Trauma and history

Anyone looking to understand trauma, must first understand it’s history and social construction. While biological phenomena like allostatic load are material realities, so too are the conditions of society.

In fact, the concept of “shell shock” wasn’t even the first time PTSD had been documented in Western medicine. Freud, for all of his shortcomings (of which he has a nearly endless supply), was famously known for a concept known as the “repetition compulsion”. This is likely familiar to you, even if you’ve never heard the name for it. The central premise was that there are specific things that can happen in our lives that are so painful, and so profoundly change the way we understand the world that we’re never able to fully wrap our minds around the enormity of the event. Freud observed that patients who had experienced horrible events in their lives often felt the need to repeat them. This could take the more discrete form of finding oneself in precarious situations that might replicate the event, such as someone who has been in a boating accident being unable to stay away from the water, or it could take the form of endlessly replaying the event over and over in one’s brain.

Freud later abandoned this idea after receiving pressure from wealthy industrialists whose sexual abuse his work would have exposed. He went on to betray his patients, and the scientific community, by creating elaborate “complexes” that put the onus for abuse on the victim. This betrayal was concretized by Carl Jung, who continued to promote the idea as the Electra Complex. It is for precisely this reason that many therapists*, believe Freud should be abandoned altogether in pursuit of theorists with better scientific methods and at least a modicum of integrity; something Freud clearly lacked.

In his seminal work “The Wretched of the Earth”, Fanon described both individual traumas and those at the population level, examining the effects of political violence on his patients. Fanon was rigorous in his methods and transparent about his aims, and while he ultimately earned himself a place as one of the greatest revolutionary thinkers of all time, he was also one of the most influential psychiatrists in history as well.

While Freud’s ideas have been largely abandoned by well-trained contemporary practitioners, Fanon continues to make a re-emergence as one of the foremost experts on the effects of torture and political subjugation. He is largely credited with the founding of Post-Colonialism as a historical and scientific discipline.

In many ways, the violence Fanon so brilliantly documented was similar to that later described by Michel Foucault, whose work was credited by Michael White with being a founding influence on Narrative Therapy. As later adopted by Foucault, Fanon described a type of endless, self-perpetuating cultural surveillance wherein people who come from colonized cultures are themselves permanently conscripted into doing the hard work of enforcing colonial rule. It is through this practice that colonialism is able to perpetuate long after the last of the foreign soldiers have left. This process was inherently destructive of everyone in its path, creating a vacuum that would later be filled with imported customs. Later, this idea would be expanded upon in Foucault’s Panopticon.

Fanon documented the effects of this violence extensively, showing the breadth of human suffering this practice engendered. If one were to take the history of trauma seriously, Fanon might also be considered the forefather of Minority Stress Theory, largely credited to Williams and Ilhan Meyer through which cultural violence enforced by a dominant culture onto an oppressed culture leads to negative health outcomes and early death.

Ideas like Fanon’s can be seen distinctly in seminal works on trauma, such as psychiatrist and feminist theorist Judith Herman’s classic trauma text, “Trauma and Recovery”. Herman described what is often known as “complex PTSD”, which describes long, protracted experiences of suffering such as that endured by prisoners of war and those subject to human trafficking. While not explicitly named as having drawn its influence from Fanon, Herman paid extra attention to acts of violence that involved the deprivation of agency. Herman was partially responsible for shifting contemporary trauma treatment to include attachment theory. Freud’s emphasis on what would be later coined as attachment was shortsighted, and relied on the sexualization of survivors. Herman decoupled trauma work entirely from these regressive ideas.

Herman believed that trauma fundamentally changes your relationship to the world and to others, as it impedes on survivor’s ability to trust their own heuristics for measuring danger. Human beings rely on mechanisms of evaluation, short-hand that tells us who is safe and who is not. As Herman pointed out, this can evaporate when the people who are supposed to care for you are the very people responsible for your pain.

 Neuroscience has shown us indeed, prolonged exposure to terrifying events causes our autonomic nervous system to be flooded with stress hormones such as cortisol and adrenaline. These begin as the body’s nature fear response, triggering hyperoxygenation of the hemoglobin and the release of the body’s glycogen stores to enable us to fight or run from a threat. After repeated releases of adrenaline, the brain begins to scan the environment for danger constantly, and begins to struggle to distinguish between that which is a threat, and that which is not. This means that the pounding of your heart, once a normal response to fear, can be misinterpreted as evidence that a threat is present.

While massive amounts of information now exist on the various types of trauma, their sequalae and treatment, the reality is that we owe the shift away from the victim-blaming tradition of the late 18th and early 20th centuries to one of compassion led by Fanon. His recognition that external forces such as war, poverty, and oppression do indeed constitute an existential threat to our psychology created a blueprint we are only starting to follow today.