On Trauma – Introductory Abstracts

Aleksandar Dimitrijevic

“The ordinary response to atrocities is to bannish them from consciousness. Atrocities, however, refuse to be buried. Remembering and telling the truth about terrible events are prerequisites both for the restoration of the social order and for the healing of individual victims.”

– J. Herman: Trauma & Recovery. The Aftermath of Violence–From Domestic Abuse to Political Terror

Last winter we hosted a Learning Module on Trauma, a psychological phenomena that wanders through all stages of life, comes in various shapes and colors and yet often remains an obscure topic to many; unrecognized in societal structures and perception. Our intention was to lift those heavy curtains and shed some light on the various corners traumatic disorders can retrieve into. Because we felt a strong curiosity for the very fundamental and underlying mechanisms of trauma, we have curated a selection of introductory academic abstracts, previously written and published in academic context by our facilitator, teacher at IPU Berlin and Stillpoint counselor, Aleksandar Dimitrijevic.

What is trauma?

Trauma is a result of an internal or external event that stimulates the mind to an unbearable degree. It can be a result of natural disasters, individual violence, and/or socially organized perpetration, which may have grave consequences for somatic and mental health. It is also socially relevant, because long-lasting post-traumatic disorders put serious burden on the health system. In a sociological perspective, specific social traumatic experiences, if culturally acknowledged, sometimes serve as a key narrative for social identity.

(…) Trauma was a very important topic of French and German 19th century medicine. It came to prominence with Sigmund Freud and was much studied by psychoanalysts. Widely used Kaplan’s “Synopsis of Psychiatry” has up to the 1980 edition relied on a 1955 study that had claimed incest occurred in just one out of one million American families (after Ross, 1996, pp. 6-7). More recent estimates claim that there are approximately one million cases of child abuse and neglect substantiated in the US each year (US Department of Health, 2005, www.acf.hhs.gov).

There is evidence that it is the type of trauma impact rather than its severity that predicts the kind and degree of symptoms, for instance symptoms following non-intentional trauma decrease within three months, while those following intentional trauma increase steadily.

What is the role of adverse childhood experiences?

A study of adverse childhood experiences that included more than 17,000 adults revealed that the incidence rate for different types of trauma is alarmingly high (for a review see Dimitrijevic, 2015). In some cases, one quarter or even a third of the subjects were exposed to trauma during childhood, with strong gender differences (e.g., there are more physically abused men, but more sexually abused women). More than one third of the sample have grown up without serious trauma. (…) Most maltreatment happens in the earliest childhood, when it has greater negative effects on developing minds and brains. (…). Incidence of family trauma is also disturbingly high, and especially for women. Every fifth subject has experienced at least one type of household dysfunction, and some more than one.

What is social trauma?

Man-made traumatizations are touching great parts of the population, those caused by genocide, war, dictatorship with racist, ethnic and political persecution, have a special position among all possible sources of trauma. Social trauma includes organized or intentional perpetration by one social group (for example a nation) against  another social group, not an individual. While we may hope that a traumatized individual, even a child, can find some support and comfort, social trauma destroys the societal and cultural structures whose support and comfort we otherwise take for granted: home, language, joint memories, as well as hospitals, counseling and psychotherapy services or legal system.

Not only is social trauma important for individuals and groups who need help, but also in the core of large group identity. Psychoanalyst and renowned international peace negotiator, Vamik Volkan (1997,1999) initiated a concept of “chosen trauma”, which is widely used. Volkan’s comparative research showed that one event – a death, massacre or genocide, a lost battle or kingdom – often becomes a centerpiece of national identity. It is then difficult to negotiate or compromise, because people have an impression that they are betraying this painful myth.

What are the consequences of trauma?

Many clinical psychologists have, in studies of various types, found that consequences of childhood trauma include and are not limited to the following (see Dimitrijevic, 2015):

Besides developmental and health issues, trauma is especially important for the field of mental health care. The more traumatic events one experienced during the childhood the more likely s/he is to develop Mood disorder, Anxiety Disorder, Substance Abuse or Impulse Control Disorder (see Dimitrijevic, 2015). Furthermore, early individual traumata are 4-10 times more frequent among psychiatric patients than in general populations. This is further underlined by comparison studies that established differences between psychotic patients with the history of childhood trauma and those without it (see Dimitrijevic, 2015), which resulted in the finding that the consequences of childhood trauma are associated with:

It was also shown that social trauma has profound negative consequences. A study with 12,746 participants, which compared Holocaust survivors with control groups with no Holocaust background (see Hamburger, in press) demonstrated that Holocaust survivors were less well adjusted, particularly showing substantially more PTSD symptoms. Another finding

was that they also showed remarkable resilience. Higher rates of mood and anxiety disorders were associated with having more potentially traumatic experiences during and after the war in a study that employed multivariable analyses across countries of the former Yugoslavia where 3,313 subjects were interviewed (see Hamburger, in press).

Connection between family and social trauma was confirmed in a study that showed significant differences in attachment styles related to types of war exposure in three samples of adolescents who grow up under different war impact conditions in towns of three former Yugoslavian countries (see Hamburger, in press).

