Psychic Injury Research Articles

:Narrating Trauma: Victorian Novels and Modern Stress Disorders

:<i>Narrating Trauma: Victorian Novels and Modern Stress Disorders</i>

L’état antérieur : quelle incidence pour l’adulte, quelle incidence chez l’enfant ?

IntroductionSearching for a previous state is a common act in all medical disciplines, it corresponds to what appears in clear in any medical or social record: the prior medical history. The history is a time marker and an indicator of a possible symptomatological evolution or the risks incurred regardless of the medical specialty concerned. When they are searched for with an indemnity purpose, they are named prior state. MethodologyThe author draws on his experience of the contradictory expertise of victims (adult or child) terrorist attacks and on the analysis of the Dintilhac mission and missions emanating from CIVI (commission d’indemnisation des victimes d’infraction) and limits the study to psychic injuries during an attack. Objectives and ResultsAn assessment requested as part of a legal process is intended to assess the sequelae attributable to a fact, a harmful event (assault, attack) and the damages resulting from it. It is then necessary to check if there was a previous state in order to determine the impact of the harmful facts on the sequelae state. Based on clinical cases, the author describes the specificities of the psychiatric and psychopathological reasoning on which the expert relies depending on whether the previous condition was revealed before the attack or whether it was aggravated or revealed by the attack. ConclusionFor the psychiatrist, there is a global analysis to be carried out on what represents the previous state in the life course of the victim, the meaning it ascribes to him, and a more specific, medical aspect, which concerns the nature of the previous state.

Battersea Action and Counselling Centre (BACC)

This is a brief account of a community psychotherapy project, set up in the 1970s in inner London, as an intervention outside state provision, to address some of the mental health needs, suffering and unmanageable distress of local working-class people. It represents a conjunction of left-wing and socialist politics with a commitment to psychoanalytic and therapeutic understandings of the psychic injuries of class.

Anger and Apology, Recognition and Reconciliation: Managing Emotions in the Wake of Injustice

Abstract This article treats rituals of apology and reconciliation as responses to social discontent, specifically to expressions of anger and resentment. A standard account of social discontent, found both in the literature on transitional justice and in the social theory of Axel Honneth, has it that these emotional expressions are evidence of an underlying psychic need for recognition. In this framework, the appropriate response to expressions of anger and discontent is a recognitive one that includes victims of injustice in the political community by showing them that they are valued members. In the aftermath of injustices, such recognitive responses are thought to include acknowledgments of victim suffering, reconciliatory gestures, and rituals of contrition. I will argue, against this narrative, that treating victim anger as evidence of an underlying need for recognition threatens to depoliticize emotional responses to injustice by treating them as symptoms of psychic injuries instead of intelligible political claims. Discussing mainly the Canadian Truth and Reconciliation process set up to deal with the history of the Indian Residential School system, I show how rituals of reconciliation and apology, in the context of settler-colonial states and neoliberal politics, serve as a biopolitical management of “bad” emotions. This will serve as a critique both of the politics of reconciliation and of social–theoretic approaches that treat expressions of discontent exclusively through a lens of recognition. Instead, I argue, in politics as well as theory, we need to engage with emotional expressions as intelligible political claims that exceed the psychic need for recognition.

Healing the stigma of HIV/AIDS

HIV: Healing Inner Voices is a film about how eight Indigenous Canadians experience HIV/AIDS. To a large extent, that makes it a film about stigma. Flo Ranville, part Sioux Lakota and part Woodlands Cree, talks of the time her partner beat her with such brutality that she had to have corrective surgery. Her physical wounds started to recover during the 10 days she spent in hospital, but her psychic injuries were worsened. “I've never been treated so badly”, she recalls.

