Browsing by Subject "Trauma"

This dissertation focuses on the fictional narratives of Eastern and Central European women authors writing in German and explores the ways in which historical and political trauma shapes their approach to narrative. By investigating the atrocities of the World War II era and beyond through a lens of trauma, I look at the ways in which their narrative writing is disrupted by traumatic memory, engendering a genre that calls into question official accounts of historical events. I argue that without the emergence and proliferation of these individual trauma narratives to contest, official, cemented accounts, there exists a threat of permanent inscription of official versions into public consciousness, effectively excluding the narratives of communities rendered fragile by war and/or displacement. The dissertation demonstrates how these trauma fictions i) reveal the burden of unresolved, transmitted trauma on the second generation as the pivotal generation between the repressive Stalinist era and the collapse of communism, ii) disrupt official accounts of events through the intrusion of individual traumatic memory that is by nature unmediated and uncensored, iii) offer alternative plural accounts of events by rejecting normal everyday language as a vehicle for narrative and instead experimenting with alternative modes of representation, articulating trauma through poetic language, through spaces, and through the body, and v) struggle against theory, while paradoxically often succumbing to the very same institutionalized language of trauma that they seek to contest. Trauma fiction therefore emerges as a distinct genre that forestalls the threat of erasure of alternative memories by constantly challenging and exposing the equivocal nature of official narratives, while also pointing to the challenges faced in attempting to give a voice to groups that have suffered trauma in an age where the term has become embedded and overused in our everyday language.

This dissertation traces the complex connections between violence, trauma, healing, and medicalization in North America. The project connects to conversations in medical anthropology and American studies, and intersects with science studies, postcolonial studies, the anthropology of militarism, and Native American studies. The central innovation in this dissertation is its focus on veterans who suffer from both the violence of war and the limits of trauma's conventional treatments. I track their experiences through a therapeutic system designed by and for Native people, and argue that questions about suffering and healing from war are inextricable from discourses and practices of gender, race, and territory.Since the Posttraumatic Stress Disorder (PTSD) diagnosis was codified in the Diagnostic and Statistical Manual of Mental Disorders in 1980, the object of combat trauma has grown to occupy significant space in popular culture. In the contemporary world, PTSD serves as the primary lens for translating military experience to both the public and veterans themselves. However, the diagnosis and all of its clinical appurtenances fall short of contextualizing the full range of traumas associated with military service and its treatments often fail to relieve sufferers of their symptoms. An early example of this was observed in American Indian veterans of the Vietnam War, who demonstrated marked “treatment resistance” to novel PTSD therapies that were developed in the 1980s. In response to this, a Veterans Affairs (VA) hospital in southern Puget Sound responded to requests by local tribal leaders to make indigenous healing and purification rituals available for American Indian veterans. Noting the efficacy of these rituals, a ritual community of indigenous veterans became established there who continue to practice their ceremonies today on a piece of sacred land adjacent to the VA hospital. The clinical PTSD diagnosis has evolved in accordance with medicalizing trends in the four decades since its recognition in the DSM. However, the social construct of combat trauma that is often known discursively as “PTSD” has grown and become increasingly entangled with various sociopolitical projects associated with war, gender, and racial/ethnic identity. In the 21st century, veterans increasingly prefer the signifier “warrior” over the civil term “veteran.” The warrior signifier conjures a more mythical notion of timeless, transcultural castes located in martial societies. At the same time, this warrior identity is being embraced by many outside of the military, including police and civilian defense contractors. Warriors are seen as a distinct kind of person who experiences war, suffering, and healing differently than civilians. Within this context, the combat trauma construct that is often generalized as “PTSD” becomes the fundamental marker of legitimate warrior experience. When the VA approved of making space for indigenous ceremony in the 1980s, it was because indigenous veterans were seen as denizens of “warrior cultures,” and understood to be ontologically distinct from non-indigenous veterans who were expected to heal best in a clinical environment. Until relatively recently, the ritual healing community was almost exclusive to the indigenous veterans it was created for. However, the ceremonies increasingly appeal to non-indigenous veterans and are now being seen as a therapeutic option for treatment-resistant veterans of all ethnicities. This situation creates the conditions for the complex intersection of several socioepistemological projects, including medicalization, race, indigeneity, militarism, and “warrior” identity among many other things. As a combat veteran with a PTSD diagnosis, my fieldwork centered on extended participation in the ceremonial life of this ritual community. Over a period of 36 months I made several trips to the site, including seven months of continuous fieldwork in 2019. I became close with the Elder Council, the team of experienced Native chaplains who officiate ceremonies in the ritual community. Drawing from several tribal traditions, particularly from Lakota/Plains traditions, these elders conduct sweat lodges, “talking circles,” and other ceremonies. These rituals serve a dedicated cohort of regular attendees, a segment of patients from the hospital’s inpatient PTSD program, and periodic visitors who are seeking healing after the failure of clinical therapy. My findings detail two developments: First, the ritual community exposes the limits of the 20th century process of medicalizing trauma associated with war/military service. For instance, ritual participants draw on the Lakota concept of iwáyazaŋ azúyeya, "the sickness one acquires from fighting others and the self" as the therapeutic object at stake, in contrast to "PTSD". Ceremonies directly address this sickness by highlighting Native experiences of colonization, the unique ways that trauma was experienced by Native veterans (particularly from the Vietnam War era), and the connections between violence and masculinity. Second, the site shifts the ways “warriordom” connects concepts of violence to concepts of culture. The notion that warriors are a unique kind of person who both suffer and heal differently from civilians may account for the increasing appeal of ritual therapy among non-Native veterans. However, the ceremonies compel veterans to confront warrior identity as a feature of white settler violence, and effectively turn healing into a process of social critique.

