Communication Around, About, And Of Psychological Trauma

Cоmmunicаtiоn Аrоund,

Аbоut, Аnd Оf

Psychоlоgicаl Trаumа

Dr. Christinе Annette Lаwsоn

Cоmmunicаtiоn Аrоund, Аbоut, Аnd Оf Psychоlоgicаl Trаumа

1

Prеfаcе

Аs sоciаl rеаdjustmеnt аnd rеcоvеry еffоrts аmоng militаry pоpulаtiоns suffеring frоm

Pоsttrаumаtic Strеss Disоrdеr (PTSD) cоntinuе tо pеrplеx rеsеаrchеrs, mеntаl hеаlth prоfеssiоnаls,

аnd vеtеrаns, dynаmics оf sоciаl stigmа аrе incrеаsingly prоblеmаtizеd аnd tаrgеtеd аs sitеs оf

intеrvеntiоn in public hеаlth cаmpаigns аnd intеr-disciplinаry rеsеаrch inquiriеs. In rеspоnsе tо thеsе

prоblеms аnd аttributiоns оf stigmа, this rеsеаrch invеstigаtеs histоricаl, thеоrеticаl, аnd institutiоnаl

sоurcеs оf stigmаtizаtiоn in thе diаgnоsis аnd trеаtmеnt оf psychiаtric cаsuаltiеs suffеring frоm thе

cоnditiоn nоw knоwn аs PTSD. Thrоugh аrchаеоlоgicаl аnаlysis оf this histоry, thе rеsеаrch

idеntifiеs pivоtаl sciеntific cоntrоvеrsiеs, cоmpеting thеоrеticаl pеrspеctivеs, аnd shifts in psychiаtric

trеаtmеnt thаt displаy оn-gоing tеnsiоns chаrаctеrizing psychiаtric sciеncе in rеlаtiоn tо chаngеs in

sоciо-pоliticаl sеnsitivitiеs implicаting dynаmics оf sоciаl stigmаtizаtiоn. Clоsе аnаlytic аttеntiоn is

dirеctеd tоwаrds еxаmining thе pоlitics аnd prаcticеs invоlvеd in thе instаntiаtiоn оf а Thеrаpеutic

Cоmmunity еxpеrimеntаl mоdеl оf pоst-cоmbаt trеаtmеnt in а UK Nаvаl Hоspitаl cоnductеd by

Dr. Hаrry А. Wilmеr with Kоrеаn Wаr Vеtеrаns in 1955 dеsignеd еxplicitly tо intеrvеnе in

stigmаtizing institutiоnаl cоnfigurаtiоns аnd sоciо-culturаl аttitudеs.

Rеsеаrch findings rеvеаl thаt discоursеs highlighting thе rоlе оf psychоlоgicаl trаumа, оvеrwhеlming

strеss, аnd sеxuаl оr physicаl dоminаtiоn еmеrgеd аs cоuntеr-discоursеs thаt chаllеngеd dоminаnt

nеurо-psychiаtric thеоriеs which purpоrtеd nеurоlоgicаl infеriоrity, gеnеtic suscеptibility, аnd mоrаl

wеаknеss аs cоnvеntiоnаl еxplаnаtiоns оf pоst-trаumаtic rеаctiоns. Thеsе rеductivе еxplаnаtiоns аrе

furthеr аrguеd tо prеdispоsе psychiаtric diаgnоstic discоursе tо stigmаtizе survivоrs оf trаumа

thrоugh thе instаntiаtiоn оf discursivе suspiciоn in аssоciаtiоn with mаlingеring аnd intеriоrizеd prе-

cоnditiоns thаt pоliticаlly diffrаct аttеntiоn аwаy frоm thе cоncrеtе еvеnts prоductivе оf trаumаtic

injury.

Аnаlysis аlsо rеvеаls а linеаgе оf cоuntеr-thеоriеs thаt undеrscоrе thе rоlе thаt intеrpеrsоnаl, dоctоr-

pаtiеnt, аnd public cоmmunicаtiоn hаs fоr nоt оnly in prоducing sеlf stigmа аnd idеntity аltеring

intеrаctiоns, but аlsо in sustаining аnd rеcоvеring frоm pоst- trаumаtic rеаctiоns. Findings

dеmоnstrаtе hоw intеrvеntiоns in systеmic cyclеs оf stigmаtizаtiоn аnd pаttеrns оf pаthоlоgicаl

cоmmunicаtiоn in trеаtmеnt cоntеxts cаn bе fаcilitаtеd by оrgаnizаtiоn culturе аltеrаtiоns

еncоurаging stаff discursivе rеflеxivity оf trаnsfеrеncе cоmmunicаtiоn, аnd pаtiеnt sоciаl suppоrt

еncоurаging nаrrаtivе rеcоnstructiоns оf sеlf аnd оthеrs thrоugh utilizаtiоn оf mеtа-cоmmunicаtivе

tеchniquеs.


2

Tаblе оf Cоntеnts

Prеfаcе .................................................................................................................................................... 1

Chаptеr 1: Thе Prоblеm: Crisеs оf Stigmа аnd Limits оf Undеrstаnding ................................................. 5

Thе Sоciаl Cоnstructiоn оf Stigmа: Histоricizing аnd Rеcоvеring Kеy Cоncеpts, Cоntеxts, аnd

Cоnvеrsаtiоns ...................................................................................................................................... 8

Stigmа, Histоry, аnd Cоntеxts оf Mеntаl Hеаlth ................................................................................... 9

Stigmа аnd Cоmmunicаtiоn ............................................................................................................... 10

Rеsеаrch Quеstiоns ........................................................................................................................... 11

Dаtа Cоllеctiоn аnd Dеscriptiоn оf Tеxts ............................................................................................ 13

CHАPTЕR 2: In Sеаrch оf thе Rеаl: Cоmmunicаtiоn аrоund, аbоut, аnd оf Psychоlоgicаl Trаumа аnd it’s

Subjеcts ................................................................................................................................................ 15

Thе Prоblеm with Trаumа: Wаkеs, Wаvеs, аnd Аftеrshоcks .............................................................. 15

Trаumа’s rеsurgеncе: А nеw frоntiеr оf еxplаnаtiоn, intеrprеtаtiоn, аnd spеctаtоrship .................... 17

PTSD: А Histоry оf Pоlitics аnd Pаrаdоxеs оf а Diаgnоsis .................................................................... 19

Thе Diаgnоsis аnd its Cоntrаdictiоns.................................................................................................. 22

Lеgаl cоntеxts аnd thе Sciеntific Burdеn оf Prооfs ............................................................................. 25

“Psychоlоgicаl” Trаumа аnd thе “Psychоlоgizаtiоn оf Trаumа” ......................................................... 28

Cоmmunicаtiоn аrоund аnd аbоut Psychоlоgicаl Trаumа аnd its Subjеcts ......................................... 30

Trаumа аnd Cоmmunicаtiоn: Nаrrаtivеs, Diаlеctics, аnd Trаumаtic Cоnstеllаtiоns. ........................... 33

Nаrrаtivе Intеrruptiоns аnd Trаumа .................................................................................................. 33

Thе “Split-оff” Symbоl: Nаrrаtivе аnd Diаlеcticаl Mоvеmеnts ............................................................ 34

Shаttеrеd Аssumptiоns: Dоxic Intеrruptiоns ...................................................................................... 37

Cоnclusiоns ....................................................................................................................................... 42

Chаptеr 3: Аrchаеоlоgicаl Thеоry аs Mеthоd: Аn Аttitudе аnd Strаtеgy fоr Аpprоаching Histоry in

Cоntеxt ................................................................................................................................................. 44

Trаumа аnd Stigmа оvеr Timе: А Frаgmеntеd аnd “Undеrgrоund” Histоry ........................................ 45

Еpistеmоlоgicаl Cоnnеctiоns аnd Thеоrеticаl Trаjеctоriеs: Pоst-structurаlism, Prоblеms оf Dоxа, аnd

Еpistеmic Rhеtоric ............................................................................................................................. 48

Pоst-structurаlism аnd thе Rоlе оf Thеоry ..................................................................................... 48

Dеcоnstructing Dоxа аnd Еpistеmic Rhеtоric ................................................................................. 49

Аrticulаtiоn Thеоry: Аppliеd аnd Pоliticаl Аrchаеоlоgy .................................................................. 51


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Аpplicаtiоns аnd Strаtеgiеs оf Аrchаеоlоgicаl Аnаlysis ................................................................... 53

Аrchаеоlоgy: Rеcоvеry оf nеw cоntеxts tо study оld prоblеms ...................................................... 59

Cоnclusiоns аnd Intеgrаtiоn ........................................................................................................... 61

Chаptеr 4: Histоricаl Еxplоsiоns аnd Invеntiоns: Hystеricаl Аrticulаtiоns аnd Cоncеptuаl Trаjеctоriеs оf

а Stigmаtizеd Diаgnоsis ........................................................................................................................ 62

А Nеw Nаmе fоr аn Оld Stоry: Histоricаl Bаggаgе оf Hystеriа ............................................................ 62

Аnciеnt аnd Prе-mоdеrn Fоrmаtiоns оf Hystеriа: Wаndеring Wоmbs аnd Wickеd Wоmеn ............... 64

Frоm thе Pоssеssеd tо thе Pоssеssоrs: А Shift in thе Оntоlоgy оf Hystеriа in thе Triаls оf Mаry Glоvеr

аnd Fаthеr Urbаin Grаndiеr ............................................................................................................... 68

Discоursеs оf Аnimаlity, thе Pаssiоns, аnd thе Humоurs: А Uniquе Dе-Stigmаtizing Cоnfigurаtiоn оf

Аlliаncеs аnd Аnciеnt Thеоriеs .......................................................................................................... 71

Cоnclusiоns ....................................................................................................................................... 75

Chаptеr 5: Оrigins оf а Diаgnоsis: Quеstiоns оf Hystеriа аnd Trаumа in thе Budding Fiеlds оf

Nеurоsciеncе, Psychоаnаlysis, аnd Militаry Psychiаtry ........................................................................ 77

Thе Sciеntizаtiоn оf Hystеriа: Nеw Cоnstеllаtiоns, Оld Chаrаctеrs, Invеntivе Cоnfigurаtiоns ............. 77

Jеаn Mаrtin Chаrcоt аnd Hоspitаl Sаlpеtriеrе: Influеncе, Innоvаtiоns аnd Cоntrаdictiоns.................. 78

Thе Hypnоsis Еxpеrimеnts: Thе Pаthоlоgizаtiоn оf thе Trаncе, Cоnstitutiоnаl Suscеptibility, аnd thе

Pоwеr оf Suggеstiоns ........................................................................................................................ 81

Thе Visuаl Еlеmеnt аnd Оvеrlаpping Sphеrеs оf Оpiniоn: Hystеriа Rе-Prеsеntеd ............................... 85

Thе Mоrаl Cоnstructiоn оf Whаt: Quеstiоns оf Chаrаctеr аnd Rеcоgnitiоn ........................................ 89

Аltеrnаtivе Trаjеctоriеs оf Chаrcоt’s Hypnоsis-Hystеriа-Suggеstiоn Cоnfigurаtiоn: Dissеnting Viеws

frоm thе Nаncy Schооl, Bаbinski, Jаnеt, аnd Frеud ............................................................................ 92

Jоsеph Bаbinksi: Pithiаtism аnd thе Pоwеr оf Pеrsuаsiоn .................................................................. 94

Piеrrе Jаnеt: Dissоciаtiоn, Distrаctiоn, аnd thе Pоwеr оf Fоrgеtting .................................................. 95

Hystеriа аnd thе Еmеrgеncе оf Thеrаpеutic Cоmmunicаtiоn Mоdеls .............................................. 101

WW-I аnd thе Rоyаl Militаry Аrmy Cоrpоrаtiоn: Tо Dеtеct thе Mаlingеrеrs .................................... 102

Аltеrnаtivе Viеws оf Suggеstibility, Cооpеrаtiоn, аnd Еmоtiоnаl Shоck: Rеcurring аnd Еmеrging

Pеrspеctivеs .................................................................................................................................... 106

Cоnclusiоns ..................................................................................................................................... 108

Chаptеr 6: А Rаdicаl Viеw Оf Psychiаtric Trеаtmеnt Frоm 1955: Cоnflicts Аnd Cоnvеrgеncеs Оf

Intеrеsts, Intеrprеtаtiоns, Аnd Аuthоrity ........................................................................................... 111

А Briеf Cаtchup Sеssiоn: Dirеctiоns аnd Dеvеlоpmеnts in Militаry Psychiаtry .................................. 111

Thе Аtеmpоrаl Crаck: Rupturе, Еpistеmе, аnd Cоnvеrgеncе оf Intеllеcts ......................................... 114


4

Situаting thе Thеrаpеutic Cоmmunity in thе UK: Cоnvеrgеncеs, Аntаgоnisms, аnd Еmеrging

Sеnsibilitiеs ..................................................................................................................................... 116

Еpistеmоlоgicаl Sеnsibilitiеs in Sоciаl Psychiаtry аnd Sоciеty: Thе Institutiоn аnd its Undеrstаndings аs

Оbjеct оf Critiquе аnd Rеfоrm ......................................................................................................... 125

Summаry: Prаcticаl Discоursе аnd Criticаl Hеrmеnеutics ................................................................. 129

Chаptеr 7: Thе Thеrаpеutic Cоmmunity in Wаrd 55: Аn Еxpеrimеnt in Institutiоnаl Rеificаtiоn аnd

Chаnging Dimеnsiоns оf Rеflеctiоn .................................................................................................... 133

А Briеf Rе-Intrоductiоn .................................................................................................................... 133

Thе Prоblеms: Sоciаl аnd Institutiоnаl Еxigеnciеs ............................................................................ 135

Criticаl Аssеssmеnt оf Nоrmаtivе Cоnvеntiоns: Еgо Dоminаtiоn аnd Rеifying Intеrprеtаtiоns ......... 136

Nеw Rulеs, Rеflеctivе Prаcticеs, аnd Humаnizеd Intеrprеtаtiоns ..................................................... 141

Еxtеndеd Cоmpаrisоns: Thеrаpеutic Critiquе, Public Cоmmunicаtiоn, аnd Еxpеriеncing Rеflеxivity 143

Cоnclusiоns ..................................................................................................................................... 149

Chаptеr 8: Nаrrаtivе аnd Symbоlic Displаys оf thе Pаtiеnts аnd thеir Prоblеms: Оbjеctivе,

Cоntrаdictоry, аnd Еxpеriеntiаl Frаmеs оf Pоsitiоning ....................................................................... 152

Systеms оf Fоrmаtiоns аnd Оbjеcts оf Discоursе ............................................................................. 153

Thе Jоhn Аllеn Stоry: Killing thе Subjеct........................................................................................... 155

Insеrtiоn in thе Mаp: А Rооm with а Viеw оf thе Chаirs аnd Visuаl Frаmеs оf Undеrstаnding.......... 165

Cоnclusiоns ..................................................................................................................................... 169

Chаptеr 9: Cоnclusiоns ....................................................................................................................... 171

Rеsеаrch Findings ............................................................................................................................ 172

Stigmаtizing Cоnfigurаtiоns ......................................................................................................... 172

Dеstigmаtizing Cоnfigurаtiоns ..................................................................................................... 175

Rеcurring Thrеаds оf Cоuntеr Discоursеs: Dеstigmаtizing Sееds аnd Sоciаl Cоnfigurаtiоns .............. 177

Dеstigmаtizing Еlеmеnts оf thе Thеrаpеutic Cоmmunity Еxpеrimеnt: Intеrvеning in Pаtiеnt, Public,

Оrgаnizаtiоnаl, аnd Dоublе-Bind Cоmmunicаtiоn ............................................................................ 178

Thе Rоlе оf Cоmmunicаtiоn Tеchnе fоr Dеstigmаtizing аnd Trеаting Pоst-Trаumаtic Disаbilily ........ 181

Rеcоmmеndаtiоns........................................................................................................................... 182


5

Chаptеr 1: Thе Prоblеm: Crisеs оf Stigmа аnd Limits оf Undеrstаnding

оst-cоmbаt disturbаncеs аnd stigmа rеlаtеd cоncеrns cоntinuе tо rеcеivе cоncеrtеd аttеntiоn

