Trauma and therapy

As I’ve suggested in a number of posts related to trauma, the aim of therapy in these cases is to help the subject make sense of their traumatic experiences, usually by some form of cognitive or symbolic processing.  So, for example, with cases of post-traumatic stress disorder (PTSD) the individual’s flashbacks and panic attacks are viewed as the result of unprocessed or non-symbolised memories.  The aim of therapy is therefore to help the individual contextualise such memories within their broader cognitive or symbolic framework, so they no longer appear alien to them.

All well and good..except it doesn’t work.  Or rather, it works up to a point but there is always something that evades sense, that escapes meaning.  And the problem is not that it’s simply impossible to make sense of everything, or rather everything concerning a particular experience (in this case a traumatic one), but rather that there is something in meaning that undermines itself and creates non-meaning.   In other words, it’s no use simply trying to ‘know’ more, in the sense of constructing more meaning.   As any PhD student knows, the more you ‘know’ the greater the mystery and uncertainty.   ‘Knowledge’ in this sense is having a better appreciation of the limits of knowledge, the limits of meaning.   However, perhaps what’s not so readily appreciated is the mechanism that’s at play here that ensures that ‘knowledge’ begets greater ignorance.

This mechanism (for want of a better term) is the Real.  But not the Real as in an ‘outside of meaning’, as ‘extra-discursive’; rather, a Real that is a function of meaning, a function of discourse.  In other words, the Real is not something ”beyond’ meaning, but something at the very core of meaning, like the kernel of the dream.  This is not to suggest that it’s impossible to construct meaning in the first place.  On the contrary, we live in a world awash with meaning; so much so in fact that it’s lost all meaning.  The point is, every time meaning is constructed it is immediately undermined by its limit.  We might even go as far as to say that trauma is a function of meaning, that trauma is at the heart of meaning, if trauma is defined as something that makes no sense.

And this brings us back to the problem of (psycho)therapy and trauma.  If psychotherapy aims at giving meaning to trauma (to put it somewhat simplistically) then it is, paradoxically, sustaining the trauma.  In other words, as it helps the patient/client make sense of their traumatic experiences it, unintentionally to be sure, engenders further trauma because of the traumatic (Real) kernel at the centre of all meaning.

There is, however, another twist to this: trauma itself, in the form of a ‘narrative’, can become a form of meaning.  As I’ve argued elsewhere1 a good example is that of the trauma of the Great War:  in fact, the War spawned a whole new genre of ‘traumatic narrative’, which is still alive today.  The same applies to individuals, from survivors of sexual abuse to survivors of concentration camps and acts of terrorism.   In fact, simply to define someone as a ‘survivor’ of a particular form of traumatic experience is to construct a form of narrative around that trauma.   This is not for one moment to demean that person’s experience; rather, it is to question whether they are any the wiser being defined as a ‘survivor’.  In other words, are they any better able to make sense of their experience?

On the other hand, what is a therapist to do if someone presents to them with a history of trauma (and possibly abuse)?  Aren’t they obliged to help the person try and make sense of their experience, to try and help them give meaning to what happened to them?  Not necessarily.  Or rather, this is not necessarily an end in itself.  What might be more helpful, in fact, is to help the patient/client recognise the limits to their (or anyone else’s) understanding of their experience.  This is not to say that there is no value in helping the subject elaborate their story, to construct a narrative around their experience.  Rather, it is to say that this elaboration, this narrative, is not an end in itself.    Instead, this is a means to an end, which is to elaborate the limits of understanding, the boundaries of meaning.    Another way to say this is that the purpose of therapy/analysis is to facilitate the subject’s encounter with the Real of their experience, the Real of their history.

  1. http://www.therapeia.org.uk/wp/touching-the-real-2/war-without-end/ []