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PERSPECTIVES
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OF PAIN |
In the
wake of Rwanda, Bosnia and Kosovo, academics turn trauma studies
into a hot discipline.
By Andreas Killen
salon.com, Feb. 11, 2000
Trauma is becoming institutionalized. Until just a few years ago,
the study of psychological trauma was a scattered, esoteric enterprise
without a formally recognized presence in the university. But in
recent years, trauma studies has become a trendy interdisciplinary
offering at a half-dozen universities around the U.S. and a handful
of others abroad.
Dr. Stevan Weine, a psychiatry professor at the University of Illinois,
recently described his work with Kosovar refugees to a group of
students at New York University's International Trauma Studies Program.
In 1999, during a visit to Kosovo, Weine spoke with many people
who had been raped or tortured. Listening to their stories, he noticed
something strange: These people, unlike most of us who have experienced
tragedy, were more than eager to talk about what had happened to
them. "They wanted," said Weine, "to tell their story
to everyone who would listen, especially the media, and above all,
Bill Clinton."
Weine's anecdote hints at this combustible and compelling mixture
of tragedy, politics and media that has given rise to the field
of trauma studies, which has become one of the hottest -- some would
say, most overheated -- fields in academe. In what seems a perfect
marriage of public policy and academic theory, recent years have
seen the convergence of a panoply of scientific and intellectual
investigations around this subject. The aftermath of trauma is being
researched in laboratories and analyzed by historians, literary
critics and experts in media, law and psychiatry. Meanwhile, the
effects of trauma proliferate in war-torn countries, clinics and
courtrooms, as well as on Web sites documenting post-traumatic stress
disorder among victims who range from survivors of ethnic cleansing
to law enforcement officers.
It's no accident that Clinton was the intended audience for these
stories. In addition to being the leader of the most powerful country
in the world, he's probably done more than anyone since Sigmund
Freud to make it acceptable to talk about psychic pain. Does the
advent of trauma studies, as its advocates claim, mean the subject
is simply receiving the long-overdue attention it deserves? Or does
it mean, as others suggest, the triumph of victim culture; the saturation
of public discourse with shocking stories?
There is no simple definition of trauma. Researchers claim to be
targeting its underlying neurophysiology by linking trauma with
shrinkage of brain tissue. Psychologists regard it as neither depression
nor mental illness, but rather as an assortment of symptoms including
nightmares, flashbacks, depression, amnesia, thoughts of suicide
and states of disassociation that plague survivors of psychologically
shattering events.
Charles Figley, head of the Psycho-Social Stress Laboratory at Florida
State University and editor of the electronic journal Traumatology,
explains that "our society has become more toxic and thus we
react to events vicariously. This is due in part to the fact that
our lives are more fraught with anxiety." Taking a more jaundiced
view, others have proposed that ours is a "trauma culture"
on the verge of drowning in a surfeit of tragic tales.
In the New York Review of Books, Ian Buruma takes a more skeptical
view by suggesting that the current proliferation of Holocaust museums,
memorials and memoirs feeds a ghoulish cult of vicarious traumatization.
The most extreme example is Binjamin Wilkomirski, the Swiss writer
whose Holocaust complex resulted in a "memoir" that used
memories supposedly recovered under hypnosis to help reinvent himself
as that most privileged of victims: the concentration camp survivor.
As psychoanalyst Ghislaine Boulanger explains, trauma has a cyclical
history connected with times of extreme violence or social upheaval,
such as the Holocaust, the Vietnam War and the feminist movement.
Initially applied to Vietnam veterans, post-traumatic stress disorder
was included in the criteria for insurance reimbursement for the
first time in 1980 and later incorporated into studies on domestic
and sexual abuse. But by the end of the 1980s, advocates of recovered
memory were lumped with alien abduction and satanic ritual abuse
theorists. This uninvited alliance was an embarrassment to the field.
The "ethnic cleansing" of the past decade may have placed
trauma on the contemporary radar screen. In the 1980s, reports of
torture or genocide in places like Chile or Sri Lanka failed to
capture world attention, but more recently, events in Rwanda, Bosnia
and Kosovo have generated a wave of protest. In the United States,
clinics for torture survivors have become a cottage industry, and
the field of trauma studies has acquired all the trappings of a
discipline: academic programs, certifying boards, journals, electronic
newsletters and international conferences.
