Trauma and Its Impacts on Temporal Experience

New Perspectives from Phenomenology and Psychoanalysis

Selene Mezzalira

• Publisher: Routledge
• Year: 2021
• ISBN:
  9781000531664
• Edition: 1
• Topic: Psicologia
• Subtopic: Psicoanalisi

This unique text develops an original theoretical framework for understanding the relationship between trauma and time by combining phenomenological and psychoanalytical traditions.

Moving beyond Western psychoanalytical and phenomenological traditions, this volume presents new perspectives on the assessment and treatment of trauma patients. Powerfully illustrating how the temporal dimension of a patient's symptoms has until now been overlooked, the text presents a wealth of research literature to deepen our understanding of how trauma disrupts individual temporal experience. Ultimately, the resulting phenomena that occur (including dissociation and cognitive distortions) position time as a transdiagnostic psychological dimension, closely connected to the subject's sense of self.

This text will benefit researchers, academics, and educators with an interest in psychoanalysis, phenomenology, and trauma and dissociation studies more broadly. Those specifically interested in the philosophy of the mind, Freud, and psychotherapy will also benefit from this book.

Chapter 1

Time and the Nature of Psychological Trauma

DOI: 10.4324/9781003230601-2

This chapter presents the historical origins of trauma, touching on phenomenology, psychiatry, and neuroscience. Although originally referring to a physical injury, the word “trauma” later came to indicate the psychic wounding stemming from a sudden, emotional, and unmanageable shock. Person-specific, developmental, event-specific, and post-traumatic variables all play a crucial role in the onset of post-traumatic psychopathology. Just like the phenomenological conceptions of trauma, the various editions of the DSM have also witnessed radical changes across the years. Finally, several cognitive neuroscientific theories have been put forward to explain post-traumatic stress disorder (PTSD) symptomatology, analyzing its neurobiological and neurophysiological bases. Traumatic psychopathology can ultimately offer a clinical model of PTSD that contributes to a deep understanding of the consciousness of time.

What Is Psychological Trauma?

The term “trauma” is the modern translation of the Greek word τραῦμα, which stands for “wound” or “injury” (Mattox et al., 2013). In the medical lexicon, this notion does not refer to a psychological stress, but to an alteration of the anatomical and functional state of the organism produced by the action of a physical agent capable of causing damage to the integrity of the person (Branchini, 2013). It was not until the end of the nineteenth century that the Jewish-German psychiatrist Hermann Oppenheim (1858–1919) provided the first theory of a traumatic neurosis resulting from distortions of nervous system activity following a strong emotional shock (Oppenheim, [1889] 1992; see also Holdorff, 2011). As Leys (2000) pointed out, the term “trauma” acquired a more psychological meaning when it was employed by several turn-of-the-century figures to describe “the wounding of the mind brought about by sudden, unexpected, emotional shock” (p. 4). Therefore, although originally referring to a physical injury, later on the word came to indicate “the psychic wounding that can potentially follow a traumatic episode” (Dass-Brailsford, 2007, p. 3).

Regardless of its source, psychological trauma is often unexpected, as the person is unprepared to face it, and there is nothing the individual can do to prevent it from happening. What accounts for the traumaticity of an event is something that is not predictable, that is, how the individual experiences the event, rather than the event itself. Even though stress and trauma are commonly regarded as states, a better conceptualization, proposed by Payne et al. (2004), regarded them as events, that is, as dynamic processes linked to various physiological and psychological responses that can differ in their expression. In fact, stress is determined not by a situation that is given in the environment, but by the individual’s reaction to it. That is, there is no physiological state that defines (traumatic) stress as such. Not only do high levels of physiological arousal accompany stress, but the latter is also perceived as threatening and as something to be avoided. It seems that (traumatic) stress depends on whether an organism perceives to be in control of the surrounding situation (Kim & Diamond, 2002). It is likely that factors such as the severity of the event, the individual’s personal history, the meaning of the event for the person, the coping skills held by the subject, and the reactions of his or her support system all play a role in developing PTSD (Ozer & Weiss, 2004).