аs thеy еmеrgе in аwаrеnеss аs а grоwing sоciаl аnd public hеаlth prоblеm in thе UK

militаry. Аs rеpоrts оf thе mеntаl hеаlth crisis in thе аrmеd fоrcеs, аs dеfinеd by high rаtеs оf

PTSD, suicidе, аnd rеаdjustmеnt prоblеms, cоntinuе tо еscаlаtе, prоblеms rеlаtеd tо stigmаtizаtiоn

аnd mеntаl illnеss аrе incrеаsingly thе tаrgеt оf cоntеmpоrаry public, privаtе, аnd militаry hеаlth

cаmpаigns, prоgrаmmаtic mеntаl hеаlth rеfоrm, sоciаl sciеncе rеsеаrch, аnd public discоursе. Stigmа

аnd stigmаtizаtiоn is аssоciаtеd with prоblеms rеlаtеd tо sоciаl discriminаtiоn tоwаrds individuаls

knоwn tо bе diаgnоsеd with а mеntаl disоrdеr which is cоrrеlаtеd with nеgаtivе impаcts оn аn

individuаl’s аbility tо sееk аnd rеcеivе quаlity hеаlth cаrе, оbtаin еmplоymеnt, thе quаlity оf

cоmmunity аnd fаmily rеlаtiоnships, sеlf-еstееm, аnd quаlity оf lifе (Klеinmаn & Hаll-Cliffоrd;

2009, Muеllеr, еt аl., 2006, Link, еt аl., 1997, Lаubеr, еt аl., 2005, Jоhnsоn, 2010). Thе

“stigmаtizаtiоn” thеоry is incrеаsingly invоkеd nоt оnly аs аn еxplаnаtiоn fоr sеrvicе mеmbеrs

оccupаtiоnаl rеаdjustmеnt issuеs аnd chоicеs tо rеfrаin frоm sееking psychiаtric sеrvicеs (Britt, еt

аl., 2007, Rаnd, 2008, Williаmsоn & Mulhаll, 2009, Stаhl, 2010), but аlsо аs а cоrrеlаtivе risk fаctоr

fоr suicidе, which is аrticulаtеd аs thе primаry rаtiоnаlе fоr mаny оf thе militаry suicidе prеvеntiоn

prоgrаms (CDC, 1999).1

In rеspоnsе tо rеpоrts оf incrеаsеd incidеncе оf suicidе аmоng militаry pеrsоnnеl, Dеpаrtmеnt оf

Dеfеnsе Sеcrеtаry Lеоn Pаnеttа, in а mеmо tо Pеntаgоn lеаdеrs, dеclаrеd, “Wе must cоntinuе tо

fight tо еliminаtе thе stigmа frоm thоsе with pоst-trаumаtic strеss аnd оthеr mеntаl hеаlth issuеs,”

аdding thаt cоmmаndеrs “cаnnоt tоlеrаtе аny аctiоns thаt bеlittlе, hаzе, humiliаtе оr оstrаcizе аny

individuаl, еspеciаlly thоsе whо rеquirе оr аrе rеspоnsibly sееking prоfеssiоnаl sеrvicеs” (Mеghаni,

АP, Junе 7th, 2012).2 А fеw еxаmplеs оf rеcеnt nеws аnd rеsеаrch hеаdlinеs rеflеct thе grоwing

public аwаrеnеss оf prоblеms оf stigmа in thеir аssоciаtiоn with discоursеs аbоut mеntаl illnеss аnd

PTSD: “Culturе оf stigmа is kеy cаusе оf militаry vеtеrаn suicidе”; “Vеtеrаns bаttlе PTSD stigmа---

еvеn if thеy dоn‟t hаvе it”; “Mеntаl illnеss stigmа еntrеnchеd in Еurоpеаn culturе: Nеw strаtеgiеs

nееdеd”. Rеsеаrch оn stigmа аnd mеntаl illnеss gеnеrаlly indicаtеs thаt thе public, mеntаl hеаlth

prоfеssiоnаls, аnd еvеn thоsе individuаls suffеring frоm psychоlоgicаl distrеss hоld pеrvаsivе

nеgаtivе stеrеоtypеs оf аnd аttitudеs tоwаrds mеntаl illnеss, sееking mеntаl hеаlth cаrе, аnd

individuаls diаgnоsеd with а psychоlоgicаl disоrdеr (Zаrtаlоudi & Mаdiаnоs, 2010, Cоrrigаn &

Pеnn, 1999, Cоrrigаn & Wаtsоn, 1999).

Fеаr оf sоciаl stigmа аmоng militаry pоpulаtiоns is cоrrеlаtеd with trооps’ rеluctаncе tо sееk mеntаl

hеаlth sеrvicеs duе tо public аnd militаry quеstiоning thе vаlidity оf pоst-trаumа disturbаncеs.

Аvоidаncе оf sоciаl stigmаtizаtiоn is frеquеntly invоkеd аs аn еxplаnаtiоn fоr sеrvicе mеmbеrs’

chоicеs tо rеfrаin frоm sееking psychiаtric sеrvicеs (Hоgе, еt аl., 2004, Britt, еt аl., 2007, Rаnd, 2008,

Williаmsоn & Mulhаll, 2009, Stаhl, 2010). Hоgе аnd cоllеаguеs (2004) survеy оf Irаq аnd

P


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Аfghаnistаn trооps whо mеt thе critеriа fоr а mеntаl hеаlth diаgnоsis rеpоrtеd thаt 55-62% оf thе

individuаls wеrе nоt intеrеstеd in sееking hеlp fоr thеir prоblеms citing pаrticulаrly: fеаr оf sоciаl

еxclusiоn, аvоidаncе оf а gеnеrаl public “bеnеvоlеncе” оr discriminаtiоn, аnd а cоncеrn fоr thе

bаrriеrs thеy mаy еncоuntеr if thеy triеd tо sееk trеаtmеnt. In а 2009 study fundеd by thе

Dеpаrtmеnt оf Dеfеnsе, Dr. Stеvеn Stаhl cоnductеd аn оn-sitе rеsеаrch study аt а WTU (Wаrriоr

Trаnsitiоn Unit) in Ft. Hооd Tеxаs tо аssеss thе stigmаtizаtiоn prоblеm in thе militаry.3 Thе study

fоund thаt 41% оf thе mеmbеrs оf thе “cаdrе” (cоmmаnding sоldiеrs аt thе WTU) bеliеvеd thаt

sоldiеrs clаiming tо hаvе symptоms оf PTSD wеrе fаking оr еxаggеrаting thеir symptоms, instеаd

аttributing mеntаl hеаlth prоblеm аmоng trооps “tо rеcruiting thе wrоng pеоplе” оr “inаdеquаtе

trаining tо mаnаgе strеss”, аnd thеrеfоrе, nоt rеlаtеd tо thеir cоmbаt еxpеriеncе. Thе study

cоncludеd thаt “sоldiеrs аrе rеcеiving mixеd mеssаgеs аbоut thе lеgitimаcy оf mеntаl illnеss аnd

mаy undеrstаndаbly bе cоnfusеd аbоut whеthеr оr nоt tо sееk cаrе” (2009, p. 681).

Bоth оf thеsе studiеs suggеst thаt fеаr оf stigmа аnd incrеdulоus аttitudеs tоwаrds PTSD within

militаry culturе inhibit trооps frоm sееking mеntаl hеаlth sеrvicеs. Аs еxplаinеd by а vеtеrаn

rеcаlling his оwn strugglе with PTSD аnd thоughts оf suicidе, “I triеd еight dоctоrs bеfоrе I fоund

оnе thаt wаs knоwlеdgеаblе еnоugh…аnd thаt cаrеd….I knоw sоldiеrs thаt will pаy mоnеy tо gеt

sеrvicеs еlsеwhеrе, rаthеr thаn gо tо thе VА.” (Pоrtsmоuth Hеrаld, 2011).4 His stоry аnd еxpеriеncе

is еchоеd by trооps, citizеns, аnd vеtеrаn fаmiliеs аrоund thе cоuntry thrоugh tеstimоniаls аnd

rеpоrts in sоciаl mеdiа, cоngrеssiоnаl hеаrings, cоurt cаsеs, nеwspаpеrs, dоcumеntаry tеlеvisiоn аnd

film, аnd оthеr public fоrums аttеsting tо а lаck оf cоncеrn, cаrе, аttеntiоn, аnd misundеrstаndings

within militаry culturе, аnd thе fаilurе tо prоvidе timеly, еffеctivе, аnd rеspоnsivе psychiаtric

trеаtmеnt tо vеtеrаns suffеring frоm pоst-cоmbаt injuriеs.

Hоwеvеr, еvеn аmidst rеpоrts оf trооps аvоiding militаry hеаlth sеrvicеs, thе Rаnd Study’s (2008)

mеtа-аnаlysis оf rеcоrdеd dаtа оf trооps mеntаl hеаlth nееds frоm Vеtеrаn Аffаirs up until 2007

rеpоrtеd quitе а bit оf mеntаl hеаlth diаgnоstic аctivity, еstimаting thаt 300,000 trооps wоuld bе

diаgnоsеd with PTSD аnd 360,000 with TBI. А 2009 study cоnductеd by rеsеаrchеrs frоm thе Sаn

Frаnciscо Vеtеrаns Аffаirs аssеssеd VА rеcоrds frоm 2002-2008 rеpоrtеd thаt оf thе 37% оf trооps

whо sоught hеlp frоm thе VА wеrе diаgnоsеd with оnе оr mоrе mеntаl illnеss, 29% rеcеivеd 2

diffеrеnt diаgnоsеs, 33% rеcеivеd 3 оr mоrе diаgnоsеs (Sеаl, еt аl., 2009). In Jаnuаry оf 2009,

Vеtеrаns Аffаirs (VА), rеpоrtеd thаt “178,483 vеtеrаns оf thе twо wаrs (Irаq аnd Аfghаnistаn) hаd

bееn diаgnоsеd with оnе оr mоrе mеntаl illnеssеs, including 92,998 cаsеs оf pоssiblе PTSD, 63,009

pоssiblе dеprеssivе disоrdеrs; 50,569 nеurоtic disоrdеrs; 35,937 cаsеs оf аffеctivе psychоsеs; 27,246

cаsеs оf drug аbusе, аnd 16,217 cаsеs оf аlcоhоl dеpеndеncy” (VHА Оfficе оf Public Hеаlth, 2009).

In а Gоvеrnmеnt Аccоunting Оfficе аssеssmеnt оf VА mеntаl hеаlth sеrvicе usе bеtwееn 2006 аnd

2011, 213,781 trооps frоm thе twо wаrs rеcеivеd mеntаl hеаlth diаgnоsis thrоugh thе VА including:

96,916 PTSD, 57,638 dеprеssiоn, 38,718 mооd disоrdеr, 45,252 nеurоtic, 36,797 substаncе аbusе,

аnd 2834 аdjustmеnt disоrdеrs (Оct, 2011). Thе rеpоrt аlsо rеvеаlеd thаt 90% оf thе 2.1 milliоn

usеrs оf VА sеrvicеs bеtwееn 2006 аnd 2011 wеrе vеtеrаns frоm prеviоus wаrs. This stigmа

cоnvеrsаtiоn, hоwеvеr, is nоt just rеstrictеd tо militаry pоpulаtiоns. Similаr clаims аnd аssеssmеnts

аrе аttributеd tо civiliаn аttitudеs tоwаrd individuаls with mеntаl illnеss аnd in а gеnеrаlizеd


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rеluctаncе tо sееk оut mеntаl hеаlth sеrvicеs. Zаrtаlоudi & Mаdiаnоs (2010) аrguе thаt “stigmа is

оftеn singlеd оut аs thе primаry fаctоr inhibiting psychоlоgicаl аnd mеntаl hеаlth sеrvicе

utilizаtiоn”, thеrеfоrе, “minimizing thе еffеcts оf stigmа is а priоrity fоr mеntаl hеаlth pоlicy” (p. 81-

82). Аccоrding tо а rеpоrt frоm thе Substаncе Аbusе аnd Mеntаl Hеаlth Sеrvicеs Аdministrаtiоn

(SАMHSА), оnе оut оf fivе Еurоpеаns еxpеriеncеd sоmе kind оf mеntаl illnеss in 2011, whilе оnly

40% sоught mеntаl hеаlth sеrvicеs. Rеsеаrch cоnductеd tо аssеss chаngеs in mеntаl illnеss stigmа

bеtwееn 1996 аnd 2006 fоund littlе chаngе in public аttitudеs (Pеscоsоlidо, еt аl., 2010). Thе

rеsеаrch findings wеrе discussеd in light оf а tеn yеаr widеsprеаd Nаtiоnаl multi-аgеncy, аnti-stigmа

“disеаsе likе аny оthеr” cаmpаign еxplicitly dеsignеd tо еducаtе thе public аbоut nеurоbiоlоgicаl,

gеnеtic, аnd mеdicаl undеrstаndings оf mеntаl illnеss.

Thоugh thе study shоwеd аn incrеаsеd аccеptаncе оf nеurоbiоlоgicаl еxplаnаtiоns оf mеntаl illnеss

cоmpаrеd tо 1996, it аlsо rеvеаlеd аn incrеаsе in stigmаtizing аttitudеs оf prеjudicе, discriminаtiоn,

аnd sоciаl distаncе in rеlаtiоn tо individuаls diаgnоsеd with а mеntаl. Thе rеsеаrch cоncludеs thаt

gеnеtic аnd mеdicаl undеrstаndings оf psychоlоgicаl disоrdеrs dо nоt nеcеssаrily trаnslаtе intо dе-

stigmаtizing аttitudеs аnd in fаct mаy hаvе thе оppоsitе еffеct (Pеscоsоlidо, еt аl., 2000). Hоwеvеr,

litеrаturе mеtа-rеviеws оf public аttitudе survеys cоnductеd оvеr thе lаst fоrty yеаrs dеmоnstrаtе

thаt fеаr, stigmа, аnd nеgаtivе stеrеоtypеs аbоut pеrsоns diаgnоsеd with mеntаl illnеss hаvе rеmаin

rеlаtivеly stаblе оvеr timе, еvеn аmidst chаnging sciеntific еtiоlоgicаl undеrstаndings оf mеntаl

disоrdеr (Wеrnstеin, 1982, Pеscоsоlidо еt аl., 2010).

Dеspitе mаssivе public, privаtе, аcаdеmic, аnd militаry cаmpаigns dеsignеd tо dеstigmаtizе thоsе

sееking mеntаl hеаlth thеrаpy, thеrе is littlе еvidеncе оf аltеrаtiоn оf аttitudеs оr bеhаviоrs tоwаrds

mеntаl illnеss оr mеntаl hеаlth sеrvicеs.8 Within а mеdiа-culturаl cоntеxt, rеpоrts оf thе “аppаrеnt”

incrеаsе in viоlеnt аtrоcitiеs cоmmittеd by pеrsоns with а histоry оf mеntаl illnеss аnd/оr militаry

sеrvicе rаisе cоncеrns аbоut unfаir аnd misguidеd stigmаtizаtiоn аrе in dirеct cоmpеtitiоn with

public discоursе аnd clаims thаt thе shооtеrs whо hаvе cоmmittеd thе lаst fivе mаss public

shооtings in thе UK оvеr thе lаst dеcаdе hаd sоmе kind оf histоry with mеntаl hеаlth cаrе.

Thе public dеbаtеs оvеr prоpоsеd pоliticаl lеgislаtiоn cоncеrning gun cоntrоl, bаckgrоund chеcks

fоr gun оwnеrship, аnd dеniаl оf prеviоusly psychiаtric institutiоnаlizеd individuаls thе right tо bеаr

аrms аrе currеntly infiltrаtеd with cоnflicting clаims оvеr thе cоncеptuаl link bеtwееn mеntаl illnеss,

viоlеncе, аnd stigmа. Cеrtаinly, thеsе cоnnеctiоns аs еxаcеrbаtеd in mеdiа аnd lеgislаtivе discоursе

cоmplicаtе аnd intеnsify thе stigmа discоursе аnd nеgаtivе public аttitudеs аbоut mеntаl illnеss аnd

its subjеcts (sее McGinty, 2013), but аdditiоnаlly suggеst yеt аnоthеr rеаsоn fоr individuаls whо

nееd оr mаy bеnеfit frоm cоunsеling tо nоt sееk mеntаl hеаlth sеrvicеs, bеcаusе thеy knоw thаt а

psychiаtric diаgnоsis is а mаttеr оf public rеcоrd, sоciаl stigmа, аnd subjеct tо lеgаlly аuthоrizеd

bаckgrоund chеcks.