The long-term and multi-faceted consequences of trauma are well documented and health conditions associated with traumatic life events are often those that benefit from early and regular attention from a healthcare provider. However, for many trauma-exposed women, seeking out and receiving healthcare is associated with physical and psychological intrusions that are linked to their traumatic experiences. Implementing trauma-informed care, based in knowledge and understanding of trauma that sensitively meets the needs of survivors, is an effective way to improve trauma survivors’ healthcare experiences. However, implementing such changes in practice to improve care for survivors is often made difficult by the current prevailing characteristics of patient-provider relationships and the U.S. healthcare system. Further, relying on providers to change practice is a disempowering position for survivors; supporting survivors to advocate for their needs within healthcare interactions and the healthcare system could be an efficient, effective and empowering solution to attaining widespread trauma-informed care.

This dissertation addresses current knowledge deficits through: 1) description and comparison of lifetime trauma exposure among community-based women from diverse locations and backgrounds; 2) examination of existing trauma-informed care practices for survivors of physical and sexual violence; and 3) descriptions of the healthcare experiences, needs, and strategies of female survivors of physical and sexual violence with regard to navigating healthcare experiences, provider interactions, and the healthcare system. A descriptive, correlational analysis and a synthesis of current literature were used to address the first and second research aims. Original qualitative interview and participatory Photovoice studies were conducted to address the third research aim.

Findings from the statistical analysis of trauma exposure among four community-based samples of women in Colombia, Hong Kong, and the United States indicate that trauma exposure is more similar than different and that trauma and its effects are pervasive in the lives of women across diverse locations. The synthesis of literature elucidates five thematic elements of trauma-informed care including: sensitive and universal screening, provider-patient relationships, minimizing distress, maximizing autonomy, and providing appropriate collaboration and referral. Findings from the qualitative interview and participatory Photovoice studies highlight imbalances in power dynamics and lack of mutual belief and trust as the most significant challenges to positive provider-patient relationships and healthcare experiences. These findings also indicate that survivors of violence use a variety of strategies to navigate healthcare encounters in the face of system-, agency- and provider-level barriers to positive healthcare experiences.

This dissertation adds to existing evidence on trauma exposure and trauma-informed care, and data on the engagement behaviors and healthcare strategies of survivors of violence addresses substantive gaps in the literature. Further, these findings generate useful frameworks and foundations for future research to continue to explore survivors’ healthcare desires, provider-survivor relationships, and provider- and survivor-led interventions to support the implementation of trauma-informed care.

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ABSTRACT

On the first day of November, ordinary commerce in Lithuania comes to a halt. Stores and offices are shuttered, while roads and cemeteries in cities and small villages come alive with the movement of families traversing the country to lay flowers and light candles at the graves of parents, grandparents, godparents, children, aunts, uncles, friends, and teachers. Velines is not a boisterous occasion like the Day of the Dead in Mexico, but it is not morose either. The cemetery is transformed into a place of reunion and remembrance as the gathered community exchanges greetings and gossip while cleaning cemetery plots, arranging flowers, and lighting candles atop the graves. Little children wander between the legs of adults; elderly men and women find resting places on benches and stones; vendors hawk candles at the entrances; and people steadily stream in and out through the gates. When the sun sets the candles flicker to life to form a cemetery on fire.

