As we know, a massive earthquake is the epitomy of a traumatic experience. While we're all thinking about Haiti, I thought I'd share some facts about individual and collective trauma that you might not already know. I am not going to cover PTSD here, Jimstaro wrote about that in a great diary the other day.
I want to share this information partly to counteract a media meme that's been developing over the past few days that has to do with "danger" "rioting" and "rising tensions" among the Haitians, which has more to do with stereotypes than anything on the ground. Don't believe me? Take it from Paul Farmer on the ground:
But contrary to rumors of looting and mayhem, the city of two million was quiet, which in itself was unusual. I had never experienced Port-au-Prince without the blaring of radios and car horns. And I expect it will remain this way -- calm, as long as people are offered dignity and respect and the necessities of daily survival: food, water, sanitation and shelter.
FYI - I posted this last night, but with the MA election getting all the attention, was asked to post again. I'm hoping you'll keep reccing Fishoutofwater's and the Shelter Box diary too. And don't forget Allie123's diary for today on Helping Haiti. Lets keep the Haiti diaries on the rec list as much as possible.
Individual Trauma
Initial reactions of shock, disbelief, and numbness are very common among trauma victims. This is because trauma affects the thought process, and people therefore struggle to understand what has happened. After a traumatic event people also routinely feel guilt, anger, irritability, fear, anxiety, and depression. Psychologists have observed increases in drug and alcohol abuse and aggressive behavior, and sexual difficulties, especially in, but not limited to, cases of sexual assault. Individuals may also withdraw from others in the belief that they cannot understand or help (Tedeschi and Calhoun 2000, 20, 25).
Trauma is also associated with a moderate increase in the likelihood of developing a physical disease. Physical discomfort is also common, and is related to the increased arousal of the autonomic nervous system. Many people experience fatigue, “gastrointestinal difficulties, headache, loss of appetite, difficulty breathing freely, aches and pains and urinary problems.” Trauma victims are also at increased risk of developing a psychiatric disorder (Ibid).
There is a huge body of literature on trauma, but I want to talk about the work of three people here, psychiatrists Robert Jay Lifton and Victor Frankl, and sociologist Kai Erikson, who first developed the idea of collective trauma. I am not going to go into PTSD here. It has been diaried before, and we're not in the "post" phase yet anyway.
Important Figures in Trauma Studies (non-PTSD)
Dr. Robert Jay Lifton, a psychiatrist, became famous for interviewing survivors of extreme trauma, including Hiroshima, Vietnam, the Holocaust, the nuclear threat, and Chinese prison camps (see, for example, Lifton 1976).
Lifton found the following psychological commonalities among trauma victims from different cultures:
- The death imprint, which comes from a confrontation with the idea of death, and involves remembering grotesque images and viewing subsequent events through the lens of death (some people cannot move past the death image, while others consider it a source of meaning);
- survivor guilt, some of which is related to the helplessness experienced during the traumatic event, which provokes self-condemnation and a feeling of moral and legal guilt for what a person did not (but in reality could not) do to ameliorate the incident;
- psychic numbing, in which the mind and emotions shut down; and
- suspicion of nurturers, in which survivors suspect that any help that arrives is counterfeit and therefore do not place trust in their relationships with others (which makes their own lives seem counterfeit to them); and
- a struggle for meaning(Sawada et al. (2004).
Additionally, in an attempt to overcome the psychic numbing that happens as the mind tries to shield itself from these threats, people have dreams, nightmares and daytime intrusions, which help them “to master the impact of the trauma and to attempt assimilation and integration of existing and pre-existing mental processes”.
As a result of all of these types of intense experiences, the victim of trauma has a changed experience of self. “The combination of the death imprint, survival of the death encounter, failed enactment and psychic numbing has severely damaged the self process, leaving a depleted and desymbolized subject who finds it extremely difficult to trust other humans or the environment, which is often experienced as threatening or lethal” (Walsh, 252).
So, trauma makes you not recognize yourself, and you find everything in your environment threatening. The old ways you used to make sense of the world no longer work either.
Thus, it is imperative for anyone who has had a traumatic experience to recover or reorder meanings and develop a new sense of self, and reestablish a sense of safety.
In Haiti, people will develop new identities, or modify their old ones, and seek things that make them feel safe again.
An Existential Approach
Another perspective on questions of meaning-making that arise in the wake of traumatic experiences comes from existential psychology, which has long dealt with these types of issues. Viktor Frankl, who founded the Third Viennese School of Psychiatry, is probably the best known of the psychiatrists who examined suffering from an existential perspective. Frankl saw despair not as a direct consequence of suffering, but as the result of not finding meaning in suffering (Tedeschi and Calhoun 2000, 10).
