Baksbat (Broken Courage): A Trauma-Based Cultural Syndrome in Cambodia

Abstract

Whether posttraumatic stress disorder (PTSD) sufficiently explains and encompasses the symptoms experienced by people from non-Western cultures is debatable. The etymological, social, and historical contexts of idioms of distress experienced by Khmer, known as baksbat, were studied through interviews with 53 Cambodian experts. Phey-khlach (double fear), bor-veas-cheas-chgnay (wishing that the trauma would go away), dam-doeum-kor (planting a kapok tree—remaining mute), chos-nhorm (submissive, easily giving in), kob yobal (ideas are buried), and loss of togetherness, were all identified as specific symptoms of baksbat. Similarities and differences between symptoms of baksbat, PTSD, anxiety, and depression indicate that baksbat is a Cambodian idiom of distress with sufficient characteristics to be recognized as a formal cultural trauma syndrome distinct from PTSD. Increased awareness of its criteria and phenomenology may help clinicians provide appropriate support for traumatized Cambodians.

Keywords:

• Cambodia
• cultural syndrome
• idiom of distress
• PTSD
• trauma response

ACKNOWLEDGMENTS

I would like to sincerely thank the Australian Government and Australian people for awarding me the Australian Leadership Award (ALA) scholarship to undertake my PhD degree at Monash University. This research project was kindly sponsored by a USAID grant via the Center for Victims of Torture (CVT) in Minneapolis, USA. I would like to express my profound gratitude to the TPO Cambodia, friends, and collaborators, who loyally supported me during this study.

Notes

The Venerable Yos Hut Khemacharo at Wat Lanka Pagoda in Phnom Penh, on December 23, 2008, told me that due to baksbat, many of his fellow monks would not express their opinions and were very submissive toward their superiors.

Traditional healers predict or diagnose their clients through looking at reasey. If someone's reasey is low, they are prone to illness; once their reasey is up, they can succeed in their life and resist illnesses, curses, and spells. Hinton and colleagues (2009) found that having low reasey (riesey) increases patients’ vulnerability to illness.

See different descriptions of rumdâh kruah (Hinton et al. 2009).

Additional information

Notes on contributors

Sotheara Chhim

SOTHEARA CHHIM, MD, is a psychiatrist, Executive Director of the Transcultural Psychosocial Organization, Cambodia (TPO Cambodia), and a lecturer of psychiatry, Royal University of Phnom Penh, Cambodia. His areas of interest are community mental health, trauma, transcultural mental health, and transitional justice. He received a Human Rights Award for 2012 from the Leitner Center for International Law and Justice, Fordham Law School, New York City, in recognition of his work promoting the rights of people with mental health problems in Cambodia.