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Book: History of Trauma and Recovery, Part One · System Speak: Complex Trauma and Dissociation

• 0:08
  Speaker 1: Over: Welcome to the System Speak Podcast, a podcast about Dissociative Identity Disorder. If you are new to the podcast, we recommend starting at the beginning episodes and listen in order to hear our story and what we have learned through this endeavor. Current episodes may be more applicable to long time listeners and are likely to contain more advanced topics, emotional or other triggering content, and or reference earlier episodes that provide more context to what
• 0:40
  Speaker 2: we are currently learning and experiencing. As always, please care
• 0:44
  Speaker 1: for yourself during and after listening to the podcast. Thank you. I want to talk about the book Trauma and Recovery, The Aftermath of Violence from Domestic Abuse to Political Terror. It's by Judith Herman, and I was referred to the book by a class that I'm taking with the ISSTD. It really has been a fascinating book that I think that you should read if you're interested.
• 1:33
  It gives the context of the history of trauma treatment through the lens of the feminist movement and through the experience of wartime veterans and the recognition that historically women have had the same sort of PTSD symptoms due to violence against them as well and how that developed into recognition for the need for treatment as much as actual treatment. It's been fascinating to me not just learning about how women were able to start receiving treatment, which in this book they really did for themselves, and I'll talk about that in a minute, but also because some of the things that it says really explain things for me of experiences or things that I have felt or endured that I did not have words for, and it gave me words, and I wanted to share them. It opens talking about the conflict between the need to tell about trauma and the need to talk about how bad the trauma was and the need to express the details of what you went through and the conflict between that and the psychological need to deny any of it happening And not just for us to deny what's happened with ourselves, but also for society as a whole to deny that it exists because it's a conflict for society to recognize that that's within us as a culture or as a people because it means we also have to do something about it.
• 3:35
  And so the author explains how both traumatized individuals and society as a whole seem to alternate between feeling numb and dissociating from the fact that there is trauma and alternating that experience with reliving it or focusing on it and that this being why there's only progress in treatment made when there's also a political movement that also opens up the venue for it to be talked about and ways for it to be addressed even legally as well as in conversation as a society. The author says witnesses as well as victims are subject to the dialectic of trauma. It is difficult for an observer to remain clear headed and calm, to see more than a few fragments of the picture at one time, to retain all the pieces, and to fit them together. It is even more difficult to find a language that conveys fully and persuasively what one has seen. Those who attempt to describe the atrocities that they have witnessed also risk their own credibility.
• 4:55
  To speak publicly about one's knowledge of atrocities is to invite the stigma that attaches to victims. She just goes on in the first few chapters. She explains the history of why there is so much stigma for victims and where that comes from, and it's just so powerful. It's just so powerful. She says, to study psychological trauma is to come face to face both with human vulnerability in the natural world and with the capacity for evil in human nature.
• 5:31
  It means bearing witness to horrible events. But then she clarifies specifically. She says, when the events are natural disasters or, quote, acts of God, end quote, those who bear witness sympathize readily with the victim. But when the traumatic events are of human design, those who bear witness are caught in the conflict between victim and perpetrator. It is morally impossible to remain neutral in this conflict.
• 6:01
  The bystander is forced to take sides. So then she goes on, she concludes from that, it is very tempting to take the side of the perpetrator. All the perpetrator asks is that the bystander do nothing. But the victim on the contrary asks the bystander to share the burden of pain. The victim demands action.
• 6:24
  So this would explain even some of the behavior of like haters of the podcast for example or why families don't let victims speak out because not only does acknowledging what a specific victim went through bring up those issues? But facing those specific issues to one individual also means bringing up the issues that other individuals have as well. And so it's literally too difficult for them to face their own stuff or the implications of that violence. So it's easier to deny all of it altogether because in a way that is their own dissociation. So those who are denying your story or those who are hating on your efforts to speak out about it are actually doing so because of their own dissociation whether they believe in your dissociation or not.
• 7:26
  How crazy is that? How powerful is that to understand what's happening? She says secrecy and silence are the perpetrator's first line of defense. If secrecy fails, the perpetrator attacks the credibility of his victim. If he cannot silence her absolutely, he tries to make sure that no one listens.
