PART I
Constructive Phenomenologies of Trauma
CHAPTER 1
Two Trauma Communities: A Philosophical Archaeology of Cultural and Clinical Trauma Theories
Vincenzo Di Nicola
Thresholdââ
Havdalah: âSeparationâ Open closed open. Before we are born everything is open in the universe without us. For as long as we live, everything is closed within us. And when we die, everything is open again. Open closed open. Thatâs all we are.
YEHUDA AMICHAI1
Prologue: The Age of Trauma
In a catastrophic age, [. . .] trauma itself may provide the very link between cultures: not as a simple understanding of the pasts of others but rather, within the traumas of contemporary history, as our ability to listen through the departures we have all taken from ourselves.
CATHY CARUTH2
What has happened in our contemporary world such that the experiences of disaster and displacement, migration and exile, horror and terror, separation and loss, catastrophe and misfortune, humiliation and shame, âthe nightmare of childhoodâ or âthe state of exception,â and other vicissitudes of lifeâwhat Freud called the discontents of civilizationâhave been reduced to the passive victimization subsumed under the rubric of trauma? Cultural trauma theorist Cathy Caruth calls it a catastrophic age. Why is our experience constructed this way in our time and why has trauma become the emblematic experience of contemporary life to the point that we may invoke the epithet âthe age of trauma?â
It is difficult to characterize trauma as a unified discourse or as a spectrum, even within a given discursive formation such as psychoanalysis or psychiatry. The best strategy to find our way through this thicket of aporias is to discern a shifting, porous, and unstable dichotomy. The investigation of trauma in this chapter straddles both the clinical and cultural poles of this dichotomy; my task, in part, is to make each of them intelligible by placing them in their context through surveys of discourses and practices. In what follows, I describe the poles of this dichotomy under the rubrics of aleph and beth. While they are neither clearly delineated nor discrete, they offer a heuristic for understanding the dichotomized ways that trauma theorists approached the discourse at hand. This requires a different history of psychology and psychiatry and a different genealogy of trauma.
The age of trauma takes place in traumaâs estate. To understand how trauma has become an emblematic clinical experience and trace its pervasive presence as cultural trauma, this chapter conducts a philosophical archaeology in the ruins of traumaâs estate, excavating its many associated discourses and apparatuses.3
Provisionally, we may call âarchaeologyâ that practice which in any historical investigation has to do not with origins but with the moment of a phenomenonâs arising and must therefore engage anew the sources and traditions.4
Philosophical archaeology allows us to discern the relationships among rupture (predicament, state of exception, evental site), trauma (the destruction of experience, of the possibility of experience), and Event (contingent, unpredictable, undecidable). I invoke the work of Giorgio Agamben and Alain Badiou to oppose trauma to Event, making an absolute distinction between them: trauma does not conduce to Event; Event does not arise from trauma. Human predicaments emerge in evental sites, where rupture occurs. Neither the rupture nor the predicament is predictable or decidable in advance. As trauma psychiatrist Lifton says of survivors of disasters and genocides, we may open out, porous and permeable to novation, or close down, emptied and evacuated, in a traumatized state.
By reading texts at the core of cultural traumaâs preoccupationsâfiction and poetry, memoirs and witnessingâthrough philosophy and critical theory, I illustrate how philosophical archaeology may approach and refresh our understanding of trauma. I contend that trauma is not the generic name of a predicament or even of a particular experience but a generic name for the destruction of experience. Yet it also offers keys for translationâif not paths of reconciliationâamong the communities that address trauma and Event: those who hold by trauma/Event as a radical disjuncture, those who hope for a transformation of trauma into Event, and those who harbor the transcendent view of trauma as Event.
A Philosophical Archaeology of the Concept of âTraumaâ
In her genealogy of trauma, Ruth Leys deploys mimetic and anti mimetic theories of trauma.5 From the perspective of cultural-intellectual history, Wulf Kansteiner, who cites Leys sympathetically, sees a scientificâmetonymic pole and a literaryâmetaphorical pole of what he describes as a âtrauma discourse spectrum.â6 Because âspectrumâ suggests an underlying order, âdichotomyâ or âdialecticâ better captures the dynamic tensions among trauma discourses. Even that is only an approximate characterization as at times the two poles of a perceived dichotomy do not acknowledge or communicate with each other, as Kansteiner contends.