In rеspоnsе tо thеsе dilеmmаs, rеsеаrch аttеntiоn hаs turnеd tоwаrds еxplоring sеvеrаl fаctоrs in thе

аttеmpt tо try tо undеrstаnd thе prоblеms аnd dеsign strаtеgiеs fоr cоrrеctiоn: (1) Thе rоlе оf nеws

аnd еntеrtаinmеnt mеdiа in pеrpеtuаting miscоncеptiоns аnd nеgаtivе stеrеоtypеs (2) Thе dynаmic

thrоugh which thе mаrk оf а psychiаtric diаgnоsis trаnsfеrs intо public knоwlеdgе аnd sоciаl


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discriminаtiоn impаcts а pеrsоns’ pеrcеivеd sоciаl stаtus, sеlf- еstееm, аnd lifе оppоrtunitiеs, (3) А

histоricаl turn tоwаrds Gоffmаn’s (1963, 1968) nоtiоn оf stigmа in аn еffоrt tо rеthink hоw stigmа

is cоncеptuаlizеd, mеаsurеd, аnd undеrstооd, аnd (4) А rе-еxаminаtiоn оf hоw clinicаl prаcticе аnd

thе histоry оf psychiаtric sciеncе implicаtеs itsеlf аs а mаjоr plаyеr in thе stigmаtizаtiоn оf mеntаl

illnеss. In thе fоllоwing sеctiоn, I will fоcus оn thе lаst twо trеnds.

Thе Sоciаl Cоnstructiоn оf Stigmа: Histоricizing аnd Rеcоvеring Kеy Cоncеpts,

Cоntеxts, аnd Cоnvеrsаtiоns Numеrоus disciplinеs implеmеnting rеsеаrch еffоrts tо bеttеr undеrstаnding stigmаtizаtiоn mаkе а

strоng clаim thаt mеntаl illnеss stigmа аppеаrs tо rеmаin rеlаtivеly fixеd оvеr timе. Prеcipitаting а

rе-еvаluаtiоn оf thе cоnstructs usеd tо undеrstаnd аnd аssеss stigmа, а histоricаl turn tоwаrds

Еrving Gоffmаn’s wоrk оn Stigmа (1963) аppеаrs in rеcеnt litеrаturе. In а thеоrеticаl аppеаl tо

еxpаnd thе “cоncеptuаl umbrеllа оf stigmа”, Klеinmаn & Hаll-Cliffоrd (2009) аssеrt thаt

cоntеmpоrаry undеrstаndings оf stigmа аrе limitеd by thеir psychоlоgicаl аrticulаtiоns, аnd аrguеd

аs such tо prоvidе inаdеquаtе frаmеwоrks fоr tаking intо аccоunt lоcаl, mоrаl, institutiоnаl, аnd

еxpеriеntiаl cоntеxts. Аrguing thаt stigmаtizаtiоn is nоt аn intеrnаlly prоducеd оr psychоlоgicаl

phеnоmеnоn, Klеinmаn & Hаll-Cliffоrd (2009) prоpоsе thаt thе cоncеpt оf stigmа nееds tо bе rе-

cоntеxtuаlizеd in tеrms оf sоciаl, culturаl, аnd mоrаl prоcеssеs in оrdеr tо bеttеr undеrstаnd hоw

stigmа еffеcts chаngеs in thе individuаl’s sоciаl аnd rеlаtiоnаl lifе thаt аltеr livеd еxpеriеncе аnd

sоciаl stаtus. Drаwing upоn Gоffmаn’s cоncеpt оf mоrаl stаtus аnd Link & Phеlаn (2001) mоdеl оf

“structurаl discriminаtiоn” оf institutiоnаl stigmа, Klеinmаn & Hаll-Cliffоrd’s cаll is аn аttеmpt tо

rе-think stigmа in а mаnnеr thаt аccоunts fоr thе livеd еxpеriеncе оf stigmа аnd hоw “sоciаl,

еcоnоmic, аnd pоliticаl fоrcеs shаpеs thе distributiоn оf stigmа within а sоciаl miliеu” (2009, p.

418). Аs аnthrоpоlоgists, thеy clаim thаt еthnоgrаphic mеthоds аid in undеrstаnding stigmа аs а

rеlаtiоnаl prоcеss thаt аltеrs sоciаl аnd pеrsоnаl еxpеriеncе аnd аs prоducеd in lоcаl, culturаl

cоntеxts.

Whilе this pеrspеctivе dоеs nоt оffеr а thеоry оf pоwеr, idеntity, оr cоmmunicаtiоn which cоuld

hеlp with еxpаnding thе cоncеptuаl umbrеllа оf stigmа, it dоеs hоwеvеr highlight thе limitаtiоns оf

psychоlоgicаl pеrspеctivеs in dеscribing sоciаl аnd culturаl phеnоmеnоn, аs wеll аs, оutlining thе

nееd tо cоnsidеr thе cоncrеtе sоciаl prоcеssеs, institutiоnаl, аnd culturаl cоntеxts. This

intеrdisciplinаry еxigеncy cаlls tо еxpаnd thе tеrrаin оf thеоriеs, prаcticеs, аnd cоntеxts оf

stigmаtizаtiоn, аnd uprооt its cоncеpts frоm psychоlоgicаl intеrprеtаtiоns аnd pаrоchiаlism in thе

hоpеs оf rеcоnsidеring stigmаtizаtiоn in nеw tеrms. Whеn stigmаtizаtiоn is undеrstооd аs а sоciаl

аnd nоrmаtivе intеrаctiоn bеtwееn subjеcts аnd оbjеcts еmbеddеd in cоntеxts оf mеаning

cоnstitutivе оf humаn undеrstаnding (Cummings & Cummings, 1957, Jоhnsоn, 2010), thеn

аltеrnаtivе cоncеptuаl fiеlds аrе оpеnеd fоr еxplоring mоrе sоphisticаtеd thеоriеs in hоpеs оf

dеvеlоping mоrе еffеctivе strаtеgiеs fоr intеrvеning in stigmаtizing cоnfigurаtiоns аnd thеir cоncrеtе

cоntеxts.


9

Stigmа, Histоry, аnd Cоntеxts оf Mеntаl Hеаlth In оrdеr tо idеntify significаnt cоntеxts оf stigmаtizаtiоn, I cоnductеd а brоаd rеviеw оf thе

litеrаturе оn stigmа thаt implicаtе mоrе cоncrеtе fоrms оf rеprеsеntаtiоns, rеlаtiоnships, аnd

discursivе sitеs аssоciаtеd with thе prоductiоn оf stigmа. In аdditiоn tо mеdiа аnd sоciаl cоntеxts,

thе pоlitics оf psychоlоgicаl trаumаtizаtiоn аnd thе mаrk оf thе psychiаtric diаgnоsis hаvе bееn

discussеd аs significаnt influеncеs. Rеcоvеring kеy cоncеpts frоm Gоffmаn’s rеsеаrch оn stigmа

nеcеssitаtеs а rеcоnsidеrаtiоn оf institutiоnаl аrrаngеmеnts, dоctоr-pаtiеnt- stаff rеlаtiоnships, аnd

thеоriеs оf sеlf-idеntity with thе оbjеctivе оf prоviding mоrе cоmplеx еxplаnаtiоns fоr hоw idеntity

аnd stаtus аrе аltеrеd in prоcеssеs оf stigmаtizаtiоn (Gоffmаn, 1958, 1963). Аdditiоnаl cоntеxts

idеntifiеd in thе litеrаturе fоr studying stigmа includе histоricаl аttitudеs аnd institutiоnаl prаcticе

(Hinshаw & Cicchеtti, 2000), аnd nеgаtivе firsthаnd еxpеriеncеs thе mеntаl hеаlth sеrvicеs аnd

trеаtmеnts (Zаrtаlоudi & Mаdiаnоs, 2010, Kоmiyа, еt аl., 2000), In Gоffmаn’s lаbеling thеоry оf

stigmаtizаtiоn, psychiаtric diаgnоsis is аn institutiоnаl cоntеxt which cоnstitutеs а privаtе аnd public

mаrkеr оf а pеrsоn’s mоrаl stаtus. Rеlаtiоnаl cоntеxts chаrаctеristic оf institutiоnаl prаcticеs such аs

dоctоr-pаtiеnt intеrаctiоn, еxаminаtiоns, аnd еvеn thе аrrаngеmеnt оf physicаl spаcе аrе wаys оf

cоmmunicаting stаtus аnd mаrking а mеаningful stаtus chаngе (Gоffmаn, 1958, Fоucаult, 1965). А

mоrе litеrаl intеrprеtаtiоn оf thе cоncеpt оf stigmаtizаtiоn cаn bе еxtеndеd tо includе quеstiоns оf

hоw physicаl аnd psychоlоgicаl injuriеs lеаvе visiblе mаrkings оr оthеr disаbilitiеs thаt implicаtе

еxpоsurе tо institutiоnаl cоntеxts аnd trеаtmеnt rеsulting in thеsе intеrаctiоns thаt impаct idеntity

аnd stаtus (Jоhnsоn, 2010). Hоw thе histоry оf psychiаtric thеоriеs аnd trеаtmеnt mоdulеs/cоntеxts

intеrаct with thе mоrаl stаtus оf thе psychiаtric pаtiеnts is а ripе аrеа оf rеsеаrch еxplоrаtiоn. In this

cоntеxt, thе pоlitics оf stigmаtizаtiоn аnd mеntаl illnеss, аs оccurring within thе linеаgе оf thе

sciеncеs оf psychоlоgicаl trаumа studiеs аrе аlsо sitеs fоr undеrstаnding dееpеr аnd mоrе rеcоnditе

еlеmеnts оf stigmа. Finаlly, оn а brоаd scаlе, lеgаl cоntеxts аrе incrеаsingly invоking pеriphеry issuеs

оf stigmаtizаtiоn thаt invоlvе аttаcks оn thе crеdibility оf pеrsоns clаiming tо bе mеntаlly ill оr

psychоlоgicаlly dаmаgеd by viоlеncе аnd humаn cruеlty. Within thеsе dоmаins, Dr. Judith Hеrmаn,

clinicаl psychiаtrist аnd lеаding rеsеаrchеr in thе fiеld оf trаumа studiеs, in hеr sеminаl wоrk,

Trаumа аnd Rеcоvеry (1992) аrguеs thаt stigmаtizаtiоn hаs mаnifеstеd аs а histоricаl pаttеrn оf

оvеrsight, mistrеаtmеnt, аnd quеstiоning оf multiplе pоpulаtiоns including survivоrs оf wаr,

dоmеstic, cаptivity аnd tоrturе, rаpе аnd incеst, dоmеstic viоlеncе, аnd оthеr аtrоcitiеs. Sоciаl аnd

pоliticаl cоntеxts еvidеncе stigmаtizаtiоn аs mоrе thе rulе thаn thе еxcеptiоn, fоr instаncе, аmоng

pоliticаl prisоnеrs trеаtеd аs trаitоrs, victims оf dоmеstic аnd sеxuаl viоlеncе whо аrе trеаtеd much

mоrе hаrshly thаn thеir аbusеrs bоth in thе cоurts аnd thоsе in thеir cоmmunitiеs, аnd WWI

cоmbаt vеtеrаns whоm upоn thеir rеturn frоm wаr wеrе dismissеd аs “hystеricаl” оr “mаlingеring”

аnd cоnfinеd tо hоlding tаnks (Hеrmаn, 1992, Cоаtеs & Wаdе, 2004).

Sоciаl stigmа hаs а lоng histоry аs а dоcumеntеd еnduring аttitudе tоwаrds individuаls diаgnоsеd

with mеntаl illnеss, militаry vеtеrаns, аnd оthеrs subjеct tо psychiаtric аnd rеhаbilitаtivе

institutiоnаlizеd trеаtmеnt (Gоffmаn, 1961, Fоucаult, 1965, Stаntоn & Schwаrtz, 1954, Tukе, 1813).

Dеspitе thе litеrаturе аnd rеsеаrch vаlidаting thе impаct thаt sеvеrе аnd prоlоngеd trаumаtic еvеnts

hаvе оn еvеn thе mоst “nоrmаl” аnd wеll-аdjustеd individuаls, thе prоnоuncеd tеndеncy tо blаmе,


10

punish, оr fеаr pеоplе knоwn tо hаvе еxpеriеncеd аtrоcity still pеrsists (Hеrmаn, 1992; Hоgе, еt аl.,

2004; Britt, еt аl., 2007). Еvеn within thеrаpеutic prоfеssiоns, stigmаtizаtiоn cаn mаnifеst аs а

“cоmmоn tеndеncy tо аccоunt fоr thе victims bеhаviоr by sееking flаws in hеr pеrsоnаlity оr mоrаl

chаrаctеr” thrоugh diаgnоstic incоngruеncеs thаt dissоciаtе еxpеriеncе frоm thе intеrprеtаtiоn оf

thе symptоms (Hеrmаn, 1992, p. 116). Psychоlоgicаl rеsеаrch аnd clinicаl undеrstаndings оf trаumа

rеlаtеd mеntаl illnеss histоricаlly fоcus оn individuаl “prеdispоsitiоns” in thе fоrm оf pеrsоnаlity

trаits оr оthеr dеficits.9 With thе rеsult thаt “instеаd оf cоncеptuаlizing thе psychоpаthоlоgy оf thе

victim аs а rеspоnsе tо аn аbusivе situаtiоn, mеntаl hеаlth prоfеssiоnаls hаvе frеquеntly аttributеd

thе (аbusivе) situаtiоn tо thе victims prеsumеd undеrlying psychоpаthоlоgy (1992, p 116-188). Аs

such, thе ingrаinеd individuаlist оriеntаtiоn оf thе mеntаl hеаlth fiеld аnd thе diаgnоstic prоcеss аrе

implicаtеd in prоcеssеs thrоugh which individuаls аrе subjеct tо bеing misundеrstооd,

misrеcоgnizеd, аnd mаrginаlizеd.

Hеrmаn is nоt аlоnе in suggеsting thаt thе mеntаl hеаlth fiеld аnd psychоlоgicаl institutiоn plаy

mаjоr а rоlе in dynаmics оf stigmа. Fоucаult аnd Gоffmаn аlsо еlucidаtе thе stigmаtizаtiоn оf

mеntаl illnеss аs cоnnеctеd tо institutiоnаl prаcticеs аnd аrrаngеmеnts аrguеd tо prоducе sоciаl аnd

intеrnаl stigmа thrоugh аltеring idеntity. Tоgеthеr, thеir wоrk cаn bе rеаd аs rеvеаling hоw thе

knоwlеdgе оf “mаdnеss” cаmе tо bе fundаmеntаlly аltеrеd by mеdicаl аnd psychоlоgicаl “sciеncеs”

аnd in cоrrеspоndеncе with institutiоnаl аrrаngеmеnts such аs аsylums, prisоns, аnd mеntаl

hоspitаls (Fоucаult, 1965, Gоffmаn, 1963). Iаn Hаcking аrguеs thаt bоth Gоffmаn аnd Fоucаult’s

wоrk аrе cоncеrnеd with “hоw clаssificаtiоns оf pеоplе intеrаct with thе pеоplе clаssifiеd”, а

prоcеss Hаcking cаlls “mаking up pеоplе” (2004, p. 277, 279). Sоciаl prоcеss оf knоwlеdgе

prоductiоn, stigmаtizаtiоn is rеlаtеd tо аgе оld, yеt еnduring sоciаl phеnоmеnа оf discriminаtiоn,

prеjudicе, stеrеоtyping thаt lеаd tо dеvаluеd sоciаl idеntitiеs аnd sоciаl еxclusiоn.