An ethnographic study of opioid use disorder in rural Maine: The problem of pain

This qualitative study was conducted to more fully understand health care providers and community leaders’ perceptions of the opioid crisis in rural Maine. In 2017, Maine continued to have one of the highest opioid overdose death rates in the country, more than double the national average. I (first author) visited eight treatment centers in Maine providing support and treatment to people recovering form Opioid Use Disorder (OUD), shadowing health care providers. I also attended OUD-related meetings held with community leaders. I conducted a total of 33 semi-structured interviews with health care providers, community leaders, and NGOs in the state of Maine. Three themes emerged integrating observations with semi-structured interviews: i) Impact of emergence of new extended release opioids, their prescription patterns, and culture around them; ii) Subjectivity of pain and importance of understanding psychic injury in OUD treatment; iii) Socio-political context and perception of OUD in Maine. Our society’s perception of pain has deep historical and cultural sources that influence the way that pain has been perceived and treated in the medical setting. Resources beyond the medical environment are needed to address pain adequately.

Ethical loneliness in the psychiatric clinic: The manufacture of non-belonging

Summary Arguing for the importance of the clinical encounter as a site of bioethical inquiry, I focus particularly on persons experiencing severe psychic distress. Acknowledging the historical wrongs that have been done to persons with severe psychic distress, I suggest that the contemporary colonization of psychiatric care by the medical model and by neoliberal values that prioritize accountability, metrics, and cost over personhood are doing a grave disservice to such patients. I draw on the writings of social theorists including Agamben to argue that the treatment of psychiatric sufferers produces a risk of causing patients to experience bare life and relegation to the status of nonpersons. Drawing on Stauffer's concept of ethical loneliness, I illustrate the kind of harm that is done when the institutions that we design to listen to patients and receive suffering fail in that responsibility. In the second half of the paper, I offer two illustrative examples of how an emphasis on attuned listening, relationality, and acknowledgement of the rich familial and cultural context of patients’ lives can allow us to engage in ethical listening that leads to receptivity and potential healing. The first illustration draws on a psychoanalytic understanding of the deep psychic injuries caused by inaugural losses in a person's earliest experience, and the second draws on a case that offers rich texture for understanding the experience of a young man who showed up at an emergency room in Morocco in a state of severe psychic distress.

Discounting Credibility: Doubting the Stories of Women Survivors of Sexual Harassment

For decades, federal and state laws have prohibited sexual harassment on the job; despite this fact, extraordinarily high rates of gender-based workplace harassment still permeate virtually every sector of the American workforce. Public awareness of the seriousness and scope of the problem increased astronomically in the wake of the #MeToo movement, as women began to publicly share countless stories of harassment and abuse. In 2015, the Equal Employment Opportunity Commission’s Task Force on the Study of Harassment in the Workplace published an important study analyzing a wide range of factors contributing to this phenomenon. But the study devotes only limited attention to a factor that goes straight to the heart of the problem: our reflexive inclination to discount the credibility of women, especially when those women are recounting experiences of abuse perpetrated by more powerful men. We will not succeed in ending gender-based workplace discrimination until we can understand and resist this tendency and begin to appropriately credit survivors’ stories. How does gender-based credibility discounting operate? First, those charged with responding to workplace harassment--managers, supervisors, union representatives, human resource officers, and judges—improperly discount as implausible women’s stories of harassment, due to a failure to understand either the psychological trauma caused by abusive treatment or the practical realities that constrain women’s options in its aftermath. Second, gatekeepers unjustly discount women’s personal trustworthiness, based on their demeanor (as affected by the trauma they often have suffered); on negative cultural stereotypes about women’s motives for seeking redress for harms; and on our deep-rooted cultural belief that women as a group are inherently less than fully trustworthy. The impact of such unjust and discriminatory treatment of women survivors of workplace harassment is exacerbated by the larger “credibility economy”—the credibility discounts imposed on many women-victims can only be fully understood in the context of the credibility inflations afforded to many male harassers. Moreover, discounting women’s credibility results in a particular and virulent set of harms, which can be measured as both an additional psychic injury to survivors, and as an institutional betrayal that echoes the harm initially inflicted by harassers themselves. It is time—long past time--to adopt practical, concrete reforms to combat the widespread, automatic tendency to discount women and the stories they tell. We must embark on a path toward allowing women who share their experiences of male abuses of workplace power to trust the responsiveness of their employers, judges, and our larger society.