Testimonial interviews with Holocaust survivors, slave laborers, and survivors of the genocide in Rwanda (for a detailed review see Hamburger, in press), demonstrated typical cognitive and emotional symptoms: survivors do not have a life history in the form of a coherent autobiographical narrative, and they display “an erasure” of feelings, comprising of a massive denial and/or disavowal of trauma, extreme ambiguity, speechlessness, psychotic or seemingly psychotic delusions and other psychotic and psychosomatic symptoms, frequent nightmares, flashback memories, as well as daydreams of persecution.

How does trauma work?

Traumatized children, especially if by intentional traumatization within the family, move toward parents and at the same time away from them and are forced to create multiple models of caregivers. Faced with the situation in which, for instance, the father, supposed or until recently actual source of comfort and love, starts abusing him or her, the child may unconsciously decide to sacrifice his or her own mind in order to save the representation of the father. These children may split their memory, cognition and emotions in order to separate two types of experiences with the parent: loving father from abusive father. There is, then, one part of themselves they do not dare admit even to themselves, one part too horrible to face. The traumatized child first defensively inhibits her capacity to think about inner states of others and her/himself, trying to avoid the insight that the parent may wish to hurt her. Consequently, trauma impedes deeper procession of emotional experiences and interferes with the (further) development of mentalizing capacity or can even destroy it.

This experience may generalize and the child then feels that “looking inside” is dangerous under any circumstances. Being unaware of inner psychological processes means, of course, that you cannot control or regulate them. Exactly this is considered to lead not only to the disorganized attachment, but to some forms of mental disorders as well.

The involvement of the social environment in the traumatization of a whole group causes severe trauma consequences visible on an interactional level. Denial of acknowledgement, a conspiracy of silence, institutional rejection, breakdown of a successful myth construction, and, moreover, of historical elucidation, are among the social symptoms perpetuating social trauma. This also has consequences for the traumatized individual, who, in a scarred and sometimes hostile environment, is then deprived of major resilience factors necessary for a successful coping process.

It is now believed that the cause of many mental disorders is a combination of: a) severe and/or repeated childhood trauma, and b) lack of a person who could provide the intersubjective foundation for mentalizing. Trauma, thus, does not have to lead to a mental disorder and will not do so in cases when there are adults ready to face and recognize child’s traumatic experience and offer help in thinking about and overcoming it.

Is trauma treatable?

Not only is trauma devastatingly painful, but it is very expensive (for details see Dimitrijevic, 2015). Therefore, more and more effort is being put into treatment of its consequences.

We now know who the most helpful parents are: autonomously attached women who had experienced significant loss(es) that they managed to overcome (labeled “Earned Secure”, as opposed to “Continuous Secure”) were able to show the lowest frequency and intensity of frightening or frightful behavior, and proved to be most helpful to their children. Due to their experiences of both traumatization and overcoming it, these mothers, more or less unconsciously, know what their children need and how to provide that. (…)

Aleksandar Dimitrijevic

Below you can view the lecture recordings with Aleksandar from our Trauma Learning Module. Visit our Youtube Channel to see all of the lectures by Aleksandar held at Stillpoint Berlin.

 

Lecture 1: What is Trauma and Which Disorders Does it Cause?

Lecture 2: How does Trauma “Gnaw our Inwards?”

Lecture 3: How to prevent and heal trauma?”

Literary References:

Alisic, E., Zalta, A. K., Van Wesel, F., Larsen, S. E., Hafstad, G. S., Hassanpour, K., & Smid, G. E. (2014). Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: meta-analysis. The British Journal of Psychiatry, 204(5), 335-340.

Bakermans-Kranenburg, M. J., Van Ijzendoorn, M. H., & Juffer, F. (2003). Less is more: meta-analyses of sensitivity and attachment interventions in early childhood. Psychological Bulletin, 129(2), 195-215. doi:10.1037/0033-2909.129.2.195.

Dimitrijevic, A. (2015). Trauma as a neglected etiological factor of mental disorders. Sociologija, 57(2), 286-299.

Hamburger, A. (in press): Genocidal Trauma. Individual and Social Consequences of the

Assault on the Mental and Physical Life of a Group. In Laub, D. & Hamburger, A. (eds.), Psychoanalytic Approaches to Social Trauma and Testimony: Unwanted memory and holocaust survivors. London: Routledge.

Volkan, V. D. (1997.) Bloodlines: From Ethnic Pride to Ethnic Terrorism. New York: Farrar, Straus and Giroux.

Volkan, V. D. (1999). Das Versagen der Diplomatie: Zur Psychoanalyse Nationaler, Ethnischer und Religiöser Konflikte. (The Failure of Diplomacy: The Psychoanalysis of National, Ethnic and Religious Conflicts.). Giessen: Psychosozial-Verlag.

Further reading:

Allen, J. G. (2001). Traumatic relationships and serious mental disorders. John Wiley & Sons Ltd.

Hacking, I. (1995): Rewriting the soul. Multiple personality and the sciences of memory. Princeton, NJ: Princeton University Press.

This academic introduction was co-written by Andreas Hamburger, Professor at the International Psychoanalytic University, Berlin.

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