Volume VI, Issue 2, Article 6 (August, 2000)
A Review of Trauma: A Genealogy by Ruth Leys, Ph.D. Published
by The University of Chicago Press
(ISBN: 0-226-4776-5), Publication Date: 15 June
2000, Pages: 328
Ruth
Leys has it right and has it wrong. Her brilliant analysis of the concept
of trauma, more like a genealogy, as the subtitle notes, than a history,
is an extension of her earlier essays and analyses (e.g., 1994). One of
her more intriguing questions from that analysis was: "If hypnosis cures
trauma, how is it done?"
She argues
in this important book that, among other things, that there are two rival
models that help explain why people are or are not suffering from a trauma-induced
problem. This is the first error I detected from her excellent analysis.
There is no doubt that there are at least two but probably more schools
of thought about the origin, maintenance, and elimination of trauma-related
problems. The Antimemisis School, according to Professor Leys, is those
who do not believe that trauma or traumatic reactions exist. They can find
far more data that supports the lack of existence than the existence, they
would argue. The Mimesis school of thought argues that trauma exists and
the reasons they give, I contend, divide this school into at least two
camps: Symptom relief and reeducation camp that uses desensitization as
the primary active ingredient to. The other camp or school of thought argues
that there are deeper meanings beyond the condition reactions. These meanings
emerged from one's family of origin and are maintained in current relationships.
To ignore this part of the client is to miss the most important cause of
the symptoms of chronic PTSD.
Among
the things that I like about this book is her near constant reference to
the trauma studies field. Like other scholars she anoints without intention.
Though she is not the first to call attention to the fact that this body
of literature, theories, organizations, practice approach and standards,
research methodology, and long history constituted a field of study independent
from its parent fields of psychology, sociology, psychiatry, social work,
systems studies, nursing, medicine, and others. With someone of Professor
Leys' stature so noting, the field of trauma studies has a new name. I
prefer traumatology as the name of the field since its origin began in
trauma surgery, spread to trauma medicine, trauma nursing, trauma studies
that incorporated traumatic stress studies, thanatology, disaster studies,
rape trauma and sexual assault trauma studies, holocaust survivor studies,
and many others.
The book
should be considered one of the key references of this field because of
the quality of scholarship alone. Professor Leys does an excellent job
articulating the meaning and understanding of PTSD and other trauma-related
challenges (e.g., dissociation) and discussing with the eye of a dispassionate
scholar, the causes and consequences of such issues as false memory syndrome,
errors in diagnosis (especially false positives), misuse in the courtroom,
the inconsistencies in data and theory emerging from van der Kolk's program
of research in neurobiology.
There are
only a few glaring errors in her book that I wish her to address at some
point in the future. Collectively I emphasize that the phenomenon of trauma
and trauma-related consequences are extraordinarily complex and the group
that appears to have data on their side are the clinical traumatologists
and their reliance on cognitive-behavioral therapy (CBT). Professor Leys
believes that clinical psychologists and hynotherapists are in the same
Mimetic Theory camp.
Together, they embrace the notion of trauma, or
the "experience of the traumatized subject," and can be understood as involving
a kind of hypnotic imitation or identification in which, precisely because
the victim cannot recall the original traumatogenic event, she is fated
to act it out or in other ways imitate it. The experience is an affront
to common norms and expectations, shatters or disables the victim's cognitive
and perceptual capacities so that the experience never becomes part of
the ordinary memory system (p. 298).
Few CBT
practitioners would recognize their own theoretical tenants in this assertion.
However, they can see it in their colleagues who practice another treatment
approach that does not depend upon behavioral theory principles.
Another
error is not including in her analysis the well-argued misapplication of
Western psychiatric models of therapy in non-Western cultures, especially
Africa. They do not challenge the fact that non-Western cultures experience
through their members' traumatic stress reactions and that these reactions
disrupt and threaten the culture unless dealt with through some socially
sanctioned way. They challenge trauma therapy practiced by and for Westerners
as the way to helping every human being. Although this approach has been
applauded and criticized for its simplicity, the point is well taken and
would bolster Professor Leys' analysis somewhat.
Another
error in the book is that Professor Leys relies on dichotomies. Dichotomies
are extraordinarily seductive and appealing. Good versus bad. Right versus
Wrong. Cognitive psychology theory has always held that humans tend to
prefer opposing positions to enable a constructed (i.e., simulation) reality
that is least stressful and more a confirmation of one's own identity.
Rather than settling for just these two Leysian constructions, Mimetic
Theory versus Antimimetic Theory, we can agree to disagree while suggesting
that a better fit with the data is at least two types of Mimetic Theory:
Behavioral and Energy Psychology (Figley, 1999; Gallo, 1999; 2000).
CBT is
without question the most effective treatment of trauma for those seeking
desensitization. Lays notes that it is a matter of changing the client's
"simulation." She suggests that treatment success occurs when the link
is eliminated between reminders of the event and unwanted emotions and
behaviors and then replacing disturbing and self-defeating self-talk with
more constructive and resilient self-statements.
In contrast,
many practitioners who adopt a more Antimemisis Theory believe that the
traumatic event and its apparent consequences in the presenting problem
is only a starting point. Systems-informed practitioners look for distress
in relationships that are linked to the collective wisdom of a particular
group, clan, or family. Rather than focusing on the traumatized, they assume
that the entire family system is traumatized in some ways and, collectively,
are enacting what they need to do in order to feel safe, connected, bonded,
and loved by others for their own protection and well being. Both approaches
are right and wrong in different ways, according to more modern approaches.
Energy Psychology is a new specialty in psychology that is part of a larger
field of energy studies that includes energy medicine, energy nursing,
and to other fields that include acupuncture, and other treatment models.
We are
still not sure of the premise of her primary question about how hypnosis
cures. If it cures, she would argue, it does so by changing the client's
"simulation." Yet, as noted earlier, then what? Eliminating the pain of
remembering sometimes leaves emptiness and confusion about how to put one's
life back together with a new "simulation."
As the
field evolves and our theoretical understanding of how shocking events
can help and hinder the survivors, Ruth Leys book gain new meaning and
importance. The few flaws noted above are far out numbered by the extraordinary
analysis of the historical literature of traumatology.
References
Figley, C. R. (1998). Psychological Debriefing, Troubled Children, and
Homophobia: Toward a Multidisciplinary, Multidimensional Field of Traumatology.
Traumatology, Volume 4: Issue 2, Article 4. (http://www.fsu.edu/~trauma/art4v4i2.htm)
Gallo, F. (2000). Energy Diagnostics and Treatment. NY: WW Norton.
Gallo, F. (1998). Energy Psychology : Explorations at the Interface of
Energy, Cognition, Behavior, and Health (Innovations in Psychology Series).
Boca Raton: CRC Press.
Leys, R. (2000). Trauma, a Genealogy. Chicago: University of Chicago Press.
Leys, R. (1994). Traumatic Cures: Shell Shock, Janet, and the Question
of Memory. Critical Inquiry, 20:4, 221-235.
Charles R. Figley, Ph.D.
Florida State University Traumatology Institute
Tallahassee, Florida USA
Volume VI, Issue 2, Article 6 (August, 2000)