Le développement de paradigmes psycholinguistiques devient nécessaire à l’espace de la psychotraumatologie. Analyse critique de la littérature anglophone et des premiers travaux francophones. Vers un nouveau modèle du traumatisme psychique

Resume Objectifs Si l’interet pour la psychotraumatologie s’est progressivement generalise au cours de la derniere decennie, faute de reperage diagnostique, de nombreux patients restent sans soins tandis que parallelement, l’offre de psychotherapies differenciees s’est majoree. Notons egalement que si les recherches en neurosciences ont explose en nombre, leurs applications concretes utiles a la pratique quotidienne semblent plus tenues, notamment au plan pharmacologique. De tels achoppements seraient-ils causes par une preeminence de la reference au « stress » au detriment de la consideration du « trauma » ? Au-dela des picrocholines querelles d’ecoles, il apparait aujourd’hui necessaire de construire une nouvelle phase d’analyse. Methodes Nous exposons une revue critique de la litterature de langue anglaise avant de focaliser sur les quelques etudes francophones existantes. Resultats La majorite des etudes anglophones referencees se rattachent aux protocoles de deux travaux princeps sans que les paradigmes linguistiques en soutenant le design apparaissent tres structures. L’analyse linguistique s’y avere en fait limitee, sans mention des richesses apportees par les ecoles de semantique et de pragmatique. Il apparait toutefois une lente complexification des methodes d’analyse textuelle dans le temps. Pour l’espace francophone, seules deux etudes existent : l’une de Louis Crocq datant des annees 1960, et une autre de Ribeton & Auxemery mettant en evidence le syndrome psycholinguistique post-traumatique (anomie traumatique, repetitions linguistiques et desorganisation discursive). Conclusion Les troubles psychiques post-traumatiques beneficient d’un renouveau d’interet pour la psychiatrie et la psychologie contemporaines. La densification de la description du trouble de stress post-traumatique dans le DSM-5 pourrait encore se completer des differentes formes cliniques specifiques constituant les troubles psychiques post-traumatiques. Aussi, a l’heure ou differents protocoles psychotherapeutiques apparaissent concurrents (protocoles comportementaux et cognitifs, traitements par l’hypnose, therapies par mouvements oculaires, therapies psychodynamiques, therapies narratives, etc.), l’analyse de la restauration du langage pourrait permettre d’unifier une conception specifique du traumatisme psychique et de ses consequences cliniques. Le paradigme que nous proposons developpe la recherche clinique a l’aide de marqueurs psycholinguistiques offrant d’evaluer l’efficacite des psychotherapies.

The Myth of What We Can Take In: Global Migration and the "Receptive Capacity" of the Nation-State

This essay critiques a recently developed concept that sanctions violence against "irregular" migrants—namely, that the nation-state has a finite and objective "receptive capacity" for taking foreigners in. I first examine its origins in environmentalist conceptions of a territory's "carrying capacity"—a term that developed as a means of managing game populations and was subsequently transformed to appraise emerging markets. Second, I work through a linguistic recurrence, noting how Freud's theory of psychic injury postulates an infinite "receptive capacity" [Aufnahmefähigkeit], which must be regulated in order to ensure survival. Freud's speculations in Beyond the Pleasure Principle potentially dissolve a mythopoetic conception of Life that has since become central to the anti-immigrant racial imaginary—one that does not disavow death but strategically incorporates it and codes as annihilation the failure to organize one's own affectability profitably.

Hate Speech and Psychic Injury: Reflections on Nigeria's 2015 Elections

Hate Speech and Psychic Injury: Reflections on Nigeria's 2015 Elections

Fanon and the New Paraphilias: Towards a Trans of Color Critique of the DSM-V.

