Learning about/from psychoanalysis

“PTSD was an “invention- discovery” born of multiple, overlapping conflicts”“the catalyst for changing the science of trauma, including the very particular symptoms that we now in the twenty- first century continue to understand as key signs of PTSD (including delayed- reaction onset, numbness of affect, intrusive memories, or hyper- arousal), was a grotesque debacle fought out through the 1950s and 1960s over financial compensation for mental health damages among Jewish survivors of life in flight, hiding, or in the ghettos and concentration and death camps.”-mental health has always been weaponized and only met with concern when the state and majority actors cannot deny or hide the impact, even then it is often blamed on events that may have happened pre-trauma“it was up to these more sympathetic doctors to make the case that the origins of the patients’ problems lay in the persecutions and imprisonments”-always having to prove guilt, not innocence“Spitzer was additionally intent on removing any need, or even any opportunity, for speculation about the etiology –that is, theorization of the causes –of psychological conditions. Instead of conjecture about the sources of a particular disorder, DSM- iii introduced the phenomenological (and, at the time, it was felt, infinitely more objective) concept of a checklist of measurable symptoms”-the DSM and its evolution is fascinating; particularly this shift from checklist to more of a systematic approach that has been happening more recently. à “The redirection of attention away from puzzles about the past –and therefore about causation –and toward the (ideally clearer- to- determine) manifestations of emotional or mental disease in the patient’s present was designed to put psychiatry on a more secure scientific footing and make it more comparable to other medical subspecialties.” -exactly, all except for PTSD“often took note of the “secondary gain ” patients might be acquiring via their sickness (whether a gain in solicitous attention or a particular balance of power in a relationship or an excuse for not changing their habits).”“One is the importance of context for the evolution of theory. In this case, the context was the toxic postfascist climate fi lled with resentment against the survivors in which the (at once medical, legal, and moral) battle over mental health damages was fi rst fought through and in which in general truth was up for grabs”“A second theme has to do with the problem of scientific objectivity and the predicaments of bias. The anti- reparations doctors regularly attacked the more sympathetic doctors for being (purportedly) unobjective and unscientific. In turn, the sympathizing doctors struggled to bring into view and coherence the multi- symptom phenomenon that they first called “survivor syndrome” and “massive psychic trauma” and which eventually, by historical contingency but also by engaged activism –as the doctors working with and on behalf of survivors of Nazi persecutions and camps joined forces with physicians pressing for attention to the emotional difficulties experienced by many veterans of the Vietnam War –came to be called PTSD.”“According to the inherited doctrine, individuals with a previously normal constitution were by definition robust and should recover rapidly from stress; if mental problems continued, there were only two possible explanations. Either there must be a somatic, physiological explanation, or the individual must have been emotionally unstable before.”-constantly plagued by this binary view of psychoanalysis and human functioning“But in case after case, as noted, the initially evaluating doctors said that whatever survivors had experienced in hiding or in the camps was something that someone with a previously healthy disposition should have been able to recover from.”“Every small scandal –and there were scandals –in which a claimant made a false claim or a lawyer appeared to have a confl ict of interest or profi t too much from representing survivors provided a further chance to link Jews in general with greed and corruption and unseemly self- interest.”-a narrative that was crafted and maintained by those who were anti-semitic“To only feel morally indignant is to miss just how much the idea that Jews were a problem was part of the commonsense texture of public discussion in the aftermath of a mass- murderous dictatorship. Moreover, the blatancy of the hypocrisy around money is noteworthy. This was also a climate, after all, in which there were not just pensions available for concentration camp guards as well as their widows, but also entire organizations of gentiles dedicated to clamoring that they had been “victims of denazifi cation ” (“Entnazifi zierungsgeschädigte”) and/ or “victims of reparations” (“ Restitutionsgeschädigte” –this included people who were distressed that Jews whose property had been lost to “Aryanization” had come back to reclaim it).”“e “a psychopathic personality with a tendency toward abnormal processing of experience and an inability to deal with life.” The expert consensus, the evaluator declared –and here we see the gesture to medical orthodoxy –was that a “normal person” would have recovered six months after liberation at the latest.”“Here rejecters liked to propose that perhaps in many cases the survivors were not aware that they were motivated by pensions, that the display of symptoms might “frequently” be the results of “largely unconsciouslyunfolding processes.”-how convienent to blame the unconscious“subsequent psychological conditions] … cannot be reduced to a simple formula”; every single case was different and in each there was at work “an entangled play of forces.”““I am here arguing that an adequate reaction when one is listening [to descriptions of the camp experiences] is to have the reaction: ‘this is unbearable.’ ” Eissler was not asking doctors or judges to feel pity. Rather, he refl ected on how any one of those professional men would himself react if he was arrested, put into prisoners’ garb, forced to do heaviest labor in the worst weather and on the absolute minimum of food, had his children murdered, been hunted by dogs, threatened with being shot, kicked in the head and abused so badly that his face carried permanently disfi guring scars –after three years of this, would he really be so stoic and be able to resume his daily life? As Eissler concluded with deadpan fury in 1963: “It remains a mystery how such a profound malfunction of the ability to identify can emerge among educated intellectuals.” It was the rejecters, he said, who had an “emotional confl ict” when they were conducting evaluations.”“In short, Eissler began to theorize the issue of bias within countertransference  –what the evaluators were bringing to their encounters with survivors”-bringing their own fear or at least their unwillingness to acknowledge such fear and terror and what the lasting impact may be“Eissler went on the offense: “Everyone should have only one purpose in this matter: to assist in relieving the sufferings of the victims of persecution. It thus stands to reason that if anyone’s personal conviction could in any way make such relieving impossible, he should silently step aside and let those take over the function of ‘experts’ whose convictions will at least augment the chance that that suffering will be assuaged.”““The minimum one may demand, under such circumstances, is that the responsible authorities recognize those who cannot control this archaic feeling and exclude them from the position of experts in matters of compensation for suffering.”“Yet, by a twist of historical fate, it later took the catastrophic decline in the USA’s moral authority internationally due to the war in Vietnamand the rise of a passionate antiwar movement to bring not just soldiers’ but also survivors’ traumas into Americans’ public consciousness and into official medical nomenclature and professional policy”“But a novelty particularly noticeable among the new Cold War dictatorships allied with the USA, especially though not exclusively in the Latin American countries of Chile , Argentina , and Uruguay , had as its main purpose “the breakdown of the individual” –the deliberate destruction of his or her identity. The point was both “to neutralize an active opponent of the regime and, second, to release this former active opponent in his or her broken down condition as a deterrent and warning to others who might be in opposition to the rulers.”-this strategy is utilized in many areas, including the military with recruits“Keilson’s second main contribution was his insistence on seeing the trigger for trauma no longer as an event, or an experience restricted to a limited amount of time, but rather as a sequential process, one that absolutely needed to include the before and the after of the worst experiences –and also one that included Freud’sconcept of “deferred” effects.”““Suffering is acknowledged, but it is stripped of its (colonialist) contents. It is understood that social processes cause pathology, but the processes themselves are off limits for discussion.”-well isn’t this America summed up