These Lithuanian Velines practices, though notable in their high level of participation, are not unique. To varying degrees All Saints' and All Souls' Day pilgrimage to cemeteries is common in many parts of what we now map as Europe. Yet these practices have a distinctive and powerful importance in Lithuania. The pervasiveness of death, suffering, loss, exile, and dislocation is a prominent aspect of the Lithuanian experience in the modern era. Significant as well is Lithuania's geographic location in a region fraught with the dynamics of the modern projects of empire, colonialism, and nationalism in all its varying forms. A central concern of the dissertation is the significance of Velines cemeteries and Velines practices for Lithuanians seeking to survive and find a way forward in the midst of the violence and upheaval of the past century, the attendant trauma, and the confusion and contestation over cultural memory that has followed.

Utilizing ethnographic method I explore Lithuanian Velines practices from the perspective of practical theology and material culture. Within Catholic liturgical theology All Saints' and All Souls' Day practices herald a powerful claim of participation in the communion of saints, an invocation of future eschatological hope, and for some, a promise of communion with those who are dead. Yet doctrinal and liturgical theology alone do not explain what is happening in these cemeteries. Rather, these cemetery spaces are framed by and shimmer with shards of Christian traditions while also hosting complex realities of human experience. Over the years these practices have been adapted and modified to construct and express important aspects of family, cultural identity, national belonging, and memory.

The dissertation is essentially a thick description of Velines and a theological inquiry into its power and significance. After the initial introduction the dissertation is divided into three parts, each part containing three chapters. Part I describes the people, places, and practices of Velines with chapters on history, cemeteries, and practices. Part II addresses the structures of social order that intertwine with and affect Velines practices in chapters on family, church, and state. Part III of the dissertation engages structures of spiritual struggle and includes chapters on trauma, memory, and hope.

This dissertation studies Monsignor Óscar Romero’s theological, hermeneutical, and pastoral approach to preaching to the suffering and wounded people of El Salvador from 1977 to 1980 while he was the Archbishop of San Salvador. At that time, the marginalization, oppression, persecution, and exploitation of the poor people of El Salvador at the hands of the government, the oligarchy, the armed forces, and paramilitary groups was unbearable. The blood of the poor people and religious leaders who defended the poor, including his friend Rutilio Grande, was running through the mountains, lakes, and beaches of El Salvador, and Archbishop Romero could no longer ignore it. Through his homilies, he gave voice to their trauma and denounced the oppressive systems and structures that were at the root of their suffering. Inspired by the Holy Spirit and guided by his sentir with God, the people, and the Magisterium of the Church, Romero became the Spirit-guided and empathetic pastor the people needed. Through his homilies, Romero provided a “sanctuary space” where these suffering and wounded people could find refuge, hope, and possibility. The dissertation examines the ways in which Romero’s theological, hermeneutical, and pastoral framework can inform sermons that speak to suffering and traumatized people, such as undocumented Hispanic/Latinx immigrants in the U.S.

Our knowledge of the kinds of trauma people experience and the impact that it has has grown by leaps and bounds in recent years. Some margin of that knowledge has crossed over into the religious landscape, particularly about pastoral care and theology. This paper will take up the idea that preaching and, by extension, the other parts of the liturgy can be a part of reforming and healing the fractured imaginations of persons and communities who have experienced traumatic events, leading them to post-traumatic growth and thriving.My knowledge of preaching being far greater than my knowledge of trauma theory, my first priority was extensive research in that field; I studied how trauma impacts both individual bodies and whole communities, first utilizing Bessel van der Kolk and Judith Hermann, two established and well-regarded researchers. From there, I moved into source material from the medical field, finding significant intrigue in a 1688 dissertation from a medical library that was one of the first texts to describe the way traumatic events fracture imagination. Then I moved to experts in the field of preaching and worship – Will Willimon, Barbara Brown Taylor, Rick Lischer, Luke Powery, and more. It became clear that preaching is a vocation of words and imagination, and trauma’s chief impacts rob people of those very things. Thus, preachers have a critical role to play in the healing of their communities by providing shared, sacred language and a space to reintegrate broken imaginations.