This essay places psychiatrist and philosopher Frantz Fanon's anti-colonial, anti-racist message from Peau Noire, Masques Blancs/Black Skin, White Masks (1952; 1967; 2008) in conversation with the new diagnoses of "Gender Dysphoria" and "Transvestic Disorder" in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Specifically, the essay discusses sexologist Ray Blanchard's controversial theory of autogynephilia alongside Fanon's ambivalent rendering of transgender desire and interracial trans phenomenology in a crucial but frequently overlooked passage in Black Skin. Fanon's anti-colonial critique of psychiatry allows us to reconsider how Blanchard's theories on paraphilia engage with the foundational psychoanalytic concepts of identification and desire, as identified by the Freudian and Lacanian models and explored in the writings of Judith Butler, Catherine Millot, Charles Shepherdson, and others. By offering a fresh interpretation of the French text, this essay argues that a "trans of color critique" can benefit from Black Skin's unexpected insight into trans desire: Fanon's "man of color," who simultaneously undergoes a gender transition and a racial transformation, represents the literal embodiment of his critique of colonial racism. Given the role of the new paraphilias in the DSM-V, this essay concludes that a trans of color critique is well positioned to reinforce the anti-colonial message Fanon addressed to the psychiatric and psychoanalytical fields, which have tended to diagnose psychic injury while ignoring its causation, and which continue to neglect the fact that medical access is just as important as material support and security for minority subjects, in particular.

The White Hotel: trauma, recovery, and the question of the Holocaust’s uniqueness

ABSTARCTD. M. Thomas’ The White Hotel negotiates an uneasy point of intersection between our theories of psychic injury and our assessments of atrocity by attempting to depict two positions that appear to exist in tension with each other: (1) an insistence that Holocaust that is historically and morally incommensurate with other catastrophes and (2) a belief that the post-traumatic maladies suffered by survivors of the Final Solution might be susceptible to a comprehensive healing. Thomas’ allegorical (and critically polarizing) coda becomes the vehicle through which he orchestrates a reconcilement these two commitments.

Timing Problems: When Care and Violence Converge in Stephen King's Horror Novel Christine

Judith Butler, Joan Tronto, and Stephen King all hinge human experience on shared ontological vulnerability, but whereas Butler and Tronto use vulnerability to build ethical commitments, King exploits aging, disability, and death to frighten us. King's horror genre is provocative for the imaginative landscape of feminist theory precisely because he uses vulnerability to magnify the anxieties of mass culture. In Christine, the characters' shared susceptibility to psychic and physical injury blurs the boundary between care and violence. Like Butler, King depicts our social worlds encrusted with normative violence: the mundane ways that norms police gender, race, class, and disability identities. And like Butler, King makes undecidability a key feature of human identity: the idea that needs and identities are uncertain. Normative violence and undecidability trouble the starting point of Tronto's care theory—attentiveness to needs—because both concepts invest interdependency with ambiguity and conflict. But like Tronto, King recognizes that care‐actors must act, even amid ambiguity and even when their actions make care and aggression converge. Christine's supernatural plot details the psychic possession of an American teenager, but the novel's more terrifying story is about interdependency and how normative violence is not the antithesis of care, but its dark underbelly.

Micro-Trauma: a Psychoanalytic Understanding of Cumulative Psychic Injury. by Margaret Crastnopol

Micro-Trauma: a Psychoanalytic Understanding of Cumulative Psychic Injury. by Margaret Crastnopol

Book Review: Micro-trauma: A Psychoanalytic Understanding of Cumulative Psychic Injury

Book Review: Micro-trauma: A Psychoanalytic Understanding of Cumulative Psychic Injury

A novel methodology for the objective ascertainment of psychic and existential damage

