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Friday, October 19, 2012

Two Trauma Communities: A Philosophical Reconciliation of Cultural and Psychiatric Trauma Theories


by Vincenzo Di Nicola, MPhil, MD, PhD, FRCPC, FAPA
Professor of Psychiatry, University of Montreal

Presented at the Harvard Program for Refugee Trauma
Massachusetts General Hospital - Harvard Medical School
Cambridge, MA, USA
Monday, October 15, 2012

This presentation is based on my doctoral dissertation,
"Trauma and Event: A Philosophical Archaeology" (EGS, August 2012).

ABSTRACT

After a brief introduction to the theme of my doctoral investigation into trauma and event, with an overview of the main assertions about origins of trauma and event in the rupture or experiential cut in the discourse of being, a dichotomy in trauma theories is identified. We cannot characterize trauma as a unified discourse or as a spectrum even within one discipline. What brings conceptual order to the concept of trauma and to trauma studies is to discern a dichotomy as a separator or marker that divides the discourses along different axes and conceptualizations. This is a meta-concept that creates two groups or two poles around which certain notions or studies or traditions congeal. Yet, any given separator that creates a dichotomy is shifting, porous and unstable. In describing two theories of trauma she names mimetic and antimimetic theories, Ruth Leys lucidly demonstrates that, "from the turn of the century to the present there has been a continual oscillation between them, indeed that interpenetration of one by the other or alternatively the collapse of one into the other has been recurrent and unstoppable." Furthermore, Leys notes that historically, the mimetic/antimimetic dichotomy constantly invites and defeats all attempts to resolve it. Leys is consistent on this to the point that she predicts that our current debates are "fated to end in an impasse." Leys' own analysis becomes part of the meta-concept of trauma, such that her mimetic/antimimetic dichotomy confirms the notion of a dichotomy but does not exhaust it. Other dichotomies come into play and while we can separate their poles, they do not match evenly with each other and are sometimes even incongruent and incompatible. Trauma in fact has a historical structure, an idea that is congruent with Michel Foucault's notion of a discursive formation or episteme.

Trauma, as a concept or theory with its associated practices, has become an apparatus. Not only has "trauma" been constructed and put in play as an apparatus describing we want to name and explain but it is hard not to reach for this apparatus as an explanatory model, with all its conflations and confusions. The two trauma theories are intertwined not only across but even within each individual theory or group of researchers, rendering the dichotomy intractable in Leys' view. My own meta-concept places Leys' approach within a larger one: hers is one dichotomy among others. This is not to say that we can stand above the dichotomy but that if we see it as an apparatus, which is a discourse with a strategic function, we cna discern that it functions not as one dichotomy, one particular difference, but an epistemological cut in any possible discourse about trauma. We see this in the bivalence in this archaeology, from the word trauma itself, to the metaphors used to describe it, to the ways in which "wound" is deployed in Western culture. From Achilles' spear that both cuts and heals, to Plato's pharmakon which is both a poison and a remedy, this bivalence reaches its apogee in the current cultural theory of trauma which I call trauma as event. I do not share Leys' pessimistic conclusion that the dichotomy in trauma theories is intractable but rather that it will remain so as long as we unwittingly repeat it, as evidenced by the fact that we each generation rediscovers the notion of traumatic stress in different but structurally similar guises. Once we are aware of trauma as an apparatus, we may more consciously entertain other theories and find a new lexicon for trauma.

My own proposal is modest: first, I believe that trauma has accrued a supplementarity or excess (cf. Jacques Derrida). In Freudian terms, this supplementarity is overdetermined or multiply-determined. I maintain that a great proportion of the variation may be attributed precisely to the "looping effects" between the clinical use of trauma and its cultural avatar. Second, we must separate the various ways in which the word trauma is deployed and differentiate our vocabulary for different aspects of the trauma process. Third, and most salient, trauma must be separated radically from event, which is the subtext of cultural trauma theory.

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