• 7:47
  The study of psychological trauma must constantly contend with this tendency to discredit the victim or to render her invisible. Just wow. I don't have words for how powerful that is to see this on the written page. The author says, the systemic study of psychological trauma therefore depends on the support of a political movement. Advances in the field only occur when they are supported by a political movement powerful enough to legitimate an alliance between investigators and patients and to counteract the ordinary social processes of silencing and denial.
• 8:31
  Repression, dissociation, and denial are phenomena of social as well as individual consciousness. So it's not just me who's dissociating, it's also society who's trying to dissociate from the pain and the awareness that this is really happening to people, that this happens to women, that children are really hurt, that it happens to men too. And so it's easier for them to just push it away and deny it or ignore it than it is to actually address the problem. It makes sense. Right?
• 9:10
  And I know that on some level, I must have been aware of this or known this or even intuitively felt it, but to find words to express it have just been very powerful. The author takes the history all the way back to Charcot. Charcot was in France and what you need to know about Charcot is that he was a French neurologist who worked at a hospital complex that had been an asylum for, like, everyone that people didn't wanna work with. Right? So, like, prostitutes and beggars and and women diagnosed with hysteria, which was like anyone they couldn't explain, right?
• 9:55
  Because back then they didn't know what we know now. So he was really really famous and people came to him to learn from him. They studied under him and he gave like these lectures and presentations every week. It was also very political, which comes to be important in a way I never understood before. But the other thing that's important about this that I also didn't understand is that both Pierre Genet and Sigmund Freud were students of Charcot.
• 10:26
  And not only were they students of him, but they were competing against each other. And no one had ever told me that. I didn't understand that. I had never read that. Somehow I missed that piece entirely.
• 10:40
  And here's why it matters. It was Charcot who did a good job. I mean, there's other things that happened, but one thing that he did a good job of was documenting and giving the evidence of that what people were calling hysteria really was an actual psychological issue and not just women failing to participate in life or not wanting to participate in life. It was not malingering. It was not made up.
• 11:15
  And so he really pioneered the way for documenting that psychological issues really could be classified and categorized and documented in a way that gave evidence to fight against some of the stigma. It gave dignity to people and credibility to their issues so that psychological issues could be studied as a part of science rather than just being dismissed as women who had failed life somehow. Does that make sense? So in that way what he did was really really good But there was a rivalry the author described so, so well between Genet and Freud because they were wanting to not just give dignity that hysteria was really a thing and that psychological issues actually existed, but they were wanting to compete for being the first one to discover the cause of it. Does that make sense?
• 12:26
  So Charcot kind of paved the way to say, this is a legit thing, but Genet and Freud were trying to figure out why it was a thing and what was causing it, and they wanted to be the first one to do it. So that's why both with Genet and Freud, women were for the first time being listened to and being able to tell their stories whereas in the past they had just sort of been quarantined away from society or placed in an asylum or sent away to recover, but no one was actually listening to them or to their stories because of the political environment and the culture in which women lived at the time. The author says by the mid eighteen nineties, Genet in France and Freud in Vienna had separately come to the same conclusions that quote, Hysteria was a condition caused by psychological trauma. Unbearable emotional reactions to traumatic events produced altered states of consciousness, which in turn induced the hysterical symptoms. Genet called this alteration in consciousness dissociation.
• 13:46
  Freud called it double consciousness, end quote. And then she says, Genet believed that the capacity for dissociation or hypnotic trance was a sign of psychological weakness and suggestibility, but Freud argued that hysteria could be found among people of the clearest intellect, strongest will, greatest character, and highest critical power. So you guys, what they did was amazing, and these were huge breakthroughs in our history of being able to tell our stories and to get treatment and to get better and to heal but also everything kept going wrong. So Charcot recognized that these were actual psychological symptoms that were really a thing and that was good. But what was bad was then he kind of put the women on show.
• 14:40
  They were exploited. What was good about it was that word spread and people started listening to women. That was good. What was bad was he then sort of stopped there because of the political implications and he couldn't really push further and still have support for his hospital. What Genet did that was good was recognize and document dissociation and coming up with the word and explaining why it was and recognizing psychological trauma as causing these symptoms.
