Trauma, PTSD and childhood experience

A while ago I wrote a post on trauma and, closely related to this, one on post-traumatic stress disorder (PTSD).    One of the key points that I highlighted in those posts, and which I think is worth reiterating, is the fact that even though many people experience at least one traumatic event in their lifetime, the majority do not go on to suffer from PTSD.

One of the reasons for this, as I pointed out in the postings, is that some people have difficulties in processing the memories of traumatic events.  This is an idea which seems to be generally accepted in the psychological and psychiatric literature, and the aim of most talking therapies is to help clients with such memory processing.  However, what is not so widely discussed, or indeed incorporated into the psychological treatment of PTSD, is the role that early inter-personal experiences play in determining whether a particular individual is likely to be susceptible to developing PTSD following a traumatic experience at some point in their life.

At first sight, this might seem a rather peculiar statement: surely, problems with memory processing are purely neurobiological?  What have inter-personal (or more correctly, intersubjective) experiences got to do with it?  If you subscribe to the idea that human beings are simply glorified information processing machines, who spend their lives trying to interpret the ‘external’ environment in order to survive and maximise their self interest, then you are probably never going to be convinced that intersubjective relationships have any relevance whatsoever.

However, from a psychoanalytic position, ‘processing’ is not simply a neurobiological process, i.e. the equivalent of data processing in a computer.1   Rather, it is about symbolic mediation, about making sense of the world and of experiences.  And symbolic mediation can only be achieved intersubjectively.  In other words, through the relationship between two or more human beings.  The point about traumatic experiences is that they are senseless, they have no meaning.  But meaning is inherently social, i.e. intersubjective.  And as babies and very young children, we are totally dependent upon other, flesh and blood, human beings not only for the material essentials of life but also for the construction of meaning and identity.

We can literally only become who we are and build up a ‘worldview’ through intersubjective relations, i.e. through interaction with others.  This is what is meant by symbolic mediation.  And an essential aspect of this symbolic mediation is the mediation of traumatic experiences, of things which make no sense.  If for any reason this process of symbolic mediation fails or does not work properly for the baby or young child then later on as an adult they are likely to have real problems dealing with traumatic, i.e. senseless, situations: they literally have no idea how to process such experiences.  In fact, they may well develop PTSD following trauma.

Of course, I am presenting a very schematic summary of what is a very complex subject.  The key point to remember in all this, however, is that (i) not everyone who experiences trauma will go on to develop PTSD and (ii) the role of therapy when working with PTSD clients is to enable them to assimilate, to make sense of, such traumatic experiences.

  1. Although, of course, even computers have to be programmed, and such programming is based upon all kinds of assumptions, i.e. is highly symbolic and discursive. []

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  1. Pingback: Why PTSD? | Leslie Chapman

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