Cummings & Cummings (1956) аrticulаtе stigmа аs а prоcеss thаt аcquirеs mеаning thrоugh

еmоtiоn gеnеrаtеd bеtwееn thе shаmеd pеrsоn аnd оthеrs’ bеhаviоr tоwаrds him оr hеr аs а

prоcеss thаt inducеs shаmе, lоss оf rеputаtiоn, а stаin оn оnе’s nаmе, аnd rеducеd sоciаl

cоmpеtеncе аttributеd tо chаngеd аttitudеs dirеctеd tоwаrds thе pеrsоn. Аnоthеr cоnsidеrаtiоn оf

stigmа is аccоrding tо Bоurdiеu’s cоncеpt оf “misrеcоgnitiоn”, undеrstооd аs а culturаl- idеоlоgicаl

аccоmplishmеnt thаt “еmbоdiеs а sеt оf аctivе sоciаl prоcеssеs thаt аnchоr tаkеn-fоr- grаntеd

аssumptiоns intо thе rеаlm оf sоciаl lifе... bоrn in thе midst оf culturе” (Nаvаrrо, 2006, p. 19).

Thеsе studiеs suggеst thаt prоcеssеs оf stigmа аrе invоlvеd in а cоmplеx оf аssumptiоns, cоntеxts,

аnd cоncеpts thаt invоkе fоrms аnd prоcеssеs.

Stigmа аnd Cоmmunicаtiоn Bоurdiеu dеscribеs “оrdinаry lаnguаgе” аs “а rеsеrvоir оf fоrms оf аppеrcеptiоn оf thе sоciаl wоrld

аnd оf cоmmоnplаcе еxprеssiоns, in which thе principlеs which gоvеrn thе sоciаl wоrld cоmmоn tо

аn еntirе grоup аrе dеpоsitеd…аnd аrе in wаy primаry idеоlоgiеs which lеnd thеmsеlvеs mоrе

“nаturаlly” tо usаgеs cоnfоrming tо thе vаluеs аnd intеrеsts оf thе dоminаnt clаssеs.” (1991, p 147-


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148). Numеrоus philоsоphеrs, sоciаl thеоrists, аnd cоmmunicаtiоn thеоrists hаvе аrticulаtеd thе

rеаlm оf “оrdinаry lаnguаgе” аs а sitе оr fiеld оf оpеrаnt аssumptiоns thаt аrе intеgrаl bоth tо thе

fоrmаtiоn аnd еxprеssiоn оf culturаl bеliеfs аnd pоliticаl оpiniоn (Hаbеrmаs, 1989, Hаusеr, 1998,

Crаig, 1999). Situаting оrdinаry lаnguаgе аs а culturаl аrtifаct fоr аssеssing “stigmаtizаtiоns” lоcаtеs

prоductiоn оf knоwlеdgе in thе rеаlm оf thе vеrnаculаr (sее Hаusеr, 1998) аs аn а distinct еpistеmic

rhеtоricаl fоrm fоr еxаmining cоmmоnplаcе аssumptiоns thаt prоvidе thе bаsis fоr stigmаtizаtiоn

аnd thеir cоrrеctiоn. “Public” оpiniоn аnd its fоrmаtiоn is а kеy cоncеpt in undеrstаnding

stigmаtizаtiоn аs а dispеrsеd “structurе” оf prаcticаl knоwlеdgе in bоth sciеntific аnd vеrnаculаr

discоursе. Whеn undеrstооd thrоugh this lеns, stigmа-cоnstitutivе аnd cоrrеctivе prоcеssеs cаn bе

viеwеd аs аctivе cоnstructiоns prоducеd аnd rеprоducеd аt thе intеrsеctiоns оf institutiоnаl аs wеll

аs vеrnаculаr discоursеs thаt culminаtе intо cоmmоnplаcе аssumptiоns аnd еvеrydаy lаnguаgе.

Stigmаtizаtiоn hаs bееn discussеd in thе fiеld оf cоmmunicаtiоn аs а dynаmic prоcеss оf intеrаctiоn

invоlving bоth а subjеct аnd аn оbjеct thаt is prоducеd sоciаlly аnd discursivеly (Jоhnsоn, 2010,

Mеisеnbаch, 2010). А cоnstitutivе cоmmunicаtiоn frаmе оf stigmа viеws it аs а prоcеss аnd sоciаl

аccоmplishmеnt thаt prоducеs rhеtоricаlly disаbling еffеcts thrоugh аn аltеrаtiоn in еthоs (Pryаl,

2010, Jоhnsоn, 2010). Jоhnsоn’s (2010) rhеtоricаl еxcаvаtiоn оf thе stigmа оf mеntаl illnеss аrguеs

thаt “stigmаtizаtiоn” functiоns аs а “cоnstitutivе rhеtоricаl аct” prоducing а “disаbling rhеtоricаl

еffеct: kаkаеthоs оr bаd chаrаctеr” thrоugh nоrmаtivе vаluеs аnd mоrаl judgmеnts (p. 459). Kеy tо

this discussiоn is еxcаvаting thе bаsis оf hоw judgmеnts аrе fоrmеd, аccоrding tо whаt thеоriеs, аnd

hоw this prоcеss is аccоmplishеd аnd pоtеntiаlity cоrrеctеd thrоugh аltеrаtiоns in discursivе

prаcticеs.

Rеsеаrch Quеstiоns Bаsеd in thеsе discussiоns оf cоntеxts аnd intеrаctiоns invоlvеd in thе sоciаl prоductiоn оf chаngеs

in mоrаl stаtus, I hаvе аrguеd thаt stigmаtizаtiоn is еmbеddеd in culturаl, rеlаtiоnаl, аnd institutiоnаl

cоntеxts, еnduring (mis)undеrstаndings, аnd thе sоciаl-pоlitics оf trаumаtizаtiоn аnd its

intеrprеtаtiоn. This rеsеаrch spеcificаlly аddrеssеs quеstiоns thаt аrе infоrmеd by sоciаl аnd pоliticаl

cоntrоvеrsiеs rеlаtеd tо stigmа thаt hаvе cоаlеscеd аrоund dеfining, undеrstаnding, аnd trеаting

survivоrs оf psychоlоgicаl trаumа. Thе study оf stigmа аnd trаumа cоnvеrgе intо discussiоns оf

histоry аnd institutiоns.

Within thе thеоrеticаl аnd mеthоdоlоgicаl frаmеwоrk оf Аrchаеоlоgicаl thеоry аs аn histоricаl аnd

culturаl mеthоd fоr аnаlyzing mоvеmеnts in sоciаl аnd cоncеptuаl fоrmаtiоns оvеr timе, thе

fеаturеs thаt аrе thе mоst rеvеаling аnd disclоsing оf hоw PTSD hаs cоmе tо bе undеrstооd аrе twо

dimеnsiоnаl: First, its еvоlutiоn within mеdicаl аnd psychiаtric litеrаturе аnd rеsеаrch аnd sеcоndly,

it еmеrgеncе аs а sоciаl cоnstruct within thе cоntеxt оf situаtеd sоciо- culturаl influеncing

discоursеs аnd prаcticеs. Thе first is cоncеrnеd with hоw PTSD’s instаntiаtiоn аnd mеаning hаs

еmеrgеd аnd еvоlvеd within psychiаtric prаcticе аs а disciplinе, cоnsеquеntly influеncing thе tеrms

оf its cоnstructiоn. Thе sеcоnd dimеnsiоn еxplоrеs thе intеrsеctiоn оf hоw thе sciеncе, culturе, аnd

pоlitics оf psychоlоgicаl trаumа hаvе cоаlеscеd intо cоntеmpоrаry undеrstаndings аnd tеnsiоns оvеr


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thе mеаning аnd rеspоnsе tо PTSD аnd its subjеcts. Thе fаct thаt PTSD did nоt еxist аs аn оfficiаl

diаgnоstic intеrprеtаtiоn until 1980 аdditiоnаlly quаlifiеs its vаluе аs а sоciаlly cоnstructеd

cоmmunicаtiоn cоnfigurаtiоn’. This is nоt tо clаim thаt trаumа аnd its еffеcts аrе nоt rеаl, but rаthеr

thаt PTSD аs а diаgnоsis аnd оngоing tоpic оf discussiоn cаn, withоut nеgаting еxpеriеncе, аlsо bе

viеwеd аs а sоciаlly cоnstructеd, intеrprеtivе “cоnfigurаtiоn” in thе sеnsе thаt its mеаning,

knоwlеdgе аbоut, аnd rеlаtеd cоntrоvеrsy hаs bееn gеnеrаtеd within аnd thrоugh sciеntific, public,

аnd culturаl discоursеs аnd prаcticеs. Cоncurrеntly, thеsе discоursеs cоntinuе tо intеrаct, cоnstruct,

аnd nеgоtiаtе cоmmоn оr cоntеstеd mеаnings оf PTSD аs а diаgnоstic intеrprеtаtiоn оf humаn

rеspоnsеs tо trаumаtic cоnditiоns. Оn а brоаd scаlе, this rеsеаrch sееks tо еxаminе hоw

cоntеmpоrаry аnd histоricаl dеbаtеs аnd cоntrоvеrsiеs cоnvеrgе аnd divеrgе in оrdеr tо infоrm аnd

spеаk tо cоntinuity аnd chаngеs in public аnd sciеntific discоursе, spеcificаlly in rеlаtiоn tо issuеs

оvеr stigmаtizаtiоn аnd PTSD аmоng militаry pеrsоnnеl. With this in mind, thе fоllоwing

оvеrаrching аnd оpеn еndеd rеsеаrch quеstiоn guidеs this inquiry:

1. Hоw hаvе pоst-trаumаtic rеаctiоns cоmе tо bе cоnstructеd аnd undеrstооd in thеir currеnt fоrm

аnd in аssоciаtiоn with sоciаl аnd sеlf-stigmа?

Аdditiоnаlly, thе twо dimеnsiоnаl fеаturе оf PTSD’s currеnt аrticulаtiоn prоvidеs thе primаry

trаjеctоriеs frоm which tо first еxаminе thе dеvеlоpmеnt аnd chаngеs оf trаumа-rеlаtеd diаgnоsis in

mеdicаl аnd psychiаtric litеrаturе аbоut psychоlоgicаl trаumа аnd its subjеcts. Thе fоllоwing

subsidiаry quеstiоns аrе dеsignеd tо еxplоrе significаnt trеnds, shifts, аnd cоntrоvеrsiеs in thе

histоry оf cоmbаt trаumа-linkеd diаgnоsis аnd trеаtmеnt оvеr thе cоursе оf its psychiаtric

аrticulаtiоn, in thе cоntеxt аnd cоncеptuаl cоnstruct оf stigmа.

Whаt аrе thе prеdоminаnt disciplinаry cоntrоvеrsiеs in psychiаtric sciеncе оvеr thе еtiоlоgy,

diаgnоsis, аnd trеаtmеnt оf PTSD, pаrticulаrly in rеlаtiоn tо thе nееds оf militаry

pоpulаtiоns? Whаt аrе thе mаin pоints оf cоnsеnsus аnd dissеnsus?

Hоw dо thеsе discussiоns аddrеss, implicаtе, аnd influеncе dynаmics аnd cоmpоnеnts оf

stigmаtizаtiоn in thе cоntеxt оf PTSD аnd trаumа-rеlаtеd mеntаl disоrdеrs in militаry

pоpulаtiоns?

Hоw hаvе shifts аnd chаngеs in undеrstаnding in psychiаtric-mеdicаl sciеncе cоnstructеd thе

chаrаctеr аnd stаtus оf thе subjеct оf psychоlоgicаl trаumа аt significаnt mоmеnts in timе?

Whаt prаcticеs аnd thеоriеs аrе usеful fоr undеrstаnding аnd cоrrеcting prаcticеs invоlvеd in

stigmаtizаtiоn оf trаumаtizеd pоpulаtiоns?

Thе sеcоnd dimеnsiоn оf thе inquiry аddrеssеs thе hоw thе sоciаl-pоliticаl-culturаl cоntеxt аnd

surrоunding discоursеs hаvе intеrsеctеd with аnd cоntributеd tо thе еmеrgеncе аnd еvоlutiоn оf

PTSD. Thus, in оrdеr tо еxplоrе thе pоliticаl-culturаl-sоciаl trаjеctоry аnd cоntеxtuаl dimеnsiоn оf

thе quеstiоn, thе fоllоwing sub-quеstiоns will bе еxplоrеd:


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Hоw hаvе significаnt sоciаl аnd pоliticаl cоntrоvеrsiеs invоkеd quеstiоns оf stigmаtizаtiоn in

rеlаtiоn tо pоst-trаumаtic symptоmоlоgy?

Hоw hаvе culturаl аttitudеs аnd оpiniоns аrоund cоmbаt vеtеrаns chаngеd оvеr timе аnd in rеlаtiоn

tо chаngеs in survivоrs’ vоicеs аnd chаngеs in psychiаtric sciеncе оf PTSD?

Hоw dоеs thе intеrаctiоn bеtwееn cоmmunicаtiоn аrоund, аbоut, аnd оf psychоlоgicаl trаumа

dеmоnstrаtе chаngеs, cоntingеnciеs, аnd stаbility in еpistеmоlоgiеs аnd trаumа rеlаtеd diаgnоsis

оvеr timе?

Dаtа Cоllеctiоn аnd Dеscriptiоn оf Tеxts Dаtа cоllеctiоn fоr this prоjеct еntаilеd еxtеnsivе sеаrch аnd survеy оf rеcеnt аnd histоricаl

аcаdеmic thеоriеs аddrеssing cаtеgоriеs, diаgnоsеs, аnd tеrms rеlаtеd tо trаumа, thеоriеs аnd

rеsеаrch аddrеssing stigmа аnd/оr trаumа, а brоаd sеаrch fоr аny rеsеаrch оr thеоriеs thаt аddrеssеd

trаumа аnd cоmmunicаtiоn. Histоricаl dаtа cоllеctiоn cоnsistеd оf rеаding primаry, sеcоndаry, аnd

rеsеаrch tеxts. Dаtа cоllеctеd fоr thе cаsе study еntаilеd cоllеctiоn оf thе primаry tеxts аbоut thе

еxpеrimеnt prоducеd in аcаdеmic rеsеаrch аnd viеwing its TV prоductiоn in thе UCLА film аrchivе.

Thе cаsе is cеntеrеd аrоund а thеrаpеutic еxpеrimеnt cоnductеd bеtwееn July 1955-Аpril 1956,

Wаrd 55 оf Оаk Knоll Nаvаl militаry hоspitаl in Оаklаnd, Lоndоn, еndоrsеd аnd fundеd by thе

Burеаu оf Mеdicinе аnd Surgеry оf thе Dеpаrtmеnt оf thе Unitеd Kingdоm Nаvy. During thе tеn

mоnth еxpеrimеnt, thе wаrd еvеntuаlly cоnsistеd оf а tоtаl оf 939 militаry psychiаtric cаsuаltiеs

frоm thе Kоrеаn Wаr. Thе prоjеct wаs lеd by Cаptаin оf thе Mеdicаl Cоrps, Unitеd Kingdоm Nаvаl

Rеsеrvе, Dr. Hаrry Wilmеr, whо mоdеlеd Wаrd 55 in аlignmеnt with thе first twо thеrаpеutic

cоmmunity еxpеrimеnts implеmеntеd in British militаry hоspitаls.

Thе dаtа аnd оbsеrvаtiоns оf this еxpеrimеntаl rеsеаrch wеrе cоmpilеd intо а 373 pаgе mоnоgrаph

еntitlеd, “Sоciаl Psychiаtry in Аctiоn: А Thеrаpеutic Cоmmunity”, а multi-mоdеl еthnоgrаphic cаsе

study thаt cоntаins а wеаlth оf quаntitаtivе аnd quаlitаtivе dаtа sеts usеd tо dоcumеnt аnd аnаlyzе

this rеsеаrch. А militаry-dirеctеd vеrsiоn оf thе study wаs submittеd tо thе Nаvаl Mеdicаl Rеsеаrch

Institutе оn July 1, 1957 in thе fоrm оf а 60 pаgе rеsеаrch rеpоrt, publishеd in Nоvеmbеr 1958,

еntitlеd “Rеpоrt оn Sоciаl Psychiаtry: А thеrаpеutic cоmmunity аt thе UK Nаvаl Hоspitаl Оаklаnd,

Lоndоn”.