In their inquiry into the âempire of trauma,â physician/social anthropologist Didier Fassin and psychiatrist/anthropologist Richard Rechtman trace a dual genealogy of âpost-traumatic stressâ which they characterize as being divided into scientific and moral strands. The scientific strand, in the domain of psychiatry, psychology, and psychoanalysis, addresses trauma both theoretically and in practice. The moral strand, related to social conceptions, âtraces changes in attitudes to misfortune and to those who suffer itâ and âtowards the authenticity of such suffering.â7
Fassin and Rechtman find the way these two strands interact most revealing. Posing a series of questions about how this occurred over time, across cultures, through disciplines and social discourses, they believe as I do that the key is in examining this dual genealogy at each crucial turning point. They see an underlying âdiscontinuity marked by the end of the historical era of suspicion that hung over victims of violenceâ (which I characterize as an epistemological shift away from the experiential cut of Karl Jaspersâ phenomenological psychiatry) and the more powerful continuity toward a moral affirmation of trauma as âthe ultimate truth.â8
In some articulations of trauma, these strands are so finely interwoven that separating them requires dexterity to discern the mesh of discourses and practices. This is the case with the influential presentation of cultural trauma by Caruth, which is criticized with precision and clarity by Wulf Kansteiner and Harald Weilnböck.9 At times, the tissue falls apart in our hands as we do this work and we lose the very pattern we are trying to reveal.
A survey of the issues at stake in the history of academic psychology and psychiatry in defining trauma reveals that these revolve around: consciousness and phenomenology; the definition of the subject; and issues of language, memory, and representation. Consulting histories of psychology and psychiatry, we may eliminate the more partisan forays establishing sectarian claims. First, let us separate the history of madness from the history of psychiatry, which are not only two different maps, but altogether two different territories. For our purposes, the history of psychology revolves around the question of consciousness, both as a philosophical question and as a technical or methodological matter. The history of modern psychiatry, on the other hand, revolves around the crucial question of the experiential chasm, as Jaspers put it: Either we can or cannot cross an empathic bridge to understand psychosis, the most alienating experience that psychiatry had encountered at that time. And psychosis, constructed as schizophrenia, became in Angela Woodsâs resonant phrase, âthe sublime object of psychiatry.â10
We can line up all the approaches and contributions around this question: whether the subjective experience of psychosis is accessible to psychiatry or not. Those who agree with diagnostic categories (based on Kraepelinian aetiopathologyâthe so-called âmedical modelââor Jaspersâs phenomenology as a science of signs and symptoms) see a phenomenological chasm between the psychotic patient and the psychiatrist. Whereas those who are continually looking for other ways to understand alienating experiences (starting with Viktor Tauskâs psychoanalytic interpretation of the âinfluencing machineâ) explicitly reject (as with R. D. Laingâs social phenomenology) or reframe the question (as with John Watsonâs behaviorism or Gregory Batesonâs systems theory).
With this map of the history of psychology and psychiatry, we may examine how another cutârupture leading to traumaâis understood as psychopathology.
Trauma: A Confusion of Signifiers
It is an error to divide people into the living and the dead: there are people who are dead-alive, and people who are alive-alive. The dead-alive also write, walk, speak, act. But they make no mistakes, and they produce only dead things. The alive-alive are constantly in error, in search, in torment.
YEVGENY ZAMYATIN11
The psychiatry of trauma is the psychiatry of the âdead-aliveâ in Zamyatinâs terms, of the âstate of exceptionâ and âbare lifeâ in Agambenâs philosophy,12 and what Badiou calls the âreactive subject.â13 The discourse of psychic trauma is marked by a confusion of signifiers. There is a confusion among what we may separate conceptually into predisposing, precipitating, and prolonging factors of trauma, to which we may add protective factors. This is the model of the psychiatric formulation employing the biopsychosocial model. Furthermore, we need to separate direct, immediate traumatic impacts from delayed, latent, or long-term consequences, called sequelae in medical terms. Finally, we may call this schema a trauma process. The term process implies diachronic evolution over time with sequences and a synchronic interplay of factors at any given moment in time.14 Thus, we may usefully separate the traumatic process into these factors: (1) predisposing traumatic contexts or situations that place individuals at riskâwe may call these distal determinants, such as causes and influences; (2) precipitating traumatic triggers are proximal determinants; (3) prolonging factors amplify, augment, or extend the traumatic process synchronically or diachronically; (4) protective factors dampen, diminish or mitigate the traumatic process.
The key question then becomes: What makes trauma traumatic? Is it the threat that something hurtful may happen, the experience of the injury itself, or living with the consequences of the threat of injury? Which aspect is the trauma and which traumatic? Is this conflation of predisposing, precipitating, and perpetuating factors normal? Is this typical in medicine or psychiatry? Infections work like this; âflu,â...