New York University's International Trauma Studies Program is one
example of trauma's new cachet as an academic subject -- evidence,
according to its director, Jack Saul, that "trauma is here
to stay." The program, now in its second year, provides specialized
training for mental health professionals who work with trauma survivors.
It tries to broaden the framework of training for all those who
deal with trauma survivors and refugees. Saul stresses that professionals
must abandon their neutrality and advocate for patients by educating
them about their human rights.
Another feature of this training concerns the secondary effects
of constant exposure to trauma. "Vicarious traumatization"
refers to the fact that dealing with disasters is emotionally draining.
A significant percentage of those who do so suffer from burnout
and symptoms of PTSD. Aside from high turnover rates, "vicarious
trauma" creates more serious problems, such as "re-traumatizing"
the client. It's not uncommon for immigration lawyers to vent by
becoming sadistic and treating their clients as liars or malingerers.
Police departments have recognized the phenomenon as a factor in
police brutality. Web sites maintained by Vietnam veterans and ex-police
officers routinely invoke books like "Copshock," which
makes the alarming claim that 20 to 30 percent of law enforcement
officers working in urban areas will develop post-traumatic stress
disorder. The exculpatory potential of such claims was illustrated
by the father of Justin Volpe, the officer who sodomized Abner Louima
in 1997. Volpe's father pleaded stress-related disorder in defense
of his son, who claimed he couldn't remember what happened. (Volpe
is serving 30 years after pleading guilty to violating Louima's
civil rights.)
It's no wonder that one issue at the center of trauma studies is
the relation between trauma and the stories told about it in courts,
the media and art. Weine, the Illinois professor, cautions that
questions about the quality of testimony cannot be ignored, given
the legal and political issues at stake, and evidence of the ease
with which these stories can be manipulated, whether by therapists
with their own agenda, or by radical ethno-nationalists solely interested
in settling old scores. Trauma is increasingly vulnerable to counterfeiting
and misrepresentation. As Steven Reisner, a psychoanalyst who teaches
at NYU's trauma studies program, puts it, trauma sells, and people
are rushing to cash in before its currency becomes devalued.
If the challenge for trauma experts lies in evaluating patients'
stories, this task seems to be growing more and more difficult.
How, for instance, does it complicate our notions of trauma that
police officers are now claiming the status of trauma victims, or
that the Kosovars have turned out to be every bit as brutal as the
Serbs? Reisner predicts that the current trauma activism in Kosovo
will end badly. The desire for clarity simply won't hold up; recognition
of Kosovar crimes will overburden the narrative of bad Serbian and
good Kosovar.
Reisner strikes a more positive note in tracing the value of trauma
to a shift in the political landscape. "What's different today,"
he says, "is that the voice of human rights as a moral compass
has become clearer." Public discussion of torture in Chile,
for instance, is no longer so easily obscured by anti-communism.
But if the tendency on the right is to downplay human rights abuses,
the left has been no less guilty of its own myopia. In its desire
to set the historical record straight, it sometimes naively accepts
stories that prove false upon closer scrutiny.
Many trauma scholars invoke the possibility that the Clinton years
made suffering a topical and valid course of study. According to
Ernie Duff, director of a community outreach center in Queens, N.Y.,
refugee mental health was once considered a soft service with low
budgetary priority, but it has gained credence under the Clinton
administration. Five years ago, says Janet Chassman, head of New
York state's Department of Mental Health Trauma Initiative, no one
wanted to hear about the aftermath of suffering. Now it's everywhere,
which she attributes to the policies of the Clinton administration.
For example, in New York City, two-thirds of patients with serious
mental illness have now been diagnosed with trauma histories.
Will the preoccupation with trauma die with the Clinton administration?
Some people may hope so. Listening to disclosures from Clinton,
Monica Lewinsky, Henry Hyde and Newt Gingrich may be hazardous to
public health: Like vicarious traumatization, it can induce exhaustion
and nausea.
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