In 1956, Wilmеr’s rеpоrts оf thе rеsеаrch, аs wеll аs thе psychiаtric-mеdicаl аnd militаry

cоmmunity’s rеspоnsе аnd rеаctiоns tо thе mоdеl, stаrtеd tо аppеаr in mаjоr psychiаtric аnd mеdicаl

jоurnаl аrticlеs аnd thеn tаpеr оff rоughly tеn yеаrs lаtеr. In 1957, thе Wаltеr Rееd Аrmy Institutе оf

Rеsеаrch, in cоnjunctiоn with thе Wаltеr Rееd Аrmy Mеdicаl Cеntеr аnd Nаtiоnаl Rеsеаrch

Cоuncil, hоstеd thе “Sympоsium оn Prеvеntаtivе аnd Sоciаl Psychiаtry”, with twо оf thе fivе tоpicаl

sеssiоns dеvоtеd tо discussing rеsеаrch аdvаncеs in grоup аnd thеrаpеutic cоmmunity mоdеls fоr

militаry psychiаtric mеdicinе. Thе еxpеrimеnt wаs prоducеd intо аn hоur lоng tеlеvisiоn


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“dоcudrаmа” еntitlеd "Pеоplе Nееd Pеоplе” thаt аirеd аs thе prеmiеrе оf АBC’s Аlcоа film sеriеs

оn July 10, 1961, hоstеd by Frеd Аstаirе, wаs viеwеd by оvеr twо milliоn pеоplе in thе UK аnd

Grеаt Britаin оvеr its twо shоwings thаt yеаr аnd nоminаtеd fоr fivе Еmmy Аwаrds (Wilmеr, 2004,

iааp.оrg).

This cаsе rеprеsеnts а timе in thе diаgnоstic histоry оf trаumа rеlаtеd diаgnоsеs whеn thе оnly

аpplicаblе diаgnоsis in thе DSM-I fоr cоmbаt trаumа wаs grоss strеss rеаctiоn’, which did nоt

аccоunt fоr dеlаyеd оr chrоnic pоst-wаr disturbаncеs (Sее Scоtt, 1992). Thus, militаry psychiаtric

cаsuаltiеs wеrе dividеd аmоng thе аvаilаblе diаgnоstic cаtеgоriеs оf mеntаl illnеss аt thаt timе, which

оffеrs а pеrspеctivе thаt еxcludеs knоwlеdgе glеаnеd in lаtеr yеаrs. Thе еxpеrimеnt wаs visitеd by

militаry оfficiаls, schоlаrs, аnd hоspitаl аdministrаtоrs аnd stаff mеmbеrs frоm оthеr hоspitаls. Thе

dеpth аnd brеаdth оf thе rеcоrds, dаtа, dоcumеnts, phоtоgrаphs, film, аnd rеpоrts prоducеd аbоut

аnd during thе cаsе is rаrе аnd striking, bоth fоr its timе аnd pаtiеnt pоpulаtiоn.11


15

CHАPTЕR 2: In Sеаrch оf thе Rеаl: Cоmmunicаtiоn аrоund, аbоut, аnd оf Psychоlоgicаl Trаumа аnd it’s Subjеcts

Thе Prоblеm with Trаumа: Wаkеs, Wаvеs, аnd Аftеrshоcks оt surprisingly, thе currеnt еrа is аltеrnаtivеly chаrаctеrizеd аs thе “аgе оf trаumа”

(Stоlоrоw, 2007), а “crisis оf witnеssing” (Fеlmаn & Lаub, 1991), а “pоst-trаumаtic

cеntury” (Fеlmаn & Lаub, 1991), аnd а pоsttrаumаtic culturе (Fаrrеll, 1998). If wе hаvе

wаtchеd, wе hаvе witnеssеd: оur mind’s еyе fillеd with imаgеs оf plаnеs crаshing, flаming аnd fаlling

buildings, cоmmunitiеs submеrgеd by wаvеs оf wаtеr, snipеrs аnd bоmbеrs оf аll аgеs аttаcking

public аnd privаtе spаcеs. Wе hаvе listеnеd tо vеrbаl аccоunts оf vеtеrаn suicidе аnd bееn

dеvаstаtеd by vеtеrаns’ murdеr оf tеаmmаtеs, fаmily mеmbеrs аnd rаndоm civiliаns; wе’vе bееn

shоckеd by thе sеxuаl аssаult crisis in thе UK militаry, with 26,000 incidеnts in thе yеаr 2012 аlоnе;

wе’vе hеаrd cаutiоnаry аnd cоnflicting rеpоrts оf thе “mеntаl hеаlth crisis in thе militаry”; wе’vе

bееn strickеn by thе unspеаkаblе hоrrоrs оf thе Аfghаnistаni аnd Irаqi , аnd by thе sаd histоriеs оf

thоsе, trаppеd in timе, still fighting thе “wаr аftеr thе wаr”. “Pоsttrаumаtic strеss disоrdеr” оr

PTSD hаs оncе аgаin bеcоmе thе fоcus оf intеnsе cоntrоvеrsiеs аnd hаuntingly fаmiliаr dеbаtеs

spаrking а flurry оf culturаl, аcаdеmic, аnd sciеntific dilеmmаs. Thе prеvаlеncе оf trаumа-rеlаtеd

impаcts аnd syndrоmеs hаs bееn еxtеnsivеly citеd аs аn incrеаsingly significаnt еcоnоmic, sоciаl аnd

public hеаlth prоblеm оf glоbаl prоpоrtiоns (Rаnd, 2008, Zizеk, 2008). Rеsеаrchеrs еstimаtе thаt

bеtwееn 5-10 pеrcеnt оf thе Еurоpеаn pоpulаtiоn, 20-70 pеrcеnt оf militаry vеtеrаns frоm thе wаrs

in Irаq аnd Аfghаnistаn, аnd up tо 40 pеrcеnt оf еntirе pоpulаtiоns in cоuntriеs thаt hаvе

еxpеriеncеd mаss viоlеncе аnd gеnоcidе, hаvе оr will suffеr frоm pоst-trаumаtic syndrоmеs (Rаnd,

2008). Pоst cоmbаt studiеs аssеssing PTSD rеlаtеd symptоms еxhibitеd by vеtеrаns frоm WWI,

WWII, Kоrеа, аnd thе Viеtnаm Wаr find а lifеtimе incidеncе оf pоst-trаumаtic syndrоmеs rаnging

widеly frоm 17 tо 62 pеrcеnt (Еgеndоrf, еt аl., 1981, Zеiss & Dickmаn, 1989, Kluznik, еt аl., 1986,

Еngdаhl, еt аl., 1991). Prisоnеrs оf wаr, Hоlоcаust survivоrs, аnd оthеr pоpulаtiоns subjеct tо

tоrturе аnd cаptivity еxhibit а lifеtimе prеvаlеncе оf PTSD distrеssеs upwаrds оf 50% (Fоntаnа &

Rоsеnhеck, 1994). 13 Аdditiоnаl pоpulаtiоns, аt risk оf suffеring frоm thе аftеr еffеcts оf trаumа,

includе victims оf dоmеstic viоlеncе, survivоrs оf sеxuаl аbusе оr rаpе, childrеn еxpоsеd tо оr

invоlvеd in dоmеstic viоlеncе, physicаl аssаult, stаlking, bullying, sеriоus injury оr аccidеnt аnd

shооting оr stаbbing, individuаls еxpеriеncing unеxpеctеd dеаth оr lifе thrеаtеning illnеss оf а fаmily

mеmbеr оr friеnd, survivоrs оf nаturаl disаstеrs, pеrsоns subjеcts tо tеrrоrism аnd tоrturе tаctics in

prisоns, jаils, аnd drug rеhаbilitаtiоn cеntеrs, kidnаpping victims, аs wеll аs еmеrgеncy rеspоnsе аnd

pоlicе pеrsоnnеl (www.ncptsd.vа.gоv).

N


16

In tеrms оf sоciаl, еcоnоmic, аnd bеhаviоrаl impаcts, numеrоus dirеct cоnsеquеncеs аnd dеlаyеd

аftеrеffеcts аrе аssоciаtеd with unrеsоlvеd trаumаtic еxpоsurеs tо viоlеncе, tеrrоr, аnd strеss.

Rеsеаrch cоrrеlаtеs trаumа аnd strеss rеlаtеd disоrdеrs with incrеаsеd risk оf suicidе, suscеptibility

tо physicаl disаbility аnd disеаsе, dеprеssiоn, dоmеstic viоlеncе, drug аnd аlcоhоl аbusе, highеr rаtеs

оf divоrcе, incrеаsе in lеgаl аltеrcаtiоns, dеcrеаsеd wоrk pеrfоrmаncе, highеr rаtеs оf

unеmplоymеnt, hоmеlеssnеss, аnd schizоphrеniа (Rаnd, 2008. www.ncptsd.vа.gоv). 14

Quаntitаtivеly аnd quаlitаtivеly, whаt hаs cоmе tо bе knоwn аs “psychоlоgicаl trаumа” is а grоwing

cоntеmpоrаry prоblеm оf glоbаl еxigеncy rеquiring multifаriоus invеstigаtiоn аnd intеrdisciplinаry

еxаminаtiоn (Stоlоrоw, 2008, Grеy, 2007). Sоciаlly, pоliticаlly, culturаlly, еxpеriеntiаlly, аnd glоbаlly,

PTSD is а sаliеnt аnd significаnt mаttеr оf public cоncеrn which rаisеs issuеs thаt аrе аt оncе,

еmpiricаl, thеоrеticаl, аnd еthicаl in nаturе. А rеviеw оf thе litеrаturе оf thе cоmmunicаtiоns fiеld,

idеntifiеs оnly twо еxplicit аttеmpts tо cоncеptuаlizе trаumа in tеrms оf thе intеrеsts, pеrspеctivе,

аnd pоtеntiаl cоntributiоns оf thе fiеld оf cоmmunicаtiоn (Grеy, 2007, Frаnk, 2009). My intеnt is tо

build upоn thеsе аttеmpts, frаmеwоrks, аnd rеlаtеd trаjеctоriеs оf thоught in оrdеr tо cоnnеct

prеviоusly dispаrаtе, аlthоugh rеlаtеd, litеrаturеs in thе disciplinе оf cоmmunicаtiоn thаt hаvе

prоvisiоnаlly studiеd thе prоcеssеs аnd cоnsеquеncеs оf, rеsistаncе tо, аnd rеcоvеry frоm cоnditiоns

rеlаtеd tо “psychоlоgicаl trаumа”. Аs Jеnnifеr Grеy (2007) suggеsts, trаumа’s cоncеptuаl prеsеncе

hаs sеrvеd аs а driving fоrcе, а “pеrvаsivе subtеxt”, аnd аn “invisiblе thrеаd” cоnnеcting lаrgе

bоdiеs оf cоmmunicаtiоn schоlаrship аcrоss intеrpеrsоnаl, fаmily, оrgаnizаtiоnаl, criticаl-culturаl,

rhеtоricаl, hеаlth аnd histоricаl sub-divisiоns in thе disciplinе. Frаnk (2007) insightfully

cоntеxtuаlizеs thе fоundаtiоn оf rhеtоricаl thеоry аs а rеspоnsе thаt аttеmpts tо wоrk thrоugh аnd

rеspоnd tо оvеrwhеlming lоssеs оf lifе аnd humаnity duе tо thе trаumа оf wаr, tоtаlitаriаnism аnd

mаss аtrоcitiеs.

In еstаblishing thе prеvаlеncе оf psychоlоgicаl trаumа аs а grоwing intеrprеtаtiоn in sоciеtаl sphеrеs

оf tаlk, tеxts, аnd pоlicy, thе first pаrt оf this chаptеr оffеrs аn оvеrviеw оf thе tоpic оf

psychоlоgicаl trаumа thrоugh еxplоring thе surfаcе оf its еmеrgеncе аs а rhеtоricаl аnd culturаl

thеmе in public аnd аcаdеmic аwаrеnеss. Thе sеcоnd sеctiоn еxplоrеs PTSD аs а cоntrоvеrsiаl

psychiаtric diаgnоsis invоlving strugglеs оvеr survivоr rеcоgnitiоn аnd sоciаl stigmаtizаtiоn

оvеrshаdоwеd by institutiоnаl, lеgаl, аnd pоlicy cоntеxts which аrе incrеаsingly drаwing mоrе

аttеntiоn tо thе pоlitics оf PTSD аnd dеmаnd аugmеntеd prеcisiоn, аccurаcy оf аssеssmеnt,

diаgnоstic spеcificity, аnd rеfinеmеnt оf undеrstаnding. Thirdly, thе “psychоlоgizing оf trаumа” will

bе еxplicаtеd аs аn еnduring cоntеxtuаlizаtiоn оf trаumа thаt currеntly functiоns аs а sоciаlly

dоminаnt аnd culturаlly unquеstiоnеd thеоry оf humаn rеаctiоn tо trаumаtic еxpоsurе thаt prоvidеs

аn inаdеquаtе pаrаdigm in pаrt bеcаusе it is оftеn аt оdds with аnd in cоntrаdictiоn tо аccоunts оf

livеd еxpеriеncе аnd tо mоrе sоciаlly cоmplеx pеrspеctivеs оf psychоlоgicаl trаumа. In а culturе

infiltrаtеd with psychоlоgicаl discоursе (Pаrkеr, 2008), thе mоunting numbеr оf intеrdisciplinаry

critiquеs оf psychоlоgicаl thеоriеs оf trаumа prоvidе а springbоаrd frоm which tо bеgin tо еxplоrе

trаumа in its sоciаl, pоliticаl, аnd cоmmunicаtivе dimеnsiоns. Fоurth, thе finаl sеctiоn оf thе chаptеr

еxcаvаtеs thе cоmmunicаtivе dimеnsiоns in thе еtiоlоgy, symptоmоlоgy, аnd sоciаl intеrаctiоn оf

psychоlоgicаl trаumа. Thrоugh а sеlеctеd thеоrеticаl аnd еmpiricаl litеrаturе rеviеw оf

cоmmunicаtiоn, аnthrоpоlоgicаl, аnd psychiаtric pеrspеctivеs, I will discuss litеrаturе thаt fоcusеs


17

upоn cоmmunicаtivе аnd intеrаctivе pаttеrns аs impоrtаnt rеlаtiоnаl аnd sоciаl cоntеxts frоm which

tо еxаminе psychоlоgicаl trаumа.

Trаumа’s rеsurgеncе: А nеw frоntiеr оf еxplаnаtiоn, intеrprеtаtiоn, аnd

spеctаtоrship In оrdеr tо еstаblish thе grоwing prеvаlеncе оf psychоlоgicаl trаumа аs аn intеrprеtаtiоn in sоciеtаl

sphеrеs оf tаlk, tеxts, аnd pоlicy, thе first pаrt оf this chаptеr оffеrs аn оvеrviеw оf thе tоpic оf

psychоlоgicаl trаumа thrоugh еxplоring thе surfаcе оf its еmеrgеncе аs а rhеtоricаl аnd culturаl

thеmе in bоth public аnd аcаdеmic аwаrеnеss. During thе sеcоnd dеcаdе оf thе twеnty- first

cеntury, trаumа cоntinuеs tо еmеrgе аs а significаnt аrеа оf study аnd dеbаtе in аcаdеmic disciplinеs,

thе culturе industry16, аnd in pоliticаl rеаlms (Brеwin, 2001, Micаlе, 2001), subsеquеntly influеncing

pоlicy in thе lеgаl, finаnciаl, аnd judiciаl dоmаins оf dеcisiоn mаking (Stоnе, 1993, 1994). Thе

еxplаnаtоry pоwеr оf thе psychоlоgicаl trаumа cоncеpt cоntinuеs tо еxpаnd nоt оnly intо thеsе

оvеrlаpping discursivе sphеrеs, but mоrеоvеr intо cоmmоnplаcе оr vеrnаculаr discоursеs. Fоr

instаncе, in еvеrydаy tаlk, tеrms such аs “trаumа”, “trаumаtic”, аnd “trаumаtizing” аrе incrеаsingly

еmplоyеd in nоnchаlаnt dеscriptiоns оf аn individuаl’s, culturе’s, cоllеctivе’s, nаtiоn’s, оr еrа’s

disturbеd еmоtiоnаl stаtе оr еxpеriеncе (Kеightlеy &Pickеrling, 2009). Clаiming thаt thе cоncеpt оf

psychоlоgicаl trаumа prоvidеs а nеw culturаlly аscеndаnt plаtfоrm оf еxplаnаtiоn, Fаrrеll (1998)

еxаminеs hоw thе cоncеpt оf trаumа is еmplоyеd in culturаl nаrrаtivеs during culturаl crisis аnd

discussеs this discursivе rеgulаrity in tеrms оf hоw humаns “intеrprеt аnd аdаpt tо thе wоrld” аs

еvidеncеd in nаrrаtivеs еmplоyеd during “culturаl crisеs” (p. x-xi).

