CSAR

What Is Trauma?
Trauma and Dissociation

by Elizabeth Howell

Statistics and common experience tell us that exposure to trauma is common to human beings. , to greater and lesser extents. But what is it that is being measured and experienced? Trauma is an event or experience that overwhelms the frameworks of the mind so as to impede its assimilation and its understandability. Trauma is overwhelming, making a person’s sense of self, of subjectivity, irrelevant to its powerful sweep. It wipes out the ability to think. As Judith Herman (1992) noted, “At the moment of trauma the victim is rendered helpless by overwhelming force” (p. 33). And David Spiegel (1990) wrote that: “Trauma can be understood as the experience of being made into an object; the victim of someone else’s rage, of nature’s indifference, or of one’s own physical and psychological limitations “(p. 251).

So how do we understand a traumatic event?

Because there are many different views of trauma, it gets very confusing. The difficulty of the question is a real problem for the field of mental health, in which “trauma studies” have now proliferated and in which the word “trauma” is so much part of our discourse, despite the fact that it is often left undefined.

One area in which we have entered murky waters has been with the attempts to define trauma as only “objective” or massive trauma, such as a devastating earthquake or an event in which one’s life was threatened or one witnessed another person’s life threatened. DSM-IV-R and DSM-5 have tried to define trauma in such “objective” ways that are assumed to pertain to the overwhelming nature of the event. A notable problem with this “objective” view of trauma is the issue of resilience: Some people are very resilient to the kinds of events that many would be extremely harmed by, and others may suffer terribly under what would appear to be minor stress. This difficulty led some to propose a subjective definition of trauma. But the problem with this subjective view is that anything that a person finds unpleasant could be defined as traumatic. This over-inclusiveness then can drain the word of any meaningful specificity.

I (Howell, 2005), have defined trauma as “that which causes dissociation,” as a way to transcend the problem of objective and subjective. My reasoning involves the understanding that psychic trauma is something that is overwhelming to the mind, something that is so terrible or so shocking that it cannot be assimilated by the existing mental frameworks, such that it has torn the fabric of understanding. Fissures and/or blank spaces begin to populate the mind. This description of trauma as “that which causes dissociation,” seemed to work as an answer to “what is trauma?” with respect to the objective vs. the subjective points of view, or the designations of “big” or “little” trauma.

A traumatic experience, which is now defined to include extremely heightened arousal, does not get registered in the hippocampus, where the experience would contribute to narrative memory. Massive terror and massive releases of stress hormones can be devastatingly overwhelming to a person, derailing a sense of psychic equilibrium and sense of self in time, and destroying any sense of imaginable safety in the world. There is now a fissure in memory and experience, and the traumatic experience lives on in dissociated self-states.

If an event cannot be assimilated, it cannot be linked with other experience, resulting in fissures in memory and experience. If the trauma has done that, it has caused dissociation. This conceptualization has the advantage of bypassing debates about the meaning of objectively defined trauma (which does not result in posttraumatic stress to all of those exposed to it) and subjective trauma (which can run the risk of categorizing anything that is distressing as traumatic).

The definition is not circular because dissociation, does not require trauma. Dissociation is the larger category, including hypnosis, absorption, adaptive dissociation, unlinked self-states, as well as trauma-generated dissociation. Other sources of pathological dissociation are disorganized attachment (Liotti, 2006) and lack of association (Putnam, 1997).

The basic point is that because we have been traumatized, we have become dissociative; that the mind becomes structured by trauma-induced dissociation. Philip Bromberg (2006) has referred to “the dissociative nature of the human mind.” Similarly, Ronald Fairbairn felt that we are all schizoid: “Everybody without exception must be regarded as schizoid….some measure of splitting of the ego is invariably present at the deepest mental level…this would not hold true, of course, in the case of a theoretically perfect person whose development had been optimum” (p. 7-8, 1952).

 

 

Elizabeth Howell is on the Editorial Board of the Journal of Trauma and Dissociation, faculty for the New York University Postdoctoral Program in Psychotherapy and Psychoanalysis; faculty and supervisor, Trauma program, Manhattan Institute for Psychoanalysis.  She has written numerous articles on trauma and dissociation, and her award-winning books include The Dissociative Mind; Understanding and Treating Dissociative Identity Disorder: A Relational Approach; and The Dissociative Mind in Psychoanalysis: Understanding and Working with Trauma (co-edited with Sheldon Itzkowitz), which has been nominated for a Gradiva award.  In 2017 she received the Lifetime Achievement Award from the International Society for Trauma and Dissociation.  She runs reading and consultation groups and is in private practice in New York City.

 

 

References:

 

Bromberg, P. (2006). Awakening the dreamer: Clinical journeys. Mahwah, NJ: Analytic Press.

Fairbairn, R. (1952). Psychoanalytic Studies of the Personality. Boston: Routledge & Kegan Paul,

Herman, J. (1992). Herman, J. L. (1992). Trauma and recovery: The aftermath of violence from

            domestic abuse to political terror. New York, NY: Basic Books.

Howell, E. (2005). Howell, E. F. (2005). The dissociative mind. Hillsdale, NJ: Analytic Press.

Liotti, G. (2006). Liotti, G. (2006) A model of dissociation based on attachment theory and

research. Journal of trauma and dissociation, 7, 55-74.

Putman, F. (1997). Putnam, F. W. (1997). Dissociation in children and adolescents: A developmental perspective. New York, NY: Guilford Press.

 

 

 

 

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