The concept of ‘mental trauma’ and its transcultural application

Abstract

Impaired ‘traumatic’ memory of disaster-affected populations has come to the forefront of humanitarian work. In this article, the application of the notion of ‘mental trauma’ by psychosocial intervention programmes, relating to the tsunami disaster, will be critically examined. It will be shown in which type of theoretical structure the guidelines’ notion of ‘mental trauma’ is rooted, presenting ‘traumatic’ experience as a division of the self, which is defined through agency and coherence. It will be argued that this entails a certain subjectivity of representation, which may not have transcultural validity. It is concluded that rehabilitation and development programmes after disasters have to integrate and address multiple levels, including community-level interventions, drawing on local coping strategies and resources.

Keywords:

• trauma
• tsunami
• self
• identity

Notes

Notes

1. McFarlane correlates the increasing discourse on trauma with the declining influence of psychoanalysis (McFarlane, 1990). The discourse on ‘trauma’ is demonstrated to have replaced psychoanalytic theory, the latter emphasising unconscious conflicts, originating in childhood, whereas the former focuses on conscious life events in adulthood. This theory is hard to validate – especially the statement that damages created in adulthood are impossible to explain through psychoanalysis, and the nature of ‘conscious’ and ‘unconscious’ life events are questionable, as discussed below.

2. In this sense, it is not possible and I do not wish to refer to related and important anthropological debates surrounding issues such as: the politics of knowledge (Hacking 1996); questions of victimisation, stigmatisation and disempowerment (Kleinman 1991); readings of psychosocial interventions as new forms of ‘cultural imperialism’ (Summerfield 1998), and the contextualisation of the motivations for international health care through ‘Western’ societies of ‘infotainment’ (Kleinman 1991).

3. We are highly aware of the fact that there is a danger of translating the notion of suffering in such a way that it can be operationalised within the psychiatrists’ a-priori institutional categories. Thereby it might be used in a way which focuses on clinical events in order to give plans for purposive action and healing (Young 1982). Though we think that the notion of ‘suffering’ is an explicandum rather than explicans, we were not able to discuss it in full detail, due to the wide range of existing literature. However, we would like to acknowledge that it certainly does not designate some uniform or single experience, rather involving categories of the body, the self, health, and illness, as well as concepts of normality and moral dimensions of responsibility, justice and social order (Young 1982; Kleinman 1991; Scheper-Hughes 1992).

4. Indigenous psychologies are far from being ‘pure’ – for example, it is critical to remember how much psychoanalytic theory itself has been influenced by the ‘East’. Jung in particular absorbed ‘Eastern’ ideas before developing his theory of the ‘wholeness’ or integration of the personality, the ‘collective unconscious’ (i.e. man is not born as a tabula rasa, but possesses many things, inherited from ancestors) and ‘archetypes’ as determinants of the psyche.

5. Reddemann's extraordinary work (2006) demonstrates that immediate or short-term ‘debriefings’ in the absence of having first built up a cognitive ‘security net’ for and with the patient run the risk of re-‘traumatising’ him. Moreover, Summerfield (1998) points to many investigations which prove that short-term debriefings do not deliver any benefits even when applied to western collectives.