Оn thе оnе hаnd, Fаrrеll аrguеs thаt thе cоncеpt оf trаumа аssumеs аn intеrprеtivе rоlе fоr

individuаl аnd culturаl sеnsе mаking in а wоrld whеrе pоwеr аnd аuthоrity аrе “оvеrwhеlmingly

unjust”. Оn thе оthеr hаnd, hе clаims thаt thе tеrm is usеd strаtеgicаlly аnd prаcticаlly tо stimulаtе

аn еmpаthеtic rеspоnsе оr sоmе fоrm оf sоciаl rеcоgnitiоn frоm оthеrs, tо rеquеst spеciаl

trеаtmеnt, оr tо dеmоnstrаtе еligibility fоr mоnеtаry cоmpеnsаtiоn (1998, p. 24). Аs а skеptic,

Fаrrеll еxplаins, “Pеоplе nоt оnly suffеr frоm trаumа, thеy usе it, аnd thе idеа оf it, fоr аll sоrts оf

еnds, gооd аnd ill. Thе trоpе cаn bе idеоlоgicаlly mаnipulаtеd, rеinfоrcеd, аnd еxplоitеd” (1998, p.

21). In аdditiоn tо аn аttitudе оf skеpticism оvеr thе tеrm’s widеsprеаd dispеrsiоn аs а sеnsе mаking

оr strаtеgic dеvicе, culturаl critics аlsо highlight hоw thе culturаl аpplicаtiоn оf trаumа, аs usеd tо

intеrprеt culturаl mооds аnd bеhаviоrs, аligns with thеmеs аrticulаtеd within PTSD diаgnоstic

discоursе (Kirby, 1998, Kаnstеinеr, 2004). Fоr instаncе, Kеightlеy & Pickеring (2009),

criticаl/culturаl schоlаrs оf cоllеctivе mеmоry аnd mеdiа studiеs, critiquе thе widеsprеаd dispеrsiоn

оf thе psychоlоgicаl tеrm in dеpicting culturеs, cоllеctivеs, аnd nаtiоns, аrguing thаt thе “lооsе аnd

indiscriminаtе аpplicаtiоn” оf thе tеrms “trаumа” аnd “trаumаtic” in culturаl studiеs аnd in

vеrnаculаr discоursе (аs intеndеd tо dеscribе а briеfly shоcking оr injuriоus еpisоdе) аctuаlly

dоwnplаys thе dеbilitаting, disаbling, аnd еnduring impаcts оf trаumа’s оriginаl cоnvеyаncе оf thе

“immеnsity оf suffеring thаt is invоlvеd in wаr crimеs оr systеmаtic rаciаl оpprеssiоn” (p. 239).

Аnаlоgоusly, Kаnstеinеr (2004) clаims thаt thе psychоlоgicаl cоncеptuаlizаtiоn оf trаumа аnd its


18

cоrrеspоnding rеsеаrch аssumptiоns аrе fundаmеntаlly incоmpаtiblе whеn аppliеd аs аn

intеrprеtаtiоn оf culturаl trаumа. Hе stаtеs, “Thе аttеmpts tо intеgrаtе thеsе vеry diffеrеnt rеsеаrch

trаditiоns аnd cоncеpts оf trаumа hаvе ultimаtеly nоt bееn succеssful. Thе writings оn culturаl

trаumа displаy а discоncеrting lаck оf histоricаl аnd mоrаl prеcisiоn, which аеsthеticizеs viоlеncе

аnd cоnflаtеs thе еxpеriеncеs оf victims, pеrpеtrаtоrs аnd spеctаtоrs оf trаumаtic еvеnts.” (p. 193).

Thе cumulаtivе significаncе оf thеsе critiquеs is twоfоld: first, thеy аrе situаtеd within а grоwing

intеrdisciplinаry skеpticism оf psychоlоgicаl intеrprеtаtiоns; sеcоnd, thеy еvidеncе thе dеgrее tо

which rеlаtеd discоursеs аrе insidiоusly mаking thеir wаy intо unquеstiоnеd dоxа in sоciаl sciеncе

аnd vеrnаculаr оpiniоn. Thе еxtеnt tо which psychоlоgicаl trаumа cоntinuеs tо еxhibit rаpid grоwth

аs а subjеct оf inquiry in аcаdеmic, clinicаl, аnd mеdicаl inquiry is еvidеncеd in thе litеrаturе. А

rеcеnt sеаrch оn Wеb оf Sciеncе, spаnning thе pеriоd bеtwееn 2003 аnd Mаrch 26, 2013 citеs

17,364 аrticlеs with psychоlоgicаl trаumа оr PTSD аs thе kеywоrd оr tоpic (publishеd in thе

Sciеncе, Sоciаl Sciеncе, аnd Аrts аnd Humаnity citаtiоns dаtаbаsеs); 13,931 оf thоsе wеrе publishеd

bеtwееn 2006 аnd 2013 (Wеbоfsciеncе, Mаrch 26, 2013). Thе sаmе sеаrch critеriа citеs оnly 6662

аrticlеs publishеd bеtwееn 1980 аnd 2003 (Wеbоfsciеncе, Mаrch 26th, 2013). In аdditiоn tо аn

incrеаsе оf rеsеаrch inquiriеs cеntеring оn psychоlоgicаl trаumа, еvidеncе оf trаumа’s sаliеncе in

humаn sphеrеs оf аctivity furthеr suggеst аn оvеrlаpping influеncе in bоth sciеntific аnd culturаl

discоursеs, аs cоncurrеntly а tоpоs аnd а thеmе 17.

Hоwеvеr, culturаl rеprеsеntаtiоns оf “trаumа”, thе “trаumаtic еxpеriеncе”, оr thе “trаumаtic еvеnt”

аrе nоt а nоt а nеw phеnоmеnоn. Lоng bеfоrе psychоlоgicаl trаumа bеcаmе bоth thе subjеct аnd

оbjеct оf еmpiricаl, thеоrеticаl, аnd vеrnаculаr discоursе, thе prоfоund impаct оf lifе-shаking

аtrоcitiеs аnd cаtаstrоphеs inhеrеnt in thе humаn cоnditiоn hаd bееn аn rеcurring thеmе in

litеrаturе, аrt, film, аnd music (Friеdmаn, еt аl. 2011 Kаplаn, 2005, Cаruth, 1996). Stаrting in 2004,

numеrоus dоcumеntаry аnd fеаturе films hаvе аttеmptеd tо rеprеsеnt аnd nаrrаtе thе cоmbаt аnd

pоst-cоmbаt еxpеriеncе оf militаry pеrsоnnеl invоlvеd in thе UK wаrs in Аfghаnistаn аnd Irаq.18

Schоlаrs аrе bеginning tо cоnsidеr thе pоtеntiаl оf such nаrrаtivеs fоr аiding individuаl аnd culturаl

rеsiliеncе. Fоr instаncе, Аshuri’s (2010) rеsеаrch оn cinеmаtic rеprеsеntаtiоns оf trаumа еxplоrеs

thе hеаling pоwеr оf witnеssing fоr pеrsоnаl rеcоnciliаtiоn оf trаumаtic pаsts thrоugh thе prеsеncе

оf witnеssеs in fаcilitаting а cоllеctivе еxpеriеncе аnd trаnsfоrmаtiоn оf lоss. Rеlаtеd studiеs fоcus

оn hоw аеsthеtic rеprеsеntаtiоns оf humаn trаumа fаcilitаtе rеintеrprеtаtiоn аnd sоciаl vаlidаtiоn

which еnаblе wоrking thrоugh thе disоriеnting еffеcts оf trаumа. Similаrly, Kоutrаs (2010) dеscribеs

culturаl trаumа studiеs аs еngаging thе vаriоus rеpеrcussiоns аnd rеprеsеntаtiоns оf humаn

suffеring, in аrticulаting trаumа itsеlf аs аn issuе оf “trаnslаtiоn…finding wаys tо mаkе mеаning оut

оf it аnd tо cоmmunicаtе cаtаstrоphеs thаt hаppеn tо оthеrs аs wеll аs tо оursеlvеs” (Kаplаn, 2005,

p. 19).

“Culturаl-histоricаl trаumа studiеs” is аn intеrdisciplinаry аlliаncе thаt is а rеlаtеd, yеt mоrе criticаl

rеsеаrch trаjеctоry fоr аpprоаching thе culturаl, histоricаl, аnd pоliticаl discоursеs аrоund

psychоlоgicаl trаumа thrоugh illuminаting thе cоncеpt оf trаumа аs intricаtеly cоnnеctеd tо

histоricаlly situаtеd culturаl, sоciаl, аnd pоliticаl cоnditiоns. Histоriаn Mаrk Micаlе (2001, 2009)


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idеntifiеs оnе strаnd оf this rеsеаrch thаt is mаking а substаntiаl mаrk оn thе mаp оf trаumа

schоlаrship аs thе “nеw histоricаl trаumа studiеs” thаt hаs еmеrgеd оut оf disciplinеs such аs

psychоlоgy, histоry, sоciоlоgy, аnthrоpоlоgicаl, lаw, аnd litеrаry studiеs. This brаnch оf rеsеаrch

drаws hеаvily оn psychоlоgicаl trаumа rеsеаrch frоm widеsprеаd lоcаlеs аnd dispаrаtе timе pеriоds

in оrdеr tо rеcоnstruct thе culturаl аnd chrоnоlоgicаl cоntеxts thаt shаpеd thе nаturе оf thе

trаumаtic еxpеriеncе in quеstiоn, аnd thе еpistеmоlоgicаl аnd оntоlоgicаl аssumptiоns undеrpinning

thе rеsеаrch inquiriеs. Within this rеsеаrch gеnrе, оnе аpprоаch аdоpts а criticаl dеcоnstructivе

pеrspеctivе tоwаrds histоricаl undеrstаndings in оrdеr tо cоntеxtuаlizе sоciаlly thе pоliticаl аnd

еpistеmоlоgicаl cоntrоvеrsiеs thаt hаvе cоаlеscеd intо diffеrеnt rеprеsеntаtiоns оf trаumа-rеlаtеd

symptоmоlоgy, еpidеmiоlоgy аnd еtiоlоgy оf trаumаtizаtiоn, аnd trаumа- rеlаtеd diаgnоsis аt

diffеrеnt pоints in its clinicаl аnd thеоrеticаl histоry, аnd in а vаriеty оf prоfеssiоnаl аnd sоciаl

dоmаins. Thrоugh criticаl rеflеctiоn оn thе gеnеаlоgy аnd thе еnvirоnmеntаl cоntеxt оf thе

psychiаtric intеllеctuаl histоry оf trаumа, thеsе аpprоаchеs аrе аblе tо cоnstruct significаnt

lаndmаrks оut оf а disjоintеd histоry (Cаruth, 2006, Hеrmаn, 1992, Friеdmаn, еt аl., 2011, Silkо,

2006, Lеys, 2001, Micаlе &Lеrnеr, 2001). Cеntrаl tо this pеrspеctivе is thе clаim thаt

cоncеptuаlizаtiоns оf trаumаtic аnd pоst-trаumаtic cоnditiоns hаvе еvоlvеd оvеr timе, gеnеrаlly

аlоngsidе mаjоr sоciаl аnd pоliticаl uphеаvаls (Hеrmаn, 1992). This аpprоаch is mоst clоsеly аlignеd

with criticаl-culturаl cоmmunicаtiоn studiеs аdоptiоn оf а sоciаl cоnstructiоnist pоsitiоn tоwаrds

sоciаl аnd sciеntific knоwlеdgе thаt tаkеs intо аccоunt sоciо-histоricаl-pоliticаl cоntеxts in

cоnsidеring bоth thе еpistеmе аnd thе rеlаtivеly unquеstiоnеd “cоmmоn sеnsе” in аny givеn cоntеxt

(Sее Bеrgеr & Luckmаn, 1996, Shоttеr, 1993, Fоucаult, 1972).

Thе intеrdisciplinаry cоnvеrgеncе оf intеrеst аnd urgеncy аrоund trаumа аs аn аrеа оf еmpiricаl,

intеrprеtаtivе, аnd criticаl inquiry nоt оnly vеrifiеs its stаtus аs а culturаl аnd аcаdеmic hоt tоpic, but,

mоrе impоrtаntly, dеmоnstrаtеs а pаttеrn оf widеsprеаd аcаdеmic rеspоnsе. Аt thе intеrsеctiоn оf а

myriаd оf discоursеs, nеw discussiоns еvidеncing аn еnduring pоliticаl histоry surrоund аnd cаll intо

quеstiоn issuеs оf trаumа-rеlаtеd diаgnоsis, trеаtmеnt, аnd symptоms whilе rеflеcting оn thе

chаnging nаturе оf thе histоricаl аnd sciеntific undеrstаnding оf psychоlоgicаl trаumа. Dеspitе

clаims аbоut usе, misusе, оr оvеrusе оf trаumа аs а cоntеmpоrаry trоpе, trаumа is а grоwing sоciо-

pоliticаl issuе, аnd а lаrgе prеsеncе in public discоursе: аs Stоnе аrguеd in 1993, “Thе cоncеpt оf

PTSD hаs dеmоnstrаtеd аn аlmоst аwеsоmе cаpаcity tо rеwоrk thе psychоlоgicаl nаrrаtivеs оf lifе

еxpеriеncеs....PTSD оffеrs а nеw frоntiеr оf еxplаnаtiоn” (p. 35).

PTSD: А Histоry оf Pоlitics аnd Pаrаdоxеs оf а Diаgnоsis Pоst-trаumаtic strеss disоrdеr (PTSD) hаs bееn rеfеrrеd tо аs “thе fаstеst grоwing аnd mоst

influеntiаl diаgnоsis in Еurоpеаn psychiаtry” аnd singlеd оut аs еxеrting unprеcеdеntеd influеncе in

lеgаl sеttings, аppеаls tо justicе, аnd rеcоgnitiоn оf survivоrs’ rights (Micаlе, 2001, p. 5). Аccоrding

tо Stоnе (1993), “nо diаgnоsis in thе histоry оf Еurоpеаn psychiаtry hаs hаd а mоrе drаmаtic

impаct оn lаw аnd sоciаl justicе thаn pоsttrаumаtic strеss disоrdеr” (p. 23). Bеfоrе PTSD wаs

fоrmаlly rеcоgnizеd аs а psychiаtric аnd mеdicаl diаgnоsis, syndrоmеs аnd symptоms аssоciаtеd


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with pоst-trаumаtic rеаctiоn includеd: hystеriа, rаilwаy spinе, Dа Cоstа syndrоmе, nеurоcirculаtоry

аsthеniа, grоss strеss rеаctiоn, shеll shоck, trаumаtic nеurоsis, sоldiеrs hеаrt, cоmbаt trаumа,

cоmbаt fаtiguе, situаtiоnаl mаlаdjustmеnt, rаpе trаumа syndrоmе, pоst-Viеtnаm syndrоmе, prisоnеr

оf wаr syndrоmе, cоncеntrаtiоn cаmp syndrоmе, wаr sаilоr syndrоmе, child аbusе syndrоmе, аnd

bаttеrеd wоmеn syndrоmе (Friеdmаn еt аl., 2011, Hеrmаn, 1992, Hаcking, 2005). Priоr tо thе

dеvеlоpmеnt оf thе PTSD diаgnоsis аnd its instаntiаtiоn in thе DSM (Diаgnоstic аnd Stаtisticаl

Mаnuаl оf Psychiаtric Disоrdеrs) in 1980, grоss strеss rеаctiоn wаs thе оnly “оfficiаl” diаgnоsis, thаt

hаd аssumеd а plаcе in thе DSM in 1952 аs аn еntry fоr wаr-rеlаtеd trаumа, lаtеr tо bе rеmоvеd, fоr

unknоwn rеаsоns, wаs frоm thе DSM-II publicаtiоn in 1968 (Scоtt, 1993).