Like Lifton, he argued that there is a basic human need to derive meaning out of life. Frankl’s approach, outlined in his famous book, Man’s Search for Meaning (1984), is based on his own experiences in a concentration camp. He argued that people derive meaning out of life in three basic ways. The first is through creating something or doing a deed. The second is through interacting with others, in love relationships, and the third is through suffering, becoming a victim of someone or something. Arguing that “self-transcendence is the essence of existence” (Frankl 1984, 50).
Frankl asserted that
even the helpless victim of a hopeless situation, facing a fate he cannot change, may rise above himself, may grow beyond himself, and by so doing change himself. He may turn a personal tragedy into a triumph... (Ibid, 147).
I have full faith that this is what the Haitians will do. They are a very resilient people.
Since Frankl’s book was published, his theories have been borne out by other psychologists and psychoanalysts. Many psychologists have noted that during the process of recovering from traumatic experiences people can create meanings and change themselves in ways that reflect substantial emotional growth (Harvey and Miller 2000; Tedeschi and Calhoun 2000; Tedeschi, et al. 1998).
From Individual to Collective Trauma
Sociologist Kai Erikson is famous for developing the concept of collective trauma. He first became known for his ground-breaking 1972 study of the effects of a flood on an Appalachian community, Buffalo Creek, West Virginia. Afterward, he continued to analyze the social and personal impacts of a number of disasters in communities ranging from a group of Haitians in Immokalee, Florida, to an Ojibwa town in Ontario, Canada. He observed that events take on a traumatic quality because of how people react to them, not because of their intrinsic nature.
As Erikson notes: “the most violent wrenchings in the world, that is to say, have no clinical standing unless they harm the workings of a mind or body, so that it is the damage done that defines and gives shape to the initial events, the damage done that gives it its name” (Ibid, 229).
Erikson defines trauma as:
a blow to the tissues of the body - or more frequently now, to the structures of the mind - that results in injury or some other disturbance. Something alien breaks in on you, smashing in whatever barriers your mind has set up as a line of defense. It invades you, possesses you, takes you over, becomes a dominating feature of your inner landscape, and in the process threatens to drain you and leave you empty.
The classical symptoms of trauma range from feelings of restlessness and agitation at one end of the emotional scale to feelings of numbness and bleakness on the other.
Traumatized people often scan the surrounding world anxiously for signs of danger, breaking into explosive rages and reacting with a start to ordinary sights and sounds, but at the same time all that nervous activity takes place against a numbed gray background of depression, feelings of helplessness, and a general closing off of the spirit as the mind tries to insulate itself from further harm. Above all, trauma involves a continual reliving of some wounding experience in daydreams and nightmares, flashbacks and hallucinations, and in a compulsive seeking out of similar experiences (Erikson 1994, 228).
Erikson noted that survivors of the Buffalo Creek flood withdrew into themselves, felt numb, afraid, vulnerable, and alone. But he also saw some group phenomena as well.
First, we must define collective trauma. Erikson considered it to be a “blow to the basic tissues of social life that damages bonds attaching people together and impairs the prevailing sense of community.”
However other researchers, including Freud, have observed that people’s allegiance to the group becomes stronger the more terrifying the external threat is, and that under extreme conditions they may even sacrifice their lives for the sake of the group. This intensified sense of belonging has been referred to as “the taming of terror,” and the social support that the victims create for themselves “the trauma membrane” (McFarlane and van der Kolk 1996, 24). So, how can it damage the fabric of social life and also bring people together?
Erikson himself also observed that “traumatic wounds inflicted on individuals can combine to create a mood, an ethos - a group culture, almost - that is different from (and more than) the sum of the private wounds that make it up” (Erikson 1994, 230-231). From this he concluded that “trauma can create community” (Ibid, 231).
This collective mood develops because in moving to the center of people’s beings, trauma gives victims the sense that they are "set apart and made special," and that that this sense of being special can become a kind of calling that draws people to others who have been marked in a similar way.
There is a caveat to this -- the camaraderie gained by people sharing disturbing experiences is not an easy one, even though it is a source of communality “in the same way that common languages and common cultural backgrounds can be. There is a spiritual kinship, there, a sense of identity, even when feelings of affection are deadened and the ability to care numbed.” Thus, “estrangement becomes the basis for communality”.
So, how can we reconcile these two ideas, that trauma tears social fabric while it brings people together? Well, that's just what it does. In fact,
trauma has both centripetal and centrifugal effects.
Trauma, then, brings people together but it also pulls them apart.