Trauma literature is in agreement that most coping occurs within the first weeks and months following the traumatic event (Shalev, 2002). Tuval-Mashiach et al. (2004) also argued that there are two coping mechanisms, which seem to play a crucial role in the early phases following trauma: narrative and cognitive mechanisms, which function in an interactive fashion and parallel each other. However, even though exposure to traumatic stress is a necessary condition to develop PTSD, the majority of trauma-exposed individuals do not develop the syndrome (Kessler et al., 1995). This is why examining the typical effects of the stressor alone cannot identify PTSD pathogenesis. PTSD seems to involve a failure of mechanisms associated with recovery and restitution of physiological homeostasis, perhaps resulting from subjective predisposition (Yehuda & McFarlane, 1995). According to Yehuda and LeDoux (2007), PTSD develops along with a failure to recover from traumatic stress: “the clinical syndrome of PTSD may describe several biological phenotypes (e.g., some characterized by exaggerated responses, some by inadequate recovery mechanisms) that reflect individual variation originating from pretraumatic risk factors” (p. 19). In fact, individual differences, related to genetic and epigenetic factors in behavioral and brain responses to stress, are supposed to play a crucial role for a rational understanding of PTSD onset and symptomatology.

Through the dynamic creation of a narrative, there seem to be three factors correlated with a positive outcome of PTSD treatment: (1) continuity and coherence; (2) the creation of meaning; and (3) self-evaluation, which is correlated to control, feeling guilty or responsible, and being active or passive (Cicchetti, 2016). On the other hand, there are many factors that contribute to causing PTSD: (1) person-specific variables (research has shown that a gene-controlling serotonin transport may play a key role in developing PTSD); (2) developmental variables, which refer to events that occurred early in life and can make the individual more vulnerable to developing PTSD; (3) event-specific variables, including environmental factors leading to an increased likelihood of developing PTSD; (4) post-traumatic variables, which are just as important as predicting or preventing PTSD from developing (Sears & Chard, 2016). In this view, a lack of social support also appears to be among the most critical variables for facilitating PTSD development. Conversely, positive social support seems to help prevent PTSD onset or reduce the severity and duration of the symptoms.

Phenomenology of Trauma

Several theories have been put forward to explain the nature of trauma. In what Stanghellini (2009) called “trauma-break-in,” trauma is thought of as something that breaks the subject’s boundaries as a foreign body and remains trapped in it. The idea that trauma is something external that penetrates the individual, however, clashes with the dialectic manifested by the relationship between the individual and the surroundings. Instead of being thought of as a set of effective barriers, subjective life can indeed be conceptualized in terms of a “conversation” between inner and outer world (Stanghellini, 2009).

According to the notion of trauma as “mortification (of desire)”, alternatively, it is an element of the internal world that contrasts with reality. In this view, more than looking like a “fact” in the outer world, trauma is supposed to let something in the internal world emerge and rub against reality. It is in this sense that trauma can be thought of as the mortification of a desire. Here, what is at play is not just a break-in from outside inward, but the relationship between inside and outside. Accordingly, trauma is something that there is not, more than something that properly “is.” Trauma is something lacking, that is, an element of the outside world that does not find acceptance in the inner world of the subject.

A further characteristic of trauma is its repetitiveness, as traumatized individuals tend to endlessly (unknowingly and unintentionally) repeat their trauma. This paradigm, known as “trauma-repetitiveness,” points to a process of rewriting past situations in the light of new experiences, thus providing the key to a semantic interpretation. The individuals’ responsibility when repeating their trauma is only apparent. In fact, they cannot do otherwise, and their hope to overcome the trauma by constantly repeating it proves to be illusory, as this same hope lacks the awareness of the trauma as such. On the contrary, this repetition acquires the nuance of a repetition compulsion, without the awareness of the traumatic nature of the original event – above all of its meaning. Stanghellini (2009) called it a “repetition without reminiscence” (p. 246), which becomes mechanical and automatic, that is, stereotypical, and leaves no room for the elaboration of the original trauma.