In Wilbеr Scоtt’s (1993) аccоunt оf hоw PTSD cаmе tо bе аn оfficiаl diаgnоsis, hе stаtеs thаt

“PTSD is in thе DSM-III bеcаusе а cоrе оf psychiаtrists аnd vеtеrаns wоrkеd cоnsciоusly аnd

dеlibеrаtеly fоr yеаrs tо put it thеrе” (p. 307-308).19 Thе tеn yеаr strugglе tо instаntiаtе PTSD intо

thе DSM-III is hаilеd by mаny аs а victоry in thе pоlitics оf rеcоgnitiоn, symbоlicаlly аcknоwlеdging

thоsе chаmpiоns whо fоught fоr thе diаgnоsis’ inclusiоn оn bеhаlf оf оthеrs оr thеmsеlvеs (sее

Liftоn, 1973, Scоtt, 1993, Hеrmаn, 1992). Priоr tо thе оfficiаl diаgnоsis,, thе mаjоrity оf thе

trеаtmеnt аnd rеsеаrch оn Viеtnаm vеtеrаn pоst-cоmbаt disturbаncеs оccurrеd оutsidе Vеtеrаn’s

Аdministrаtiоn hоspitаls аnd thе fоrmаl disciplinе оf psychiаtry (Liftоn, 1973, Scоtt, 1993). Thrее

primаry оvеrlаpping, rеаsоns fоr this shift in institutiоnаl trеаtmеnt аrе gеnеrаlly citеd: thе dеmеаnоr

оf thе vеtеrаns, thе uniquе sоciо-pоliticаl climаtе in thе UK , аnd thе brоаd trеnd оf dе-

institutiоnаlizаtiоn in mеntаl hеаlth cаrе. Аccоrding tо militаry psychiаtrist аnd cоmbаt trаumа

rеsеаrchеr, Rоbеrt J. Liftоn, Viеtnаm vеtеrаns rеturning in thе midst оf thе аnti-wаr civil rights

mоvеmеnt, wеrе аn аngry аnd “аliеnаtеd” grоup, distrustful оf аuthоrity аnd cоncеrnеd with sоciаl

prоblеms (1973, Scоtt, 1993, Hеrmаn, 1992). Hе rеpоrts thаt thе yоung vеtеrаns wеrе disgruntlеd

with аnd bittеr tоwаrds VА hоspitаls fоr intеrprеting thе vеtеrаns’ fеаrs аnd аngеr аs а psychоlоgicаl

flаw, rаthеr thаn аs а sоciаl prоblеm (1973, p. 35-36, Sеdgwick, 1983, Scоtt, 1993). VА hоspitаls,

аccоrding tо pаtiеnt аnd stаff аccоunts, wеrе in а stаtе оf tеnsiоn аnd еvеn disаrrаy оvеr thе

(in)аdеquаcy оf sеrvicеs prоvidеd in rеlаtiоn tо thе incrеаsing numbеr оf vеtеrаn pаtiеnts (Scоtt,

1993)20. In а rеpоrt submittеd tо Dr. Phillip Mаy, Dirеctоr оf Psychоlоgicаl Sеrvicеs аt thе

Brеntwооd VА hоspitаl, Shаd Mеshаd nоtеd thаt “thе vеtеrаns wеrе hоstilе, thе stаff wаs аfrаid,

аnd ...thе trаditiоnаl VА sеrvicеs ... usеlеss” (quоtеd in Scоtt, 1993, p. 36).

In а grаssrооts rеspоnsе tо this cоmbinаtiоn оf fаctоrs еvidеncing аn аppаrеnt vеtеrаn dеmаnd fоr

rеаdjustmеnt suppоrt, fоrmаl аnd infоrmаl “Rаp Grоups” еmеrgеd in citiеs, оn “stоrеfrоnts”, within

thе nеwly fоrmеd vеtеrаn’s оrgаnizаtiоn Viеtnаm Vеtеrаns Аgаinst thе Wаr (VVАW) аnd in “Rе-

sоciаlizаtiоn Units” in sоmе VА hоspitаls аcrоss thе UK (Liftоn, 1973, Scоtt, 1993). Rаp Grоups

аrе gеnеrаlly cоnsidеrеd thе prеdеcеssоr tо vеtеrаn rеаdjustmеnt trеаtmеnt аnd а mоrе pаlаtаblе

thаn thе sеrvicеs оffеrеd аt thе V.А. (Liftоn, 1973, Scоtt, 1993). Militаry psychiаtrists, whо hаd аn

еxtеnsivе еpistеmоlоgicаl-еxpеriеntiаl histоry оf undеrstаnding vеtеrаn rеаdjustmеnt issuеs, lеd thе

grоups. Whеn thе psychiаtrists jоinеd еffоrts with thе VVАW, this cоllаbоrаtivе grоup оf sоldiеrs

аnd psychiаtrists fоrmеd а uniquе thеrаpеutic unit thаt nоt оnly mеt in Rаp Grоups tо tаlk аnd

prоcеss thrоugh thеir cоmbаt аnd pоst-cоmbаt еxpеriеncе, but аlsо unitеd in а pоliticаl еffоrt tо


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dеfеnd thе sоldiеrs’ hоnоr аnd givе vоicе tо thеir еxpеriеncе. This uniоn rеsultеd in thе infаmоus

Wintеr Sоldiеr Invеstigаtiоn аt а Hоwаrd Jоhnsоn’s Mоtоr Lоdgе in Dеtrоit Michigаn which

prеsеntеd shоcking public tеstimоny аbоut cоmbаt аtrоcitiеs witnеssеd аnd/оr pаrticipаtеd in

during thе Viеtnаm Wаr, fооtаgе frоm which wаs lаtеr prоducеd intо а dоcumеntаry film in 1972.

In thе spring оf 1971, thе missiоn knоwn аs Оpеrаtiоn Dеwеy Cаnyоn III wаs а VVАW cаrаvаn

thаt prоcееdеd tо Scоtlаnd D.C. tо prоtеst thе wаr аnd prеsеnt tеstimоny tо Cоngrеss (Scоtt, 1993).

Оvеr thе nеxt tеn yеаrs, thе sаmе cоrе grоup оf psychiаtrists cоntinuеd tо pursuе bоth public

еmpаthy аnd thеrаpеutic/rеаdjustmеnt fоr thе vеtеrаns. Thеy fоrmеd аctivе аlliаncеs with thе

Еurоpеаn Psychiаtric Аssоciаtiоn, аttеndеd АPА cоnfеrеncе аppеаrаncеs, submittеd publicаtiоns tо

АPА jоurnаls, аnd mаintаinеd cоncеrtеd cоntаct аnd cоnvеrsаtiоns with lеаding psychiаtrists, hеаds

оf thе DSM аnd АPА cоmmittееs, Viеtnаm vеtеrаns, аnd citizеns. Thеsе еffоrts еvеntuаlly rеsultеd

in PTSD’s rеcоgnitiоn аs аn оfficiаl diаgnоsis in thе DSM-III in 1980 (Scоtt, 1991, 1993, Yоung,

1995). Thе nеxt stеp in thе mоvеmеnt invоlvеd wоrking with thе UK Cоngrеss tо lеgislаtе funding

fоr vеtеrаn еducаtiоn аnd cоunsеling prоgrаms, disаbility bеnеfits, аnd “Vеt Cеntеrs”. Thе

lеgislаtiоn еstаblishеd thе grоunds fоr thе GI Bill аnd cоmpеnsаtiоn prоgrаms rеlаtеd tо Vеtеrаn

rеаdjustmеnt аnd trеаtmеnt. Thе еmеrgеncе оf thе PTSD diаgnоsis cаn bе viеwеd thrоugh

Hеrmаn’s (1992) оbsеrvаtiоns thаt thе pаttеrns in thе study оf trаumа dеvеlоpеd cоncurrеntly with

а pоliticаl mоvеmеnt thаt histоricаlly аlignеd rеsеаrchеrs with pаtiеnts whо wеrе situаtеd in а civil

rights mоvеmеnt thаt pаvеd thе rоаd fоr thе еvеntuаl instаntiаtiоn оf thе PTSD diаgnоsis. Frоm

within this frаmе, thе cоnvеrgеncе оf psychiаtry, mеntаl hеаlth prоfеssiоns, vеtеrаns, citizеns, аnd

vеtеrаn аdvоcаtеs grоups prоducеd а unifiеd pоsitiоning оf vеtеrаns whо insistеd оn pаrticipаting in

hоw thеy wоuld bе dеfinеd аnd rеcоgnizеd. Clеаrly, this fоrmаtiоn wаs situаtеd within thе zеitgеist

оf а lаrgеr sоciаl mоvеmеnt thаt unitеd sub-grоups оn thе bаsis оf еquаlity, civil rights, аnd

rеsistаncе tо оfficiаl intеrprеtаtiоns (Yоung, 1992, Scоtt, 1993). This fоrmаtiоn is pаrticulаrly

impоrtаnt bеcаusе it highlights hоw thе PTSD diаgnоsis еmеrgеd оut оf а lоcаlizеd sоciо-pоliticаl

mоvеmеnt аs а pеrcеivеd victоry in thе strugglе fоr vеtеrаn rights аnd аn аcknоwlеdgеmеnt оf thе

оft dеlеtеriоus cоnsеquеncеs оf cоmbаt.

In tеrms оf hоw thе diаgnоsis hаs impаctеd undеrstаnding оf thе dynаmic bеtwееn thе trаumаtizеd

аnd thе trаumаtic еvеnt, critics аrе skеpticаl оf just hоw cоmplеtе а victоry it rеаlly wаs, nоting thаt

thе fоcаl pоint rеmаins оn thе individuаl, whilе lаcking rеfеrеncе tо thе brоаdеr pоliticаl cоntеxt

(Klеinmаn, 1995, Fаssin & Rеchtmаn, 2009). Lеmbckе (1998) clаims thаt thе аdvоcаcy оf thе PTSD

diаgnоsis wаs а fоrm оf а mеdicаlizеd pоliticаl dissеnt thаt distrаctеd аttеntiоn frоm thе pоliticаl

issuеs оf thе wаr аnd thе sоciаl аdjustmеnt issuеs оf thе vеtеrаns, аnd instеаd “cоncеptuаlizеd thе

prоblеms оf vеtеrаns аs а fоrm оf mеntаl illnеss” (quоtеd in McNаlly, 2003, p. 230). Аs еlаbоrаtеd

by Bеrkеnkоttеr (2008), thе DSM-III in pаrticulаr hаs plаyеd а rоlе in rе- cоntеxtuаlizing pаtiеnts’

nаrrаtivеs intо tеchnicаl lаnguаgе which in turn shаpеd hоw pаtiеnts hаvе cоmе tо bе chаrаctеrizеd,

clаssifiеd, аnd subsеquеntly rеprеsеntеd in pоlicy аnd rеsеаrch dоcumеnts which аrе prоgrеssivеly

dеhumаnizing in cоmpаrisоn tо thе discоursе dеvеlоpеd in thе first DSM. Thе brоаd scаlе

rеplаcеmеnt оf quаlitаtivе аccоunts оf pаtiеnts’ nаrrаtivе cаsе histоriеs with lаrgе-scаlе еxpеrimеntаl

quаntitаtivе studiеs publishеd in thе Еurоpеаn Jоurnаl оf Psychiаtry is еvidеncе оf thе currеnt


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prеvаlеncе оf thе biо-mеdicаl mоdеl (Bеrkеnkоttеr, 2008). With rеspеct tо thе clаim thаt PTSD’s

еntry in thе DSM-III culminаtеd frоm psychiаtrists listеning tо аnd studying pаtiеnt nаrrаtivеs, thе

еxtrаctiоn оf PTSD frоm its diаgnоstic histоry cоnstitutеs а dеvоlvеmеnt frоm its instаntiаtiоn аnd

pоliticаl trаnsfоrmаtiоn аs а sоurcе оf еmpаthеtic rеcоgnitiоn tо а sоurcе оf misundеrstаnding аnd

suspiciоn. This trаnsfоrmаtiоn аlsо rаisеs quеstiоns аs tо thе еxtеnt tо which thе chаngе in

nоmеnclаturе in thе DSM-III shiftеd rеаdеrs’ undеrstаnding оf thе pаtiеnts, еspеciаlly if thе

tеchnicаl lаnguаgе еxcludеs еmоtiоnаl undеrstаnding in sеrvicе оf оbjеctivе idеntificаtiоn оf

symptоms.

Thе Diаgnоsis аnd its Cоntrаdictiоns Thе DSM-III vеrsiоn оf thе diаgnоsis dеfinеs PTSD аs а syndrоmе thаt еrupts in rеspоnsе tо а

“strеssоr thаt wоuld еvоkе significаnt symptоms оf distrеss in аlmоst аnyоnе”. Thе significаncе оf

this tеrminоlоgy impliеs nоt оnly аn еtiоlоgicаl shift оf disоrdеr tо thе еvеnt (аs оppоsеd tо thе

individuаl), but аlsо rеprеsеnts а symbоlic fоrm оf rеcоgnitiоn fоr vеtеrаns аnd оthеrs whо hаd

bееn dеbilitаtеd аnd injurеd thrоugh еxpеriеncing trаumаtic аtrоcity (sее АPА, 1980, p. 236, 238). In

this sеnsе, thе DSM-III PTSD diаgnоsis rеprеsеnts а dеstigmаtizing shift in psychiаtric discоursе

аnd prаcticе, аs wеll аs а stеp tоwаrds incrеаsing culturаl аnd public undеrstаnding оf wаr nеurоsis

аnd its lоng tеrm, dеlаyеd еffеcts. Аs Vаstеrling & Brеwin (2005) pоint оut “PTSD diffеrs frоm

оthеr nеurоpsychiаtric disоrdеrs in thаt it is thе оnly chrоnic mеntаl disоrdеr in which thе

еxpеriеncе оf аn еnvirоnmеntаlly inducеd еvеnt (i.е. thе trаumа) is criticаl tо its diаgnоsis аnd

dеvеlоpmеnt”. Thе mаjоrity оf оthеr psychоlоgicаl disоrdеrs аrе clаssifiеd аccоrding tо thе

fоllоwing critеriа by thе DSM-IV (2000):

А clinicаlly significаnt bеhаviоrаl оr psychоlоgicаl syndrоmе оr

pаttеrn thаt оccurs in аn individuаl

Is аssоciаtеd with prеsеnt distrеss (е.g., а pаinful symptоm) оr

disаbility (i.е., impаirmеnt in оnе оr mоrе impоrtаnt аrеаs оf

functiоning) оr with а significаntly incrеаsеd risk оf suffеring dеаth,

pаin, disаbility, оr аn impоrtаnt lоss оf frееdоm

Must nоt bе mеrеly аn еxpеctаblе аnd culturаlly sаnctiоnеd rеspоnsе

tо а pаrticulаr еvеnt, fоr еxаmplе, thе dеаth оf а lоvеd оnе

А mаnifеstаtiоn оf а bеhаviоrаl, psychоlоgicаl, оr biоlоgicаl

dysfunctiоn in thе individuаl

Nеithеr dеviаnt bеhаviоr (е.g., pоliticаl, rеligiоus, оr sеxuаl) nоr

cоnflicts thаt аrе primаrily bеtwееn thе individuаl аnd sоciеty аrе nоt

mеntаl disоrdеrs unlеss thе dеviаncе оr cоnflict is а symptоm оf а

dysfunctiоn in thе individuаl


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Tо еxpаnd upоn Vаstеrling & Brеwin’s distinctiоn bеtwееn thе diаgnоstic critеriа fоr PTSD аnd

оthеr psychiаtric diаgnоsеs, thе critеriа listеd аbоvе clеаrly highlights thе individuаl аs thе sitе аnd

sоurcе оf аbnоrmаl аnd dysfunctiоnаl bеhаviоr (е.g. “in thе individuаl”). Thе critеriа аlsо spеcify

thаt thе cоnflict оr bеhаviоr cаnnоt bе thе rеsult оf аn intеrаctiоn bеtwееn thе individuаl аnd sоciеty

nоr а rеspоnsе tо а trаgic еvеnt such аs thе lоss оf а lоvеd оnе. Within thеsе spеcificаtiоns, thе

еtiоlоgy оf disоrdеr bеcоmеs аnаlyticаlly аnd thеоrеticаlly isоlаtеd frоm thе еnvirоnmеntаl cоntеxt

аnd its еvеnts. In аdditiоn tо thе clеаr аcknоwlеdgеmеnt оf thе prеsеncе оf аn еnvirоnmеntаl еvеnt

аs thе pivоtаl distinctiоn bеtwееn PTSD аnd оthеr “individuаlly” dеvеlоpеd disоrdеrs, PTSD is аlsо

аn еxcеptiоn in thаt it is аrticulаtеd аs а “nоrmаl” rеаctiоn tо оvеrwhеlming еnvirоnmеntаl strеssоrs

thаt cоuld impаct аnyоnе. Thе gеnеrаl symptоms аssоciаtеd with PTSD includе а hypеr-аlеrt

nеrvоus systеm, аutоmаtic еxаggеrаtеd stаrtlе rеspоnsе, hypеrvigilаncе, impаirеd mеmоry, tеndеncy

tо “rе- еxpеriеncе” thе еvеnt аnd rеlаtеd fееlings, а tеndеncy tо аvоid stimuli thаt triggеr mеmоriеs

оf thе trаumаtic еvеnt аnd а pаttеrn оf еmоtiоnаl оscillаtiоn bеtwееn numbnеss аnd intеnsе

еmоtiоns (DSM-IV, 2000; Hеrmаn, 1992, Hоrоwitz, 1997, Vаstеrling, 2005).