Personal injury is a legal term for a physical or psychic injury suffered by the plaintiff under civil and/or tort law. With reference to non-pecuniary damages, the evidence itself of physical and/or psychic injury is not sufficient for damage compensation. The process of ascertaining impairments and/or disabilities which pertain to the "personal sphere" of the individual, such as pain and suffering, loss of amenity, and/or psycho-existential damage, poses particular difficulties in relation to the obtainment of scientific evidence. The "immateriality" and the subjective connotation of the personal sphere are, in themselves, critical issues. The clinical data obtained from the neuropsychological ascertainment find their essential prerequisite in the active participation of the examinee who, in legally relevant contexts (criminal law, civil law, insurance), may be "affected" by personal interests. The present manuscript presents a novel interdisciplinary methodology, experimented on a series of judicial and extra-judicial cases, aimed at the attainment of objectivity and accuracy eligible in relation to the judicial settlement of cases and other matters involving the ascertainment of peculiar aspects of non-pecuniary damage.

The Lonely Girl: Investigating the scholarly nexus of trauma life-writing and process in tertiary institutions

Memoir writing and publishing has surged in recent years and this pattern is reflected in a surge in the number of students seeking to undertake degrees in auto-ethnographic creative non-fiction writing within tertiary institutions,specifically in relation to their own personal trauma. This paper discusses attempts to implement a pedagogical model to facilitate the supervision of students seeking to write trauma narrative, positing that because of the nature of their writing, they are closer to further psychic injury throughout the process than students not undertaking trauma writing. The result is that specialised attention is warranted and necessary, and indeed without specialised care, the offering of such degrees within tertiary settings could be framed as ethically fraught. The paper will discuss the current pedagogical model, and its implementation. But then will look at a case study where the model fell dramatically short. The ensuing argument is that the model should only ever be regarded as a default to be constantly developed. It argues that students choosing to undertake life writing around personal trauma are exposed to further psychic danger as a direct result of their studies, and must be seen as individuals, with specific and hyper-vigilant supervision needs.

Shock, memory and the unconscious in Victorian fiction

Jill L. Matus, Shock, Memory and the Unconscious in Victorian Fiction. Cambridge: Cambridge University Press, 2009, pp.x + 254. Hardback £62.00, isbn 978-0- 521-76024-9. Paperback £18.99, isbn 978-0-521-31025-3.In introducing Embodied Selves: An Anthology of Psychological Texts 1830-1890 in 1998, Jenny Bourne Taylor and Sally Shuttleworth claimed that there had been little work done on the close connections between Victorian narrative and the wider concerns of the emerging materialist science of self. Since then, the reciprocal relationship between nineteenth-century fiction and 'mental physiology' has become a particularly rich field for scholars of Victorian literature and culture. Following the groundbreaking work of Bourne Taylor and Shuttleworth, a number of other significant monographs have appeared by such scholars as Nicholas Dames and Anne Stiles. Jill L. Matus's perceptive and wideranging book, Shock, Memory and the Unconscious in Victorian Fiction, which has now been released in paperback by Cambridge University Press, provides a further insightful contribution to this flourishing field. It takes the experience of 'shock' or 'psychic injury' as its subject, analysing this phenomenon in a number of psychological works as well as in important examples of the period's prose fiction. In a series of interlinked individual case studies, Matus explores writing by Gaskell, Dickens, Eliot and Stevenson in detail alongside the work of significant figures from the world of mental science, including William Carpenter, Alexander Bain and E.S. Dallas. This approach is a suitably interdisciplinary one, but with an interesting twist; as Matus asserts, her 'book aims to explore in particular the participation of fictive narrative in what has been assumed to be the province of emergent psychology and memory science' (p.9). Matus, as a result, makes fascinating close readings of literary texts a central part of her project here, allowing her to argue convincingly that Victorian fiction does not only 'follow' or 'reflect' medical science, but in some cases helps shape it (p.12).The book's first chapter, 'Historicizing Trauma', provides a firm historical and theoretical basis for the in-depth analysis that follows. As Matus explains, another aim of Shock, Memory and the Unconscious in Victorian Fiction is to reveal 'a genealogy of trauma that reaches back into the mid-nineteenth century' (p.43). Her book therefore not only deepens our understanding of the Victorian novel; it also contributes to recent discussions of the application of trauma theory to literature. In analysing Victorian texts in the light of pre-Freudian ideas about trauma and the 'wounded psyche', Matus is able to reveal 'the historical contingency of trauma theory' (p.183). What is most important in nineteenth-century psychological and fictional accounts of trauma is not 'memory loss and dysfunction', as in twentieth-century instances, but rather the influence of contemporary 'theories of emotion and states of consciousness' (p.183).These themes are considered in further detail in Matus's second chapter on Elizabeth Gaskell's North and South, part of which has already appeared in different form in her Cambridge Companion to Elizabeth Gaskell (2007). Wittily labelling the text 'a condition-of-consciousness novel' (p.62), she provides a rich account of the narrative's interest in 'the effect of very powerful feelings on psychic functioning' (p.61). Beginning with the novel's notoriously high death toll, she analyses how the novel's significant events, like the upheaval of the Hales from Helstone, the strike scene and psychically-disturbing proposals of marriage, 'produce emotional upheaval and provoke a response of shock and pain' (p.63). She notes intriguingly that 'the experience of and response to powerful emotion is not conventionally gendered in this novel' (p.63), affecting John Thornton as much as Margaret Hale. Matus also shows, with particularly effective use of textual evidence, how Gaskell 'draws heavily on the language of dream and trance' in order to portray such traumatic experiences (p. …