In an ethnography of queer women’s (lala) activism in China, I tell the story of a social movement from its effusive beginning to disillusionment and pose the difficult question of what went wrong. I trace the dissolution of a key organization, the Chinese Lala Alliance, in which I played a leadership role for over ten years, and examine the pattern of interpersonal drama that frequently erupted between lala activists throughout China. With “glass hearts” that easily shatter, many activists air their grievances and angrily demand redress with an affective intensity that further escalates conflict and fractures sociality. I argue that trauma results from the chronic, systemic oppression that impact the lives of most queer women. The intimate kinship bonds formed between lala activists also leads to deeply felt pain and injury when conflict erupts.Delving into the in-fighting, the break-down of social bonds, and the demise of an organization, I point out the problems with the tools of critique and confrontational politics, which have defined queer and feminist politics around the globe. Utopia is a vision of the social, but those with utopian fantasies of safe space in the activist community are inevitably disappointed when interpersonal conflicts arise. Perceiving their experience of injury and pain as abuse and oppression inflicted by another, activists with glass hearts deploy the powerful tools of confrontational politics against other activists, with devastating consequences. To build sustainable social movements, we need a different activist culture that prioritizes healing and reparative work. I also situate “movement trauma” in the national landscape and draw parallels between the temporal arch of lala activism and the Chinese Dream. The pursuit of progress, in both capitalism and activism, follows a trajectory from effusive optimism and hope to disenchantment a decade later.

This dissertation examines a series of novels by Aminata Zaaria, Ken Bugul, Gaston-Paul Effa, Boubacar Boris Diop and Yolande Mukagasana. At the heart of my study is a problem that haunts much literary production and literary criticism about post-colonial Francophone African writing: the layers of distance and misunderstanding that often exist between readers and writers. Several of the authors in this study express frustration at the limited expectations that readers have of them, complaining that readers outside of the continent continue to read their novels solely in order to gain a grasp of socio-political "realities" of Africa. I propose a return to a select group of author's largely semi-autobiographical texts in order to better understand each writer's individual literary projects within the interdisciplinary framework of trauma studies. Interviews that I conducted with Senegalese and Cameroonian publishing directors, psychologists, sociologists and authors themselves offer an analysis of these texts within the context of broader social debates.

My first chapter focuses on Zaaria's La Nuit est tombée sur Dakar (2004) and Bugul's Le Baobab Fou (1983) and Cendres et Braises (1995) in order to examine intergenerational Senegalese semi-autobiographical representations of prostitution. My study ultimately finds that neither Senegalese society nor Zaaria and Bugul's narratives evidence healing through writing. Rather, both present literature as a "default" chosen because the authors found no one with whom they could initially share their stories face-to-face. Chapter Two hones in on Bugul's relationship with her mother, a painful theme revisited from one end of Bugul's semi-autobiographical oeuvre (Le Baobab Fou, 1982) to the other (De l'autre côté du regard, 2002). Chapter Three examines the trauma of parental loss in Gaston-Paul Effa's semi-autobiographical works, from Tout ce bleu (1996) to a more recent novel (Nous, les enfants de la tradition, 2008) in order to examine the evolution of Effa's personal identity quest and his extensive self-analysis over time in light of the author's permanent exile in France. My fourth chapter begins with a study of genocide survivor Yolande Mukagasana's recent narrative entitled N'aie pas peur de savoir (1999) in order to examine author/reader relationships in light of the often inconceivable trauma of genocide. I then move on to consider the ethics of speaking "for" genocide survivors by analyzing the well-known Senegalese author Boubacar Boris Diop's Murambi, le livre des ossements (2000) and the related Fest'Africa project. I end Chapter Four with a critique of Etoke's Melancholia africana: l'indéspensable dépassement de la condition noire (2010) in order to question whether or not sweeping theories of the various traumas experienced by members of Africa and its diaspora are in fact helpful in every context. Finally, I end my study with Effa's Voici le dernier jour du monde, which exhibits the interplay between autobiography, biography, fiction and the issue of literary violence.

I ultimately argue that a major difference between the "talking cure" of psychoanalysis and the process of seeking healing through literary narratives involves the question of audience. In the case of Sub-Saharan African literature, the author/reader relationship does not necessarily provide a safe space akin to the doctor/patient model in Freud's "talking cure." Therefore, I ultimately call for a closer analysis of the myriad ways by which authors are seeking healing and answers outside the realm of literature.