May 12, 2004

Trauma Newsletter

Author: Siegfried Othmer

The news broke on a day that did not exist for me. I left for Australia on the 27th, and arrived on the 29th. I knew nothing about the scandalous photos that had just surfaced in the US on the 28th until I returned a few days later. Significantly, the photos were not the topic of conversation in Australia. Was that mere politeness, a reluctance to probe their guest with respect to these disagreeable facts? I was thus able to enjoy my visit without having to come to terms. Don’t all of us wish that such innocence could have continued? On another occasion, I found myself in Australia at the time of the bombing of the Alfred P. Murrah building in Oklahoma, and in Edmonton, Alberta at the time of the destruction of the World Trade Center. Perhaps I should publish my travel schedule so that precautions can be taken.

What is the relevance of this to our concerns? In a little town in the United States, some dozen large photos in a public space feature the young people of the town who are currently serving the Armed Forces in Iraq. One of those pictures was just taken down, because the soldier—a woman soldier—was seen in the photos just released from Saddam’s gulag. The display of her picture had become an embarrassment. How does it come to be that that smiling young woman could metamorphose into the laughing, taunting creature with a tethered naked Iraqi male prisoner on the floor?

One of the benefits of the global village that we are becoming is that we can immediately have the benefit of the insights of people such as Semantha Power, author of the book “A Problem from Hell” (which I confess still sits on my bookshelf unread. It refers to the ongoing problem of genocide.). In a conversation with Bill Moyers, she refers to her many past interrogations of people involved in committing torture. She is struck by their ordinariness. Discussing these events over coffee, one cannot point to any aspect of these people that would alert one to their inhumane propensities. She goes further: “We are so much alike.” There was very little by which she could differentiate herself from those whom she was interviewing.

In his film “Shoah,” Claude Landsmann surreptitiously videotapes a former German concentration camp guard. The guard is reluctant to revisit his earlier career, and describes himself as horrified at what transpired. What comes across is his ordinariness. It is not possible to think of him as a menace in his then-current state.

Increasingly in our work I have come to see the sub-clinical variants of pathological conditions as having a lot of explanatory power. I call it the penumbra. When we understand the most severe pathologies—Reactive Attachment Disorder, suicidal depression, Bipolar Disorder, Conduct Disorder, rage, Autism, seizure disorder, the trauma response, panic anxiety, etc., these insights can help us broadly to understand clinical phenomenology that is not quite so extreme. The exceptional failures reveal how the system is supposed to work in general, through exposing its breakdown mechanisms.

One of these is Dissociative Identity Disorder. Perhaps it is possible to view DID as merely a slight extrapolation from the normal constitution of the self. Conversely, then, we might use DID to understand aspects of ourselves. Perhaps there is a continuum in connectivity between our various selves and the extreme of DID in which none of the personalities appear to be aware of the others. Features of multiplicity may indeed characterize all of us. If environmental stresses force some of these personalities to shape in a particular way, and to differentiate themselves from pre-existing ones, that may in fact be the natural order of things—one of the survival strategies that we have inherited. Healing DID, then, may not be a matter of extinguishing any of the alter personalities, but rather merely one of bringing all of them into awareness and communication, and into a kind of internal democracy of mutual regulation. We will have reduced another major mental illness conceptually to a network problem!

With this model, it is possible to understand the concentration camp prison guard who can go home on leave and lovingly tuck his children in at night. Or the Israeli soldier who breaks the arm of an eight-year-old Palestinian boy over his knee. Or the Rwandan who machetes his own neighbor. Who can walk the streets of Japan now and have any inkling of the atrocities meted out against the Chinese, the Koreans, and the Americans in the Philippines? It is not possible to separate the individual from the societal context in which he is asked to function. We are social beings, for good or ill. The question has been asked whether people can be coaxed to act against their conscience while hypnotized. It seems that hypnosis is not necessary at all. In social interactions, we are tethered to yet another network that inveigles us.

