ‘i am now a different person’ the most severely harmed stated imply ‘i am not a person’..
on suicides of those returning from war.. studies of battered women similarly report a tenacious suicidality. in one group of a 100 battered women.. 42% had attempted suicide..
thus former prisoners carry their captors hatred w them even after release.. and sometimes they continue to carry out their captors’ destructive purposes w their own hands..
this is huge to our system of ie: school and work.. mostly school because it’s the 12+ early years..
dang. the whales in sea world.. perpetuating the whales in sea world..
5 – child abuse
in organized sexual exploitation, full initiation of the child into the cult or sex ring requires participation in the abuse of others..
the profound sense of inner badness becomes the core around which the abused child’s id is formed, and it persists into adult life.. this malignant sense of inner badness is often camouflaged by the abused child’s persistent attempt to be good.
none of her achievement in the world redound to her credit, however, for she usually perceived her performing self as inauthentic and false. rather, the appreciation of others simply confirms her conviction that no one can truly know her and that, if her secret and true self were recognized, she would be shunned and reviled..
self injury is also frequently mistaken for a suicidal gesture.. there is a clear distinction however.. self injury is intended not to kill but rather to relive unbearable emotional pain, and many survivors regard it, paradoxically, as a form of self preservation..
self injury is perhaps the most spectacular.. but only one among many.. .. others by voluntarily inducing autonomic crises or extreme autonomic arousal. . purging and vomiting, compulsive sexual behavior, compulsive risk taking or exposure to danger.. use of psychoactive drugs.. become vehicles by which abused children attempt to regulate their internal emotional states.. thru these devices, abused children attempt to obliterate their chronic dysphoria and to simulate, however briefly, an internal state of well being and comfort that cannot otherwise be achieved..
there 3 major forms of adaptation – the elaboration of dissociative defenses, the development of a fragmented id, and the pathological regulation of emotional states– permits the child to survive in an environ of chronic abuse.. further, they generally allow the child victim to preserve the appearance of normality which is of such importance to the abusive family.. most abused children reach adulthood w their secrets intact
although a majority of victims do not become perpetrators, clearly there is a minority who do..
6 – a new diagnosis
(on victims getting harsher sentencing/judgment – ie: patricia hearst – ie: why did they go along w it and/or hurt others) complicity and cooperation are terms that apply to situation of free choice.. they do not have the same meaning in situations of captivity..
this tendency to blame the victim has strongly influenced the direction of psychological inquiry.. looking for personality traits that predispose to victimization.. the conclusion is inescapable that ordinary , psychologically healthy men can indeed by coerced in unmanly ways.. for women.. no consistent profile of the susceptible woman has emerged.. the majority show no evidence of serious psychopathology before entering into the exploitative relationship..
a survey of the studies on wife beating concludes: ‘search for characteristics of women that contribute.. is futile.. it is sometimes forgotten that mens’ violence is men’s behavior.. what is surprising is the enormous effort to explain male behavior by examining characteristics of women‘
1964 study ‘the wife beater’s wife’.. researchers, who had originally sought to study batterers found that the men would not talk to them.. they thereupon redirected attention to the more cooperative battered women, whom they found to be castrating, frigid, aggressive, indecisive, and passive.. they concluded that marital violence fulfills these womens’ masochistic needs.. and set out to ‘treat’ them.. while this unabashed, open sexism is rarely found in psych lit today, the same conceptual error , w their implicit bias and contempt, still predominate.. thus.. patients who suffer from complex after effects of chronic trauma still commonly risk being misdiagnosed as having personality disorders.. ie: battered women described by clinicians as ‘hysterics’.. ‘hypochondriacs’..
1980s.. manual comes up for revision. group of male psych proposed ‘masochistic personality disorder’ for battereds.. a number of women’s groups outraged.. heated debate .. i was one of the participants.. what struck me os tat the time was how little rational argument seemed to matter..
on and on about how to treat..
even ptsd diagnosis does not fit .. they are based on the prototypes of combat, disaster, and rape. in survivors of prolonged, repeated trauma, the symptom picture is often far more *complex.. survivors of prolonged abuse develop characteristic personality changes…. deformation of relatedness and id..
need new name for prolonged.. i propose to call it ‘complex ptsd’..
50-60% of psych inpatients and 40-60% of outpatients report childhood histories of physical or sexual abuse or both.. in one study of emergency room patients, 70%.. abuse in childhood appears to be one of the main factors that lead a person to seek psychiatric treatment as an adult..
p 2 – stages of recovery
7 – a healing relationship
on therapist relationships
8 – safety
recovery unfolds in 3 stages: 1\ safety 2\ remembrance and mourning 3\ reconnection w ordinary life..
like any abstract concept, these sages are a convenient fiction, not to be taken too literally.. they are an attempt to impose simplicity and order upon a process that is inherently turbulent and complex…
once safe.. survivor may wish to put experience out of mind and get on w life.. and may succeed for a time.. but not a linear process.. memory bound to return..
9 – remembrance and mourning
10 – reconnection
‘if you survive it becomes a good war’
11 – commonality
groups for safety/memory/reconnection.. commonality w other people carries w ti all the meanings of the word common.. it means belonging to a society have a public role, being par of that which is universal.. being known
yeah.. let’s try just focusing on – maté basic needs law –
afterward – the dialectic of trauma continues (1997)
violence w police et al
epilogue to the 2015 edition
trauma: war on drugs.. sept 11.. iraq.. ptsd.. ace scores..
many themes of book: overcoming barriers of shame and secrecy, making intolerable feelings bearable thru connection w others, grieving the past, and coming to a new perspective w a more compassionate view of oneself in the present.. witnessing the lives transformed in this process fo recovery is what enables us old timers, the practioners of ‘plain old therapy’ to keep on keeping on
but we have the means to do something way more radical/healing..