Some thoughts on trauma:
- A traumatic event creates a rupture in our narrative. Different people experience it differently: some are more resilient; some are less resilient. Cultural conditioning plays a role in this (one author gives the example of the death of a child in a country that has a high infant mortality rate).
- The symptoms of trauma are often presented as avoidance (or constriction), intrusion, and hyperarousal. Avoidance leads the victim to avoid things that might cause them to reenact the traumatic experience: they will stay away from the site of the traumatic event, not talk to people, maybe even stay in their house. Intrusion is the reliving of the trauma, when traumatic memories reappear without context or warning--flashbacks. Hyperarousal is an increased vigilance, an effort by the body and mind to prevent being re-traumatized.
- Trauma and disability often co-present. Freud, for instance observed that when a wound accompanies the accident, the traumatic neurosis tends to be lessened. I think this observation has strong implications for a discussion of the mind/body relationship, but I need to think that through.
- Trauma is often rendered as a series of paradoxes: it is unspeakable, but the victim needs to retell the story. It is unknowable (and this takes several forms--unknowable, at least at first, to the victim; unknowable to those asked to listen to the stories; forgotten) but known (remembered). It is a moment in time, and a moment out of time.
- Trauma and PTSD are not the same thing. PTSD is a codification of traumatic symptoms that emerged around WWII, and whose definition was periodically revisited (it appeared in the DSM-I, but not the DSM-II; it appeared in the DSM-III in part thanks to the lobbying efforts of Vietnam Veterans advocacy groups; it was revised for the DSM-IV and reclassified in the DSM-V). This codification allows PTSD to be measured, diagnosed, cured, medicated, grant-funded, and all kinds of other things: it has become, in a sense, a commodity. Trauma and its effects (as per point #1 above) are dealt with differently by different people from different backgrounds and cultures.