We should have known this already. There was the famous experiment by Stanley Milgram back in 1971 in which he sought to research the mentality of those who simply took orders under the Nazi regime. Subjects were ordered to deliver shocks to people whenever they failed items on a simple test. The shocks gradually escalated in severity. Despite the fact that moans eventually emanated from the chamber in which the hapless “victim” was hidden from view, the subject could usually be persuaded to escalate the shocks to the point of (apparent) risk of lethality. Such was the power of authority of the experimenter. The subject might protest; beads of sweat might appear on his brow; but he could usually be persuaded to continue to deliver the ostensibly painful shocks.

Then there was the experiment by Philip Zimbardo in which Stanford psychology students were randomly assigned to be prisoners and guards. The experiment had to be stopped after a few days because the guards, having taken their responsibilities a bit too seriously, were becoming abusive. Nothing distinguished the inmates by way of race, class, income, status, etc. They were classmates. They nevertheless became prisoners in fact as well as in label, with all of the privileges attendant thereto.

Johann Wolfgang von Goethe described himself as “capable of committing any conceivable human crime.” I am sure that in the modern day, however, his conceptions would have been expanded.

That the news is not all bad is made clear in the book “On Killing,” by Lt. Col. Dave Grossman. An investigation by Brigadier General S.L.A. Marshall after WWII revealed that at most 15-20% of soldiers employed their weapons in the war, regardless of the circumstances to which they were exposed. It was one thing to lob a 25-lb artillery shell over hill and dale impersonally toward a distant enemy, and quite another to aim a rifle at a human being and serve as his explicit, immediate, and personal executioner. At the crucial moment, a vast majority of soldiers became conscientious objectors, even when they were being shot at. During the Korean War, the numbers for active participation were up to forty percent, by dint of great effort. This remained a continuing concern to the military, however, which then devised additional means to actively train soldiers to kill. By the time of the Viet Nam war, participation in the acts of war was up to 90%. The downside of this “success” was far higher rates of PTSD and lesser mental illness in Korea and in Viet Nam. That’s the good news! People were constrained to act as trained, but their essential selves asserted themselves later. (Now, of course, we have left it to society to groom children for depersonalized warfare through video games.)

This all has implications for our view of “evil,” if I may use such a theologically freighted term. The language of mental health does not quite cover the territory. “Evildoers” are not just the other guys, but potentially all of us under the right circumstances. President Bush twists the theology of his own Christianity beyond recognition. “Sin” is universal. Jimmy Swaggart and Jim Bakker are cases in point. They knew they needed to hear their own message. The continual shoring up of the ethical constraints on our behavior is necessary precisely because of our rather universal tendencies toward slippage. We must look to our internal mental hygiene, but we must also support societal constraints on behavior.

The question is being asked whether the prison guard behavior of our soldiers is anomalous. Is it, one asks hopefully, just a matter of a few bad apples? Alas, no. This behavior is of a piece with Guantanamo, with Afghanistan, with the “mild” torture that has been perpetrated against Palestinians for decades with our tacit approval, and with the violence in our own prisons and youth internment facilities. We have by far the highest rate of serious assault in our society, some ten times more than other civilized countries such as Norway. Ghetto children are dying in urban warfare in Los Angeles at a rate matching the death rate of our soldiers in Iraq, yet it is not even news. We have the largest prison population in the world, now majorly outdistancing South Africa and the former Soviet Union. We have the largest drug problem in the civilized world. We have the largest incidence of child-on-child violence outside of Latin America. There is no anomaly here.

More than a year ago, one of our long-term clients was assaulted by the local police as he was walking home from a biofeedback session and took a short-cut through a college campus. He was tightly hand-cuffed, kicked, verbally abused and threatened with sodomization. He was held for hours. He asked that the pressure be relieved on his handcuffs, and his request was refused. He received bruises that he documented later with photos.