• 15:18
  But then what was hard about what he did was how he dismissed it because of weakness and suggestibility which has since been proven false in research by the way. And then what Freud did that was good was showing that it happened with everybody who had been exposed to trauma, not just weak people or someone who wasn't strong enough to not dissociate, which I find kind of validating even today. That it's not just that I wasn't good enough or just strong enough. I just talked about this on the podcast like a week ago or two weeks ago. Sometimes it feels like, does this just happen because I'm not strong enough?
• 16:00
  Why can't I be good enough or strong enough to prevent this from happening? Why can't I just make it a choice to keep this from happening? I I don't think that we always can actually and that's what Freud talked about which I really really appreciated. But then he also was limited in application of what he was doing and kind of backtracked his own studies because of the political issues at the time. The other thing that both Genet and Freud discovered independently but verified for each other is that the symptoms would go away if people listened to the women.
• 16:43
  The author says, by the mid eighteen nineties, these investigators had also discovered that hysterical symptoms could be alleviated when the traumatic memories as well as the intense feelings that accompanied them were recovered and put into words. Genet called the technique psychological analysis and Freud called it abreaction. Later Freud changed that to psychoanalysis. So then Breuer who was working with Freud called it the talking cure. So the more that they let their patients talk, which actually had not been done before you guys, they still thought these medical problems were caused by physical problems because they were women or because they were weak or because they had not had enough babies or because they had learned to read.
• 17:37
  Like they were still had such social and political oppression oppression on women and such a context for women that they were not listening to the stories of what had happened to women. And when they did, they didn't really consider anything to be wrong with it because they were so dissociated from recognizing that what women had been through with trauma was actually violence. So the author talks about Freud and says repeatedly his patients told him of sexual assault, abuse and incest. Following back the thread of memory, Freud and his patients uncovered major traumatic events of childhood concealed beneath the more recent, often relatively trivial experiences that had actually triggered the onset of the symptoms. So very similar to now, people weren't coming to treatment because of what had happened to them.
• 18:33
  They were coming to treatment because of small things that were causing problems in the present, but ultimately that was being caused by childhood trauma. But when their patients were the daughters and wives of famous aristocrats and wealthy families that were influential and politicians, they could not continue to listen to the women and not take action, but also were not in a position to be able to change the social influences so they felt in order to accept the stories and do something about it. And so they literally had to stop listening to the women tell their stories because they came to the point where if they believed them, it had such ramifications and implications for society as a whole that was too much for them to handle. And so they themselves had to dissociate from their patients in order to continue to survive in their environment. How wild is that?
• 19:46
  Like, it was such a huge breakthrough almost, except things kind of fell apart there. And then the author goes in to talk about the political history, which is just fascinating. She talks about how the eighteen seventies, the feminist organizations could not even publish literature yet or have the right to hold meetings yet, and that they had to hold back some of the things they wanted to do just to support the new republic in France, for example, and young governments that were still coming into place. They had to support those governments enough that those governments would be successful so that they would then be able to earn or obtain the freedom to do what they wanted, but they still could not do it directly. But by, like, 1888, the author says women were then speaking up for themselves and not needing men to speak for them even in training for science and kind of called out Charcot for exploiting women for his lectures and for being famous instead of letting the women speak for themselves.
• 21:02
  So she says, by the turn of the century, the political impulse that had given birth to the heroic age of hysteria had dissipated. There was no longer any compelling reason to continue a line of investigation that had led men of science so far from where they originally intended to go. The study of hysteria had lured them into another world of trance, emotionality, and sex. It had required them to listen to women far more than they had ever expected to listen and to find out much more about women's lives than they had ever wanted to know. Certainly, they had never intended to investigate sexual trauma in the lives of women.
• 21:43
  As long as the study of hysteria was part of an ideological crusade, discoveries in the field were widely applauded and scientific investigators were esteemed for their humanity and courage. But once the political impetus had faded, these same investigators found themselves compromised by the nature of their discoveries and by their close involvement with their women patients. You guys, that's exactly the same thing that happened with the false memory syndrome movement in the 80s. In the 1980s when that all happened, that's the same kind of things that clinicians faced for standing by their patients. They faced legal ramifications.
• 22:27
  They faced social ramifications. Some of them lost their licenses without having done anything wrong. So the context is different because we like to think that we're in such a more liberated society now, but really in the nineteen eighties clinicians themselves were violated in so many ways and it was like what the author later calls like an emotional rape almost of how they were violated trying to share and defend and explain their patients' stories for research in how to help them and for trying to explain things like DID and teach about them. There was such a backlash against it that people's lives were ruined. So this is a pattern that continues to happen and why political involvement can become so critical to research in ways that I had never understood before.