Now, “the [traumatic] symptom is a wordless presentation of an unnamable dilemma” (Wright, 1976, p. 98). This phenomenon can be interpreted in two ways. First, one might think that the so-called death instinct is the strategy through which the individual tends (or tries) to reduce the triggers associated with the traumatic occurrence. Or, second, one might think that “internal working models” (relational patterns acquired during early social interactions, which are repeated later in life) are installed in the re-presentation of the trauma like a self-fulfilling prophecy. The concept of trauma as “emergence of sense” has therefore the merit of clarifying the relationship between time and trauma as well as its meaning (Stanghellini, 2009).

Typically, we tend to bestow meaning on events based on our past experience. In contrast, trauma has the character of the novelty, of the “first-timeness” (Straus, 1982): trauma is the “radical alterity” (Stanghellini, 2009, p. 247). The novelty does not connote the traumatic event itself, but rather the sense we give it. Trauma takes shape as something radically different from what is already known, and is therefore comparable to no previous experience. Trauma is “the Thing” (la Chose, in French) as Jacques Lacan (1901–1981) used to say. “The Thing” is what the subject traces unconsciously and emotionally, but whose meaning the person does not grasp at the conscious level, namely, an unnamed object. “The Thing” is that “something” that lies at the core of experience, and grounds the process of Nachträglichkeit (Boothby, 2001).

Lacan used to call “ex-timacy” (ex-timité) the peculiar characteristic of trauma as opposed to what is most intimate within the subject, that is, the Self. In the notion of “trauma-Otherness,” an experience is traumatic if it is not translatable into a meaningful discourse, if it is left without a word, if it cannot be told and therefore intersubjectively shared. Fonagy and Target (2006) spoke in this regard of a defect of “mentalization,” that is, an inability to reflect on experience. On the one hand, a mentalization defect hinders the elaboration of the trauma; on the other hand, the trauma induces dissociative dynamics that hampers mentalization processes. Trauma, (absence of) mentalization, and dissociation would therefore be intertwined in a vicious circle. Ultimately, mentalization is of crucial importance in allowing traumatized individuals to achieve greater perspective on the trauma through reflection upon personal and intersubjective states of mind (Allen & Fonagy, 2006).

According to the so-called “mimetic” interpretation of trauma, the stressor can deconstruct the individual’s cognitive and perceptual apparatus, rendering it unable to recall the traumatic event (Leys, 2000). According to an “antimimetic” perspective, on the contrary, individuals tend to distance themselves from the traumatic event by deviating from it and by viewing it as if it were “outside.” Therefore, the mnestic trace of the trauma is not integrated into conscious memory, as trauma cannot be assimilated as a mnestic trace open to intentional retrieval. In the first instance, the individual is too close to the trauma to process it; in the second instance, the person is so far from it to the point that he or she dissociates from it. Either way, the traumatic event remains a “foreign body” impossible to integrate into one’s own life story, and the traumatic event does not find room in the subject’s narrative identity. Trauma can therefore be thought of as the opposite of narration, which refers instead to the Otherness as to that quid novi to be assimilated within the individual’s experience. Naming the traumatic event as something “other” is an essential condition to the generation of one’s identity narrative; however, if the event cannot be narrated, it will be established as trauma.

Trauma can thus be regarded as the radically “Other” when compared to the individual’s life story – something that bears no “sense” in the subject’s experiential horizon. Trauma occurs in the intersubjective dimension when we do not know how to find a “relational home” for the event (Stolorow, 2007). Traumatized individuals do not know how to contextualize the traumatic event in their self-narrative. “Contextualizing” the trauma means to give it a meaning and a sense in the framework of one’s self narrative. In this view, a traumatic event becomes traumatic precisely because of its ability to be like “a key in a lock.” Only with the right key one can penetrate the trauma and let it be organically integrated into a whole narrative. The specificity of the traumatic experience consists here of the intertwining between the traumatic event and the subject’s personality structure.

Trauma tends to be widespread and to repeat itself in a play that does not allow the individual to situate it in the past. Trauma has the feature of the present continuous. In the self-re-creation of the trauma, the individual is placed in front of the inability to act otherwise. Yet trauma can also be seen as a moment of truth, as an opportunity for individuals to break away and grasp themselves in the traumatic occurrence as if it was a mirror. In the concept of “trauma-revelation,” the focus goes on what is most intimate in the person. In this perspective, the revelation is trau...