After the death of his mother, he finally wrote down all that had transpired that evening in the greatest detail, even though he was writing more than a year after the event. He submitted the material for review by the District Attorney and the Police Department investigative unit. The fact that they found nothing there worth investigating shows just how low the standards are for police work. It is all a matter of context. One day the police beat up Rodney King, and a few days later the police come to our home to tell me about the death of Brian. They could not have been more solicitous.

We are all multiples, or have the potential to become multiples. And just as it is extremes of threat to the person that result in splitting of the personality at an early age, it is extremely stressful situations that call forth other aspects of our person. I have previously written about an occasion in which my spirited driving apparently unleashed a torrent of road rage. Once this guy was set off, nothing I could do would cause him to break off his pursuit. I did not like my own reaction to being cornered, and in fact was shocked by it.

One of the formulations of personality types that is used in corporate training involved a division according to two dimensions, thus giving four quadrants. Everyone was therefore sequestered in one corner or another. Under extreme stress, we were told, people move to the corner opposite their home turf. That is to say, we move to a place that we do not even recognize. We are no longer who we know ourselves to be.

A better theology is expressed by the nun in “Dead Man Walking:” A man should not be defined in terms of the single worst thing he ever did in his life. But the movies make it easy for us. We are always shown a figure that is capable of remorse, and capable of compassion, thus allowing us to develop sympathy for the character. Life does not make it quite so easy. Even the person who is not capable of remorse now commands our understanding, simply because we know what the issue is. It is another network problem. A nervous system that never had the opportunity to learn empathy and compassion cannot be expected to possess it. This is now an alterable state of affairs, and matters are in our hands.

As we survey the field of mental health, we see escalating trends for depression, for child Bipolar Disorder, for asthma and for the autistic spectrum. The trends are not subtle, and they refer to the most severe of mental conditions. Add to that the stresses of economic uncertainty descending on an ever greater fraction of families, and the adverse effects of media exposure on our young, and it is clear that we face a major mental health crisis in our society. It is customary to see all these things as independent events or trends. But if we search for a thread of connectivity, we may find it in diminished emotional regulation, and perhaps more fundamentally in a diminished sense of self. We know that multiplicity is grounded in trauma, in fundamental threats to the integrity of the self. Ironically, when the scaffolding of the self is not as solidly established as it may have been in the past, it may be even more subject to the buffetings of even minor traumas.

Is it not ironic that the health and integrity of “selfhood” has suffered in the very society that most elevates the self, the individuum. This is because the self does not thrive in the isolation to which we have effectively banished it. The “particle” of self-hood emerges only out of a network of interactions, the “fields.” This also means that there is no single-particle solution to the problem. We must also address the interaction matrix. As a society, we are living “The Lord of the Flies.” We are turning our kids over to surrogate parentage of the wire mothers of technology and the Cyclops in the living room. There is a dearth of adult supervision, of simple human engagement. The result is a self that is more fragile, more subject to trauma, and more readily fractured into multiplicities even in its adult form. The health outcome of minor trauma, inflicted on a vulnerable nervous system, is disregulation. We must look to the penumbra of trauma, and the penumbra of the dissociative response, for a model of what is happening in our society.

With neurofeedback, we always address the needs of one individual, and we come along after the fact, after the damage is already done. How much more we could do if the training were simply available as a normal aspect of education. Everyone gets to train their brains. The overt intent may be to train intellectual function, but the most beneficial aspect may turn out to be the training of emotional regulation, and a better integration of the self. Perhaps a stepping stone to that goal would be to begin to talk to our clients in terms of making this technology their own—an aspect of their continuing education about themselves; part of their effort at either maintenance of function or of self-improvement. Perhaps Heartmath, The Wild Divine, and the further development of Smart Brain Games point to the possibility of making self-regulation training commonplace and accessible to nearly all. Here the games are constructed such that success is contingent on a well-regulated nervous system, and not as it is now, namely on the momentary suspension of ethical constraints on behavior.