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Before 1980, when it received the imprimatur of the American Psychiatric Association, few had heard of post-traumatic stress disorder (PTSD). Scarcely a day now passes without fresh sightings, with the alleged afflicted ranging (on a scale of decreasing credibility) from the victims of Rwandan horrors and the Oklahoma City bombing, to the entire population of Israel after the Rabin assassination, to the unfortunate Paula Jones. Hidden behind these diverse ascriptions of PTSD are, according to Ruth Leys, certain problematic tensions in the various theoretical accounts of psychic trauma, which it is the goal of her book to articulate.
In this meticulously researched, and therefore somewhat technical, though still highly readable book, Leys traces the development of the concept of psychic trauma, and its complex association with memory, from its turn-of-the-century origins in the works of Charcot, Breuer, Morton Prince, and Freud, who figures predominantly. The shell-shock victims of the two world wars give the issue a fresh urgency, and the attempts of physicians like Abram Kardiner and William Sargant, and the psychoanalyst Sándor Ferenczi, to understand and deal with the problem add further twists to the notion of trauma. In the post-war years, the sufferings of Vietnam veterans, and the rise of the womens movement (resulting in an increasing recognition of childhood sexual abuse) once more direct the attention of the psychiatric profession to trauma issues. More recently, the focus shifts to causal-mechanical models of traumatic neuroses, as for example, in the claim of Bessel van der Kolk that post-traumatic memories have a distinctive neurobiological encoding, which the brain cannot represent in narrative form. The idea that trauma is literally unrepresentable is taken up by the literary theorist Cathy Caruth, who uses it to weave a deconstructionist theory of language inspired by the poststructuralist (and Nazi collaborator) Paul de Man.
Leys achievement in Trauma is to show how these historical developments in the concept of trauma swing back and forth between two opposed theoretical tendencies, between what Leys calls mimetic and antimimetic theories. The origins of the mimetic account owe much to the early use of hypnosis, which functioned as both a clinical and a conceptual tool in trauma. Charcot observed that the hypnotized subject could easily be made to imitate or repeat what they are told on command. Under hypnosis, "hysterical crises" could be induced in traumatized subjects, leading Charcot to hypothesize that these crises represented an imitative repetition of the traumatizing experience. In the mimetic model, the traumatic experience overwhelms the subject so completely that normal memories of it are never formed; the integrity of the subject has been so disrupted as to preclude "the kind of specular distance necessary for cognitive knowledge of what had happened." In this way, the mechanism of post-traumatic amnesia was understood as analogous to post-hypnotic forgetting. As Leys describes, this account has a number of problematic consequences. It brings the testimony of the traumatized into doubt, since "the victim is imagined as having been absent from the traumatic event." Worse still, the similarity to the hypnotic state raises questions about suggestibility and the possibility of false memory, and about imitative identification with the aggressor which seems to implicate the victim in her own traumatization. Leys believes these difficulties led theorists to renounce the problematic aspects of the hypnotic-mimetic account in favor of a new antimimetic model, which reinstates an intact, autonomous subject as a detached observer of the traumatizing event. By picturing trauma as a purely external assault on a passive victim, the antimimetic model restores the credibility of the victims testimony, while at the same time removing any concerns about the causal role of the victim in the trauma. However, as Leys shows through her careful analysis of the development of the trauma concept, the notion of mimesis in trauma did not simply fade away with the development of the antimimetic model. Instead, mimesis repeatedly resurfaces as a causal-explanatory mechanism in the work of several theorists, and indeed elements of both essentially incompatible models can be found operating in one and the same theoretical framework.
For me, the most enjoyable chapters in the book, and certainly the most controversial, are those in which Leys critically examines the work of Bessel van der Kolk and Cathy Caruth, who together have developed an influential blend of experimental neuroscience and post-modern literary theory. Here, the tone of the book shifts perceptibly from descriptive analysis to frank criticism. Leys is clearly unimpressed with the standard of science and scholarship of these theorists, and her elegant dissection of their research and arguments makes for fascinating reading.
Trauma is undoubtedly an important and original contribution to trauma theory. It raises serious questions about the intellectual underpinnings of trauma theory that no one working in the field should ignore.
Stephen Austin is a physician who is currently engaged in graduate work in philosophy at the University of Toronto. His philosophical interests include rationality and the philosophy of language and mind, and the realism/antirealism debate.