Editor’s Note: Diana Rose, known for her leadership in service-user research, submitted a lengthy essay to Mad in America that examines the meaning of the word “trauma” today. We asked her to provide a brief summary of her paper, as a way of introducing the topic to MIA readers.
Here is her introduction:
The word ‘trauma’ is everywhere accompanied by ‘triggers’ and ‘trauma informed services’. There are geographical differences in how it plays out as well as its limits. It was not always like this. Initially it was specific to Post-Traumatic Stress Disorder’, a category appearing in DSM and ICD in the 1980s. But it has gradually been complexified so that it can mean almost anything. In one reading this means it is meaningless. I trace the histories to show this. I then take a detour into linguistics to show how it works at the level of language and other symbolic systems including the body which figures hugely in some writings.
I think it is this detour into linguistics that has led to the piece being labelled ‘academic’. It is certainly true that many readers will not be familiar with Continental semiotics and the unfamiliar can be read as ‘academic’. For those who know the field I will be accused of ‘oversimplifying’. A double-bind. My response is that if you are dealing with unfamiliar terrain, and one that flows from a different continent to boot, you need difficult language. But I understand the response and especially the response to stop reading. It is a risk I will take.
Trauma-informed care seems to be simply the opposite of usual care. The argument is that trauma-blind systems retraumatise those who have already been traumatised previously, which in the writings of some means practically everyone. UK writers tend to focus on coercion, which is hardly new as this is and always has been a pillar of the survivor movement. Compassion appears frequently and is a virtuous aim but is applicable to all, not just those who have been subject to trauma.
Some argue that memories of trauma are not available to consciousness as they are stored in a special part of the brain called the limbic system. As this is a system we share with our distant ancestors, this is also called the ‘reptilian brain’. Aside from the fact that modern neurologists have all but rejected this idea of ‘localisation’ in how the brain functions, that certain functions are the province of different parts of the brain, the racist and sexist implications of this are clear. It gives a biological basis to the barbarism / civilisation ladder.
As to politics, this narrative on trauma claims to be survivor-led. So who are the activists? If nearly everyone has experienced trauma then it looks like a general uprising is being called for. It should be noted that most writings on this subject emanate from the Global North. Is trauma the ‘same’ in the Global South? The literature suggests not, that even something as clear-cut as rape means something different in, for example, Africa, than it does in Advanced Western Democracies. It means losing your land, the ability to feed your children and that is just at a material level. These are not the consequences of rape here, they are intrinsic to what it means.
Someone needs to tell the ‘academics’ that the purpose of language is communication, not obfuscation—a ‘trauma’ all its own.
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Psychiatry singlehandedly made word-trauma a thing. One look in the DSM and you may never be the same.
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At a glance, it seems the popularity of describing things as “Trauma” is primarily a way of asserting the reality that one’s distress is a consequence of one’s experience. I think it’s a response to a strain of “mental health” that presents distress as more or less entirely internal.
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The understanding of trauma is a nightmare. It seems that it has become worse across time.
It seems that we are illiterate in communicating wherever there is trauma. It feels like it creates pain and defensiveness in everyone concerned and instead of resolution, it so often leads to exacerbation rather than healing. It feels like trauma is mostly a pathology quagmired in tribal allegiances. Imagine how an unrepaired broken leg would quickly become more and more damaged within sides and incendiary warfare.
We do heal, it seems to be in reaching-out to the misguided that causes the long-term traumatic damage, more than the initial injury. The problem is we turn to each other in our pain. When this is messed-up with humiliation, blame and denial the injury becomes toxic. What I’ve found is this quagmire leads me into an obsessive need to undo the toxic ”helping”. If people could say ”I can’t hear this” there would so much less damage.
God help us if such people are personally compromised, unself-aware and terrified of not being seen as ‘nice’.
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For reasons unclear to me, Diana regularly describes the Power Threat Meaning Framework as taking positions which it completely opposes. Thus: ‘A further ‘model’ of trauma and
responses to it is somewhere outside these divisions. That is, the Power / Threat / Meaning
framework delineated by Lucy Johnstone and colleagues (Johnstone et al., 2018). This was published by the British Psychological Society and seems part of the effort by some members to drag psychology away from its emblematic individualism but the framing of ‘trauma’ is squarely interpersonal.’ The PTMF explicitly AVOIDS, where possible, the word ‘trauma’ in favour of the term ‘adversity’ because of the very problems she identifies in her article – ‘trauma’ has so many meanings, not all of them helpful. And – the PTMF is absolutely centrally about making the link between distress, and forces BEYOND the interpersonal (ie economic, political, ideological etc..) I do wonder if she has even read the PTMF, because this is quite an impressive misrepresentation.
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