• 23:29
  It's not just about getting money for studies or trying to fund studies. But, like, for example, in America right now, trauma can't even be funded through the National Institute of Mental Health. It only can be brain science and it can only be evidence based things, which is why there's such a focus on the MRIs, the functional MRIs, right? Because it's the only way to get funding for research for trauma and DID right now in that context, in that example. So this is exactly what was happening in the 1890s and it's why even Freud himself almost recanted and backed off his theory entirely, changing what he said.
• 24:16
  Even though he later kind of came full circle, this was the context in which they were in. And not to make what happened okay, but it explains kind of why they did what they did. Genet, however, never abandoned his traumatic theory of hysteria and never retreated from his hysterical patients but he lived to see his works forgotten and his ideas neglected. How sad is that? Like to think now that we have a whole society for study of trauma and dissociation And we have a podcast about dissociation, and we understand DID as a dissociative disorder.
• 24:57
  And Janae didn't know that that's what happened with his research or what it came to in fruition later or that we honor even his terminology through his hard work of listening to patients because at the end of their lives, everything just fell apart. So then the author says that the reality of psychological trauma was forced upon public consciousness once again by the catastrophe of the first world war. The horrors of trench warfare, men began to break down in shocking numbers, confined and rendered helpless, subjected to constant threat of annihilation, and forced to witness the mutilation and death of They lost their memories and their capacity to feel. How amazing is that? Not good amazing that that happened to these men, but that people finally made the connection between what women had been expressing for thousands of years and what they were recognizing now in a new way as what came to be termed shell shock by Charles Myers.
• 26:22
  So they started to categorize and identify hysterical symptoms specifically such as mutism, sensory loss, or motor paralysis. But they treated these with electric shocks and even with the men shamed them for their laziness and their cowardice. Still not getting that it was literally caused by the trauma itself as opposed to there being some weakness in the person. So they came so close but they weren't connecting the dots still and still shamed the patient rather than helping them. So the next big name that comes into play is W.
• 27:06
  H. R. Rivers who was a physician who worked with veterans, and he is the one who advocated for humane treatment and wanted to use the psychoanalytic principles from Genet and Freud. And the author talks about this famous case where a man was sent to him who was quote, restless and irritable and tormented by nightmares. His impulsive risk taking and reckless exposure to danger had earned him the nickname Mad Jack.
• 27:42
  Today these symptoms would undoubtedly have been caught would undoubtedly have qualified him for a diagnosis of post traumatic stress disorder And the goal of sending him to Rivers for treatment was to get him back into combat and back on the front lines and Rivers didn't fight with that. He didn't argue with that even though now we would think of that as like the last thing the person needed, right? But he wanted to argue for the efficacy of the talking cure. He wanted to document and defend that listening to people's stories actually helped them get better. So rather than being shamed, this guy was treated with dignity and respect.
• 28:26
  And rather than being silenced, he was encouraged to write and talk freely about the terrors of war. And ultimately, because of connection, you guys remember connection is where healing happens. Like, we've spent a year and a half, two years now learning that. Because he felt the support and connection from Rivers listening to his stories, he was not forced to go back into combat but actually chose to go back into combat because he felt connected to his comrades and supported by Rivers. So it was the first time that, quote, men of unquestioned bravery could succumb to overwhelming fear.
• 29:07
  And second, that the most effective motivation to overcome that fear was something stronger than patriotism, abstract principles, or hatred of the enemy. It was the love of soldiers for one another. So now there's two connections being made that anyone can have a trauma response and also that it's connection that heals that trauma response and that it's really connection that overcomes trauma beyond anything else. The most healing thing is connection. Then the author talks about in 1922 there was an American psychiatrist, Gardner, who was analyzed by Freud which was common, right?
