Monday, October 05, 2015

RECONCILING TRAUMA



For the next few days I’m going to be working my way through a pile of materials about PTSD, which necessarily pulls in narrative-based theory (telling your story) and other subjects like cross-discipline studies, experience-based learning, fMRI, and so on.  It becomes clear that PTSD studies are in a state of reconsideration and reconfiguration.  I’m not part of any academic group, but my community here in Montana includes people who need more understanding and better strategy than drinking, which is already a problem.  I see that depression is part of this complex and recognize in myself that anger is an immediately effective way of handling depression, even if you have to fantasize about the target and even it doesn't work very well in the long run.

Daniel H. Lende with PTSD support group

If you want to follow along, I’ll identify what I’m reading and how it strikes me.  The place I started was a book called “The Encultured Brain: An Introduction to Neuroanthropology” edited by Daniel H. Lende and Greg Downey.  So far I’ve only read one article:  “War and Dislocation: A Neuroanthropological Model of Trauma among American Veterans with Combat PTSD” by Erin Finley.  I was impressed enough that I ordered her book, “Fields of Combat.

Greg Downey and his cross-species relationship, Louis

It hasn’t come yet so there will be a “second wave” of thinking when this book and others arrive.  In the meantime I found her 2008 article called “Cultural Aspects of Post-Traumatic Stress Disorder: thinking on Meaning and Risk.”  The gist of it is that “meaning” is one of the factors that can relieve trauma that won’t end otherwise.  An expert told her that “meaning” was about depression rather than PTSD, but she found in her research that the two overlapped a lot.


Dr. Edna Foa

At the time she was writing, two people were working on what is called “Prolonged Exposure TherapyDr. David Riggs and Dr. Edna Foa.  It’s a strategy of reiteration to the point of habituation, which is sometimes used for phobias and obsession.  I don’t find it attractive, so I skipped it for now.

Finley’s point of view is more research-oriented so she wants to know what makes one man vulnerable and not the next, what makes one event traumatic and not the next.  Cultural meaning, life history, genetics, echo from previous traumas, all seem relevant.  She was particularly interested in NCO’s whose place in the social and power structure of the military is both to protect the men under them and obey the men over them -- which sometimes puts them in impossible conflicts.

Lt. Col. Dave Grossman

Lt. Col. Dave Grossman points out that one way to resolve this is to define some people as evil (ok to kill) and others as innocent (must protect).  Surely we see this in our whole society as a political tool demonizing the “Other” and even in the erratic thinking of deranged shooters.  I once read a bit of memoir by a woman who worked one summer in Alaska canning salmon.  Her job was to separate the dark meat of each fish from the light.  She found herself demonizing the dark, at first as a fantasy, but then the dark fish meat became in her mind “bad” and even “evil.”  This suggests to me an organic brain function left over from evolution and coming down to “ingroup” versus “outgroup.”



Memory, which is narrative, seems important to study.  Here Finley talks about Theresa O’Nell, an anthropologist working with Native American communities in Montana, who answers the question of why just telling stories down at the VA bar isn’t effective, but the stories that leave men weeping and distraught after protected sharing can have profound effects on them.  

There is a lot of plot-fodder in this, but O’Nell has a new “take.” which is from a different culture.  (Sioux) They speak of iglata, stories that are funny and often told when a little bit “mellow” from drinking.  Many of my Blackfeet friends tell these stories, but get upset when I retell them, because they are about “owning” the experience while putting a collar on it, deflating it.  The contrast is wagtoglata, which is to “retell one’s heroism.”  This is often translated as “boasting” when anthropologists explain that important events are preceded by the oldest, most important, and most respected men telling their achievements in order to endorse the importance of a ceremony.  

There is another level of story in the Blackfeet context.  One is the sweat lodge stories that go deep (men-only among Blackfeet) and the other is the old women’s stories in the wee small hours when no one else is around, which are also truth-telling but more moral, more focussed on the group, its “way.”  World-making.

O’Nell’s book is called Disciplined Hearts: History, Identity, and Depression in an American Community.”  25¢ at Amazon.  Grab it!

In her article in “The Encultured Brain” Finley offers six elements: 1) cultural environment, 2) stress, 3) horror, 4) dislocation, 5) grief, and 6) cultural mediators.  In a long comment on the article, Mike Defreitas (no background) takes exception.  He wants to focus on a physiological neurological tension between hyperarousal and hypoarousal and the various ways people handle this universal reciprocal relationship.  It is controlled by the sympathetic/parasympathetic system and therefore not conscious, except for the effects, like panting or increased heart rate.

Philip Bromberg


The expert he quotes is a psychoanalyst, Philip Bromberg, whose books are “Awakening the Dreamer: Clinical Journeys” and “Standing in the Spaces: Essays on Clinical Process Trauma and Dissociation.”  (Expensive books.)  DeFreitas recommends “mindfulness,” which is very trendy just now.  Most of the time I find psychoanalysis full of moonbeams and self-congratulation, but Defreitas also brings up Joseph Ledoux, whom I respect, in order to recommend a duality that I knew from theology:  one is thought from inside the circle of believing, which Defreitas identifies with thought from inside the experience of hyperarousal, even trauma; and thought from outside the circle, when reflecting safely and therefore free to use the pre-frontal cortex to be rational.  

There is a new suggestion (several books) that suggest functioning morality is a matter of bringing that sort of rational reflection into reconciliation with the under-consciousness, learned by experience without realizing it, cultural conviction of what seems intuitively right.  Without that, finding a satisfactory and vivid personal meaning is not possible, no matter how rational a taboo experience may have been.

The little story I wrote about the “Bear Knife” was meant to approach a narrative that would suggest this reconciliation, but I’m not the first to try this -- in fact, the most famous and beloved story of this kind is “Ceremony” by Leslie Marmon Silko, which describes a Navajo veteran coming back into meaningfulness.  Maybe “The Man Who Killed the Deer” by Frank Waters is aligned with this strategy.

So much to read, so much to think about.  Possibly lives renewed by new ideas.

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