Collective and Individual Trauma in Haiti
If we consider culture to be a shared set of meanings, Haitian culture will be changed from this disaster. In the process of recovering from trauma, and the huge amount of grief that is going to be involved in that, individuals are going to be making new meanings from their earthquake experiences. These meanings will come together to change current culture and produce new cultural forms. A huge amount of memorialization necessarily will be part of this.
One of the other things that is going on in Haiti may perhaps be called a spiritual trauma. An article in the New York Times today by Damien Cave pointed out the fact that the burying people in mass graves disconnects the Haitians from the links they feel with their ancestors. It's another huge loss.
Haitians must now add another loss: the ability to identify and bury the dead. Funeral rites are among the most sacred of all ceremonies to Haitians, who have been known to spend more money on their burial crypts than on their own homes.
It is the product in part of familiarity with death — the average life span of a Haitian is 44 — but also the widespread voodoo belief that the dead continue living and that families must stay connected forever to their ancestors.
“Convening with the dead is what allows Haitians to link themselves, directly by bloodline, to a pre-slave past,” said Ira Lowenthal, an anthropologist who has lived in Haiti for 38 years. He added that with so many bodies denied rest in family burial plots, where many rituals take place, countless spiritual connections would be severed.
“It is a violation of everything these people hold dear,” Mr. Lowenthal said. “On the other hand, people know they have no choice.”
They have no choice. They are going to have create some kind of adaptive religious mechanism that addresses this.
I hope that if we can get a better grip on what traumatic events do at both the individual and group levels, we can understand things that go on in the streets after disasters and be more critical of media depictions of situations on the ground. And we can start to envision what is going to be needed during the recovery phase of this disaster.
Yes, there is desperation and people will search for supplies, and there will be some alienation and distrust of nurturers. But people will come together and do incredible things for each other too. That's just the nature of group trauma.
Yahoo article on trauma and Haiti
References and Further Reading:
National Center for PTSD (Veterans Administration)
Caruth, Cathy, ed. Trauma: Explorations in Memory. Baltimore: The Johns Hopkins University Press, 1995.
Erikson, Kai T. A New Species of Trouble: The Human Experience of Modern Disasters. New York: W.W. Norton & Company, 1994.
Frankl, Viktor. E. Man's Search for Meaning: An Introduction to Logotherapy, Third edition. New York: Simon & Schuster, 1984.
Fullerton, Carol S. Shared Meaning Following Trauma: Bridging Generations and Cultures. Psychiatry 67(1):61-62, 2004.
Herman, Judith Lewis. Trauma and Recovery: The Aftermath of Violence - from Domestic Abuse to Political Terror. New York: Basic Books, 1997.
Janoff-Bulman, and Andrea R. Berger. The Other Side of Trauma: Towards a Psychology of Appreciation. In Loss and Trauma: General and Close Relationship Perspectives. J.H. Harvey and E.D. Miller, eds. Philadelphia: Brunner-Routledge, 2000.
Jenkins, Janis H. Culture, Emotion, and PTSD. In Ethnocultural Aspects of Posttraumatic Stress Disorder: Issues, Research, and Clinical Application. A.J. Marsella, M.J. Friedman, E.T. Gerrity, and R.M. Scurfield, eds. Washington DC: American Psychological Association 2001.
Kleinman, Arthur, Veena Das, and Margaret Lock, eds.
Social Suffering. Berkeley: University of California Press, 1997.
Leys, Ruth. Trauma: A Genealogy. Chicago: University of Chicago Press, 2000.
Lifton, Robert Jay. The Life of the Self: Toward a New Psychology. New York: Simon and Schuster, 1976.
Robben Antionius, C. G. M., and Marcelo M. Suárez-Orozco, eds.
Cultures Under Siege: Collective Violence and Trauma. New York: Cambridge University Press, 2000.
Sawada, Aiko, Julia Chaitin, and Dan Bar-On
Surviving Hiroshima and Nagasaki: Experiences and Psychosocial Meanings. Psychiatry 67(1):43-60, 2004.
Tedeschi, Richard G., and Lawrence G. Calhoun. Trauma and Transformation: Growing in the Aftermath of Suffering. Thousand Oaks CA: SAGE Publications, 2000.
van der Kolk, Bessel A., Lars Weisaeth, and Onno Van der Hart. History of Trauma in Psychiatry. In Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society. B.A. van der Kolk, A.C. McFarlane, and L. Weisaeth, editors. New York: The Guildford Press, 1996.
Walsh, Noel. Life in Death. In Trauma and Self. C.B. Strozier and M. Flynn, eds. Lanham MD: Rowman & Littlefield, 2005.
Young, Allan. The Harmony of Illusions: Inventing Post-Traumatic Stress Disorder. Princeton: Princeton University Press, 1995.
And yes, I pulled this stuff out of my dissertation.