• 29:55
  Many therapists but especially psychologists go through their own therapy as part of training so it's not uncommon that he had to go be analyzed by Freud before he himself could be analyzing other people. That makes sense. But when he worked with veterans, once he started working in New York he was working with veterans and he was troubled by the severity of their distress and by his inability to cure them. And recognizing patterns of trauma in the veterans he started to notice that perhaps he had his own issues that had been difficult and he'd says, quote, the ceaseless nightmare of his own early childhood, poverty, hunger, domestic violence, and his mother's untimely death had influenced the direction of his intellectual pursuits and allowed him to identify with the traumatized soldiers. So because of his own experience, he was actually able to identify with and support veterans who had gone through trauma in a way that other people were not able to.
• 31:05
  So it upped the level of connection and it increased the level of healing because he was listening to them in an attuned way and more empathetically than others had been able to do. So the author says, quote, Cardner recognized the war neuroses represented a form of hysteria, but he also realized that the term had once again become so pejorative that its very use discredited patients. He said, When the word hysterical is used, its social meaning is that the subject is a predatory individual trying to get something for nothing. The victim of such neurosis is therefore without sympathy in court and without sympathy from his physicians who often take hysterical to mean the individual is suffering from persistent form of wickedness, perversity, or weakness of will, end quote. So even before the second world war happened, he was saying this is not about weakness or about people being bad.
• 32:09
  This is about an actual response to events they have experienced. When the second world war happened, military psychiatrists tried to remove the stigma from the stress reactions of combat. By then, it was recognized that any man could break down under fire, and that the psychiatric casualties could be predicted in direct proportion to the severity of combat exposure. So by now they knew enough that they could actually tell how many days a soldier had to be exposed to intense combat situations to have a trauma response. But they had also connected what Rivers had said.
• 32:53
  And so, quote, the power of emotional attachments among fighting men were emphasized. In 1947, Carter revised his classic text in collaboration with Spiegel, a psychiatrist who had just returned from treating men at the front. Carter and Spiegel argued that the strongest protection against overwhelming terror was the degree of relatedness between the soldier, his immediate fighting unit, and their leader. Similar findings were supported by psychiatrists Grengel and Spiegel, who noted that the situation of constant danger led soldiers to develop extreme emotional dependency upon their peer group and leaders. They observed that the strongest protection against psychological breakdown was the morale and leadership of the small fighting unit.
• 33:44
  So for the second world war, it was actually the first time that they did things differently trying to protect soldiers to some degree. They focused on, even in battle approaches, being able to do things in such a way that it pushed people out to fight but then brought them back together, and then pushed people out to fight and then brought them back together. They were trying to minimize the separation between the soldiers as individuals and the unity of soldiers as a group. The problem was that once again things fell short. So they had discovered that the talking cure with hypnosis would really help.
• 34:26
  Some were inducing This is also where some of the psychological experiments come into play and that's a whole different podcast. They tried to find ways to induce dissociation so that it could be treated and they could be sent back to combat more quickly. Again those experiments are a whole different podcast and I don't want to talk about them right now but what they found was even short term hypnosis, so very much like the short term evidence based cognitive behavioral therapies, did not work as well as the long term talking cure of psychoanalysis. Their research showed that there was not enough follow through and because the treatment depended on connection, when connection was removed the healing failed even if there were short term benefits. That it was not the same as an actual long term healing and that because the brain was actually changed by the experience of being a soldier that they needed long term connection, and that just a short term thing was not enough.
• 35:42
  It didn't it was not able to sustain itself regardless of the patient or the patient's issues or what the patient did. It was not about the patient failing. It was about treatment not being enough. And so in some cases when treatment was cut short it was actually more damaging because it almost reinforced the trauma rather than by then isolating the person from the healing rather than if they had not had any treatment at all. Which I find fascinating even as part of transitioning therapists or in research now about shame theory and what we know about attachment and what we know about attunement and how big those misattunement experiences can be.
• 36:35
  So then what was unique about the Vietnam War in the seventies was that for the first time soldiers were organizing against their own war while it was still happening. That had never been done before, and for the first time, groups of soldiers were starting to organize themselves specifically for the purpose of talking about what they had been through. So these were called rap groups. End quote. The purpose of the rap groups was twofold, to give solace to individual veterans who had suffered psychological trauma and to raise awareness about the effects of the war.
• 37:15
  End quote. So here's what's significant that came out of that. It wasn't just that veterans set up their own support groups. That's significant. That is absolutely significant.