Réflexions éthiques sur les interventions médicopsychologiques auprès des victimes

Recognition of the psychic injury potentially inferred by a traumatic event's reality led to cares reproduction for the persons concerned by the event (victims, families, rescuers). These “urgence medicopsychlogiues” interventions are conceived for potentially traumatic events, meaning sudden, violent, unpredictable events leading to life threatening experiences. Being confronted to death's reality leads to the annihilation of the usual defence mechanisms and to an incapacity to be able to elaborate what is being experienced. Confrontation with the trauma can have multiple and unpredictable consequences. Premature psychic cares for the persons implied are therefore implemented, as are somatic cares. If these processes allow coverages (care) adapted to the clinical demonstrations (appearances) of the psychic injured (wounded) persons, they can lead (drive) to multiple drift of which their use for not traumatic facts. If these processes allow care to be adapted to the clinical demonstrations of the psychic injured persons, they can lead to multiple drift, among them, being treated for non traumatic events. This, in particular, may lead to “psychiatrisation” of reactions nevertheless adapted to critical events, to standardized cares and to the illusion that a one and only intervention could be enough to dike all risks linked to post-traumatic disorders. Cares as close as possible to the traumatic event are only one of the many answers to be brought to the persons involved and can not be organized without frame, limit and an ethical position of the professionals who participate in it. Our comment, which is based on our experience in coordinating more than 300 medical psychological emergency interventions, aims at announcing our thinking about what ethic is at stake when taking care of these psychic victims. The current situation is paradoxical: on one side there is a bigger recognition of the reality of the psychic wounds and the potential consequences caused by a traumatic event and of other, this systematic consideration leads to a collective identical demand of the traumatic fact transforming it into a political stake. The social and political recognition of the psychic traumatism is parallel to its instrumentalisation and exploitation. That leads inevitably to maintaining the subjects involved in a state of dependence, vulnerability and psychic incompetence, that of the victim. In the absence of ethical reflection on early psychological care, the medical psychological emergency diversion of care is inevitable with its main consequence: the stake in the show of the psychic suffering is leading to the fact that every implied person is dispossessed of its own history. The traumatic fact having become a social and political stake, the medias do participate in the overbid with, for some, drift which lead to the systematic call to the psychiatrics and psychologist in order to comment on the slightest event, to a psychiatrisation of demonstrations of distress, to a stigmatization of people involved into the reducing category of the traumatized “victims”, to a focus on a one and only type of suffering, to a generalization of traumatic events and to an attempt of instrumentalisation of the medical psychological emergency devices. The traumatism has to remain a clinical event, which requires specific care joining a medical logic and must not become an object of demand joining a social and political logic.