• 37:27
  But beyond that, quote, these veterans refused to be forgotten. Moreover, they refused to be stigmatized. They insisted upon their own rightness and the dignity of their distress, end quote. So these are huge things that trauma itself has the need to be spoken about and that victims of trauma or survivors of trauma have the right to do the talking for themselves about their own experiences in long term settings and as people with dignity despite what has been done to them. So that along with the context of the women's liberation movement in the nineteen seventies is what confronted how women had been silenced by fear and shame and how women had been silenced about their own violations of every form of sexual and domestic exploitation.
• 38:33
  There was so much silence surrounding it that even when women began to speak out and people began to listen to them there still wasn't even a word to call it. Betty Friedan literally called it the problem without a name end quote. It was also no accident that the initial method of the movement was called consciousness raising. Quote, consciousness raising took place in groups that shared many characteristics of the veterans rap groups and psychotherapy. They had the same intimacy, the same confidentiality, and the same imperative of truth telling.
• 39:13
  The creation of a privileged space made it possible for women to overcome the barriers of denial, secrecy, and shame that prevented them from naming their injuries. In the protected environment of the consulting room, meaning with therapists, women had dared to speak of rape, but the learned men of science had not believed them. But in the protected environment of consciousness raising groups, women spoke of rape and other women believed them. So like veterans who had not been listened to, this latest generation of veterans began helping themselves and helping each other. And that's where healing happened.
• 39:55
  And so at the same time with the women's liberation movement, the same thing happened with women. Women began to meet with other women. And women as a group brought healing to themselves by speaking their stories and healing to each other by listening to those stories. This was huge. This was so huge.
• 40:18
  And the healing that came out of this was exponential. It was exponential. So the quote, the first public speak out on rape was organized by the New York radical feminist in 1971. The first international tribunal on crimes against women was held in Brussels in 1976. Rape reform legislation was initiated in The United States by the National Organization for Women in the mid nineteen seventy's.
• 40:53
  And within a decade reforms had been enacted in all 50 states in order to encourage the silence victims of sexual crimes to come forward. Because of those breakthroughs, it was discovered that one in four women had been raped and one in three had been sexually abused in childhood. And it was through that movement of the feminists, of the women at the time, that words began to give names to what had happened to them. So quote, entering the public discussion of rape for the first time, women found it necessary to establish the obvious that rape is an atrocity. Feminists redefined rape as a crime of violence rather than rape crisis center opened in 1971 and then in 1972 two women, a psychiatric nurse Ann Burgess and Linda Holmstrom, a sociologist, started the first study on the psychological effects of rape.
• 42:01
  Quote, They observed a pattern of psychological reactions which they called rape trauma syndrome. They noted that women experienced rape as a life threatening event, having generally feared mutilation and death during the assault. They remarked that in the aftermath of rape, victims complained of insomnia, nausea, startle responses, and nightmares as well as dissociative or numbing symptoms. Then Lenore Walker used the term battered women's syndrome for the women who fled to shelters. And then, Only after 1980 when the efforts of combat veterans had legitimated the concept of post traumatic stress disorder did it become clear that the psychological syndrome seen in survivors of rape, domestic battery, and incest was essentially the same as the syndrome seen in survivors of war.
• 42:56
  I would be interested to note the timing of this with Peter Barrish's research as well. I will ask him about that. That was just the first chapter you guys. That was just the first chapter and her point is that without the context of a political movement it's never been possible, it has never been possible to advance the study of psychological trauma and that this is part of why we need to continue speaking out when it's hard, it's part of why we need to be brave despite the risks and it's part of why we need to keep going so that we are in some way paving the way for it to be easier for others to get help after us. The pioneering work of this story leads up all the way till right before we were born.
• 43:48
  You guys, that's not that long ago that still no one even believed or knew that trauma was a part of anything. It wasn't even recognized. It's literally only been in our lifetime that we can connect trauma to causing all of these symptoms. And trauma as being why this happens to us and what is wrong with us is not what is wrong with us. It's what is wrong with what was done to us.
• 44:16
  It is what is wrong with what they did to us. And that is why we have to keep speaking out. Thank you for listening. Your support of the podcast, the workbooks, and the community means so much to us as we try to create something together that's never been done before. Not like this.
• 44:52
  Connection brings healing, and you can join us on the community at www.systemsbeat.com. We'll see you there.