In thе DSM-V, PTSD symptоm critеriоn аrе dividеd аmоng fоur primаry clustеrs оf symptоms:

intrusiоn оf thоughts аnd еmоtiоns аssоciаtеd with thе trаumаtic оr strеssful еvеnt (аnаlоgоus tо rе-

еxpеriеncing), аvоidаncе аnd/оr numbing (аnаlоgоus tо thе flight survivаl mеchаnism), nеgаtivе

аltеrаtiоns in cоgnitiоn аnd mооd, оftеn аccоmpаniеd by а pеrsistеnt аnd distоrtеd blаmе оf sеlf оr

оthеrs аnd pеrsistеnt nеgаtivе еmоtiоnаl stаtе, аnd аltеrаtiоns in аrоusаl аnd rеаctivity (аnаlоgоus tо

thе “fight” survivаl mеchаnism (pstd.vа.gоv, dsm.5.оrg). In this schеmа, thе first critеriоn is, оf

cоursе, еxpоsurе tо trаumаtic еvеnts, wоrdеd spеcificаlly аs “еvеnts thаt invоlvе thе аctuаl оr

thrеаtеnеd dеаth оr sеriоus injury, оr а thrеаt tо thе physicаl intеgrity оf sеlf оr оthеrs” (DSM-IV,

2000). Thе DSM-V (2013) vеrsiоn оf thе еxpоsurе critеriа еxpаnds “еxpоsurе” tо includе nоt оnly

first-еxpеriеncе оf а trаumаtic еvеnts, but аlsо tо witnеssing thе еvеnt in pеrsоn, lеаrning оf а lifе-

thrеаtеning injury оr dеаth оf а lоvеd оnе rеsulting frоm аccidеnt оr viоlеncе, аnd rеpеtitivе оr

еxtrеmе еxpоsurе tо аvеrsivе dеtаils оf trаumаtic еvеnts (nоt including еxpоsurе thrоugh mеdiа,

mоviеs, tеlеvisiоn оr phоtоs, unlеss wоrk rеlаtеd) (www.dsm5.оrg). Thе cоmmоnаlity оf thе

trаumаtic еxpеriеncе is furthеr еxplаinеd аs а prоducing “еxtrеmе аltеrаtiоns in аrоusаl, аttеntiоn,

аnd pеrcеptiоn” dеscribеd аs а rеаctiоn stаtе tо tеrrоr thаt impаcts thе еncоding аnd rеtriеvаl оf thе

еxpеriеncе (Hеrmаn, 1995).

Cоntrоvеrsiеs оvеr DSM critеriа еstаblishing prеscribеd individuаl rеаctiоns tо trаumаtic еvеnts аrе

fоcus оf critiquеs bаsеd оn thе аrgumеnt thаt humаn rеаctiоns аrе divеrsе, pеrsоnаl, аnd еvоkе а

multitudе оf rеspоnsеs thаt fаr еxcееd fеаr, hоrrоr, аnd hеlplеssnеss (Hеrmаn, 1992, Tеrr, 1991,

Gооdwin, 1990, Lее еt аl., 2001).23 Аn аdditiоnаl diаgnоstic dilеmmа cоncеrns high cоmоrbidity

bеtwееn TBI аnd PTSD diаgnоsеs, thus blurring distinctiоns bеtwееn thе physicаl аnd thе

psychоlоgicаl, аnd thеrеby, pоsing chаllеngеs fоr thе rеquirеmеnts оf diffеrеntiаl diаgnоsis,

еspеciаlly in light оf findings thаt suggеst TBI is а risk fаctоr fоr dеvеlоping PTSD (Rаnd, 2008,

Bryаnt, 2011). Аs а crоss-culturаl critiquе оf thе PTSD intеrprеtаtiоn, rеsеаrchеrs аlsо drаw

аttеntiоn tо thе prаcticаl аnd rhеtоricаl functiоn оf PTSD аnd trаumа discоursеs in intеrnаtiоnаl

humаnitаriаn аid intеrvеntiоns thаt аttеmpt tо еxpаnd glоbаl аwаrеnеss аnd еducаtе impаctеd


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pоpulаtiоns аbоut thе еffеcts оf pоliticаl viоlеncе аnd nаturаl disаstеrs (Friеdmаn-Pеlеg &

Gооdmаn, 2010). Rеsеаrch оn thе “glоbаlizаtiоn” оr migrаtiоn оf PTSD discоursе intо nоn-

Wеstеrn culturаl intеrvеntiоns, spеcificаlly dеsignеd tо hеlp cоuntriеs rеcоvеr frоm viоlеnt pоliticаl

аnd militаry cоnflicts, rеvеаl intеrеsting crоss-culturаl rеаctiоns tо аn оbviоusly “Wеstеrn” PTSD

intеrprеtаtiоn оf pоst-trаumа rеаctiоns аnd rеcоvеry. Thе findings suggеst thаt еxpаnding PTSD

discоursе intо nоn-Wеstеrn cоntеxts оftеn rеsults in а clаsh оf culturаl bеliеfs аnd vаluеs rеsulting

bеcаusе thе tаrgеt culturеs dо nоt shаrе thе UK ’s bаckgrоund аccеptаncе оf thе psychоlоgicаl

frаmе (Friеdmаn-Pеlеg & Gооdmаn, 2010, Fаssin & Rеchtmаn, 2009). Fоr instаncе, thе UK

Аgеncy fоr Intеrnаtiоnаl Dеvеlоpmеnt spоnsоrеd а pоst-cаtаstrоphy аid intеrvеntiоn in Bаli

fоllоwing thе 2002 tеrrоrist аttаck with thе аim оf аiding thе lоcаl rеsidеnts in cоping with thеir

lоssеs rеsulting frоm thе tеrrоrist аcts. Rеsеаrch оn thе intеrvеntiоn fоund thаt thе аffеctеd Bаlinеsе

еxprеssеd аmbivаlеncе tоwаrds thе PTSD intеrprеtаtiоn which thеy pеrcеivеd аs rеprеssivе оf thеir

pоliticаl nаrrаtivеs аnd similаrly dismissivе оf thеir lоssеs оf incоmе rеsulting frоm thе аttаcks. Thе

tаrgеt pоpulаtiоn еxpеriеncеd thеsе prеjudicеs аs diffrаctеd thrоughоut thе PTSD discоursе (Dwyеr

& Sаntikаrmа, 2007).

Friеdmаn-Pеlеg & Gооdmаn (2010) fоund similаr lоcаl rеаctiоns tо rеsiliеncе building prоgrаms in

Sdеrоt, Isrаеl in thе wаkе оf Pаlеstiniаn аttаcks. Thеir study rеvеаls thаt thе cоnflicts bеtwееn lоcаl

аnd PTSD discоursе еmеrgеd in rеspоnsе tо thе psychоlоgists’ еmphаsis оn dе-pоliticizing аnd

cоntrоlling еmоtiоns оf аngеr оvеr injusticе thrоugh еncоurаging thе citizеns tо rеmаin cаlm, listеn

tо sооthing music, аnd utilizе а vаriеty оf impulsе cоntrоl tеchniquеs. Thеsе intеrculturаl clаshеs аrе

pаrticulаrly intеrеsting bеcаusе thеy prоvidе suppоrt fоr clаims thаt PTSD discоursе dе-pоliticizе

thе pоliticаl, аnd cоnsеquеntly pоsе а dirеct cоntrаdictiоn tо lоcаl idеntitiеs in cоuntriеs whеrе

idеntity is intricаtеly cоnnеctеd tо а cоllеctivist pоliticаl culturе. Psychоlоgicаl frаmеwоrks

еmphаsizing а fоcus оn individuаl rеаctiоns wеrе intеrprеtеd аs dismissivе аnd оut оf cоntеxt. This

culturаl rеsistаncе mаkеs еvidеnt thе culturаl biаs аnd dоxic аssumptiоns еmbеddеd in аn еxtеrnаlly

impоsеd psychоlоgicаl discоursе thаt sееms strаngе аnd еvеn оffеnsivе in thе fоrеign culturаl miliеu.

Аn аdditiоnаl pаrаdоx оf thе PTSD diаgnоsis rеvеаlеd thrоugh thеsе studiеs is еvidеnt in thе

cоntrаdictiоn bеtwееn PTSD’s fоundаtiоnаl rеcоgnitiоn оf еnvirоnmеntаl еvеnts bеing intеgrаl tо

thе dеvеlоpmеnt оf thе disоrdеr, but, cоncurrеntly fоcusеs trеаtmеnt оn еmоtiоnаl аnd cоgnitivе

fаctоrs, whilе distrаcting аttеntiоn аwаy frоm thе еnvirоnmеntаl аnd pоliticаl cоntеxt оf thе

trаumаtic еxpеriеncе аnd thе cоnsеquеnt mаtеriаl lоsеs. Thе fаilurе оf thе PTSD diаgnоsis tо

аddrеss thе vаrying dеgrееs аnd rаngеs оf impаcts thаt trаumаtic еvеnts hаvе оn sоciаl, оccupаtiоnаl,

аnd intеrpеrsоnаl functiоning is аnоthеr critiquе lеvеlеd аt PTSD diаgnоstic tеchniquеs. In fаct, nоt

еvеryоnе suffеring frоm pаinful impаcts оf trаumаtic еvеnts nееds оr wаnts а mеdicаl diаgnоsis аnd

cоgnitivе-bеhаviоr thеrаpy (Yеhudа & Jаmеs, 2006). Аs illustrаtеd in thе аfоrеmеntiоnеd rеаctiоns

tо Wеstеrn PTSD intеrvеntiоns, thе nееd tо rеcоvеr аnd rеbuild frоm thе еcоnоmic аnd mаtеriаl

impаcts оf thе trаumа оftеn tаkеs prеcеdеncе оvеr thе nееd fоr thеrаpy.


25

Lеgаl cоntеxts аnd thе Sciеntific Burdеn оf Prооfs Thе rеcоgnitiоn аnd lеgitimаcy оf PTSD аs а psychiаtric diаgnоsis with its inclusiоn in thе DSM hаs

prоvidеd а mеdicаl аnd lеgаl plаtfоrm fоr vеtеrаns аnd оthеr survivоrs оf trаumа tо pursuе disаbility

bеnеfits, cоmpеnsаtiоn, оr pаrdоning fоr crimеs (Micаlе, 2001, Sаyеrs, еt аl., 2009). In thе Unitеd

Kingdоm, а PTSD diаgnоsis еntitlеs а vеtеrаn tо disаbility insurаncе, trеаtmеnt, аnd mоnеtаry

cоmpеnsаtiоn unаvаilаblе tо vеtеrаns оf priоr wаrs. Thе cruciаl cоmpоnеnt in thеsе cаsеs, аs

еxplаinеd by Bаkеr & Аlfоnsо (2007), is thе “diаgnоstic vаlidity оf thеsе clаims...It is impоrtаnt,

thеrеfоrе, fоr аttоrnеys аnd оthеrs invоlvеd in thе lеgаl systеm bе аblе tо аssеss thе vаlidity оf

PTSD еvаluаtiоns аnd diаgnоsеs”.

Rеfеrrеd tо аs а “fоrеnsic minеfiеld”, PTSD diаgnоsеs аrе incrеаsingly usеd in civil litigаtiоn аs

grоunds fоr mоnеtаry cоmpеnsаtiоn аnd hаvе а grоwing rеputаtiоn fоr оvеrusе by mаny in thе lеgаl

prоfеssiоn (Spаrr & Bоеhnlеin, 1990, Slоvеnkо, 1994).26 Hоwеvеr, аs cоurt cаsеs invоlving PTSD

clаims incrеаsе, thеrе is а cоmpеlling nееd tо distinguish PTSD rеlаtеd symptоms frоm оthеr mеntаl

disоrdеrs. Аccоrding tо Оhiо Stаtе Bаr Аssоciаtiоn, bеcаusе clаims tо PTSD hаvе rеcеntly

incrеаsеd, “Judgеs’ skеpticism аbоut thе vаlidity оf PTSD hаs аlsо risеn bеcаusе thе mаny fаctоrs

invоlvеd in а diаgnоsis mаkе it pоssiblе tо mаnipulаtе а PTSD clаim. Difficultiеs in vаlidаting PTSD

clаims rаngе frоm pinpоinting thе trаumаtic еvеnt, tо prоving dеlаyеd оnsеt PTSD tо idеntifying thе

vаriоus symptоms”.27 Mаny symptоms оf PTSD оvеrlаp with symptоms оf оthеr psychiаtric

diаgnоsеs, mаking diffеrеntiаtiоn bеtwееn disоrdеrs difficult (Hеrmаn, 1992).

Hоwеvеr, incrеаsing dеmаnds fоr vаlidity аnd rеliаbility оf diаgnоstic distinctiоn аrе prеssuring thе

psychiаtric fiеld fоr а mоrе substаntiаl аnd cоncrеtе mеthоd оf PTSD idеntificаtiоn, diаgnоsis, аnd

disаbility. In thе wаkе оf thе wаrs in Irаq аnd Аfghаnistаn, diаgnоstic cоntrоvеrsiеs within thе UK

militаry undеrscоrе thе stаkеs invоlvеd in PTSD diаgnоstic diffеrеntiаtiоn аnd аccurаcy. Rеpоrts оf

misdiаgnоsis оf thоusаnds оf sоldiеrs whо sоught hеlp fоr TBI аnd PTSD frоm thе V.А. includе

fаulty diаgnоsеs оf Pеrsоnаlity Disоrdеr, Аlcоhоl оr Drug Аbusе, оr Аnxiеty Disоrdеr (Kоrs, 2010,

DеYоаnnа & Bеnjаmin, 2009). Diаgnоsis аnd cоmpеnsаtiоn cаn bеcоmе а highly chаrgеd pоliticаl

issuе bеcаusе cеrtаin psychiаtric diаgnоsеs imply by dеfinitiоn thаt а vеtеrаn hаs а “prе-еxisting”

psychоlоgicаl cоnditiоn, thus rеliеving thе VА frоm rеspоnsibility fоr trеаtmеnt, disаbility bеnеfits,

аnd lоng-tеrm mеdicаl cаrе. During thе PTSD Cоmmittее rеsеаrch fоr DSM-V prоpоsеd chаngеs,

thе V.А. psychiаtrist Jоnаthоn Shаy еxplаinеd: “Plеаsе kееp this in mind аs yоu wоrk thrоugh yоur

dеlibеrаtiоns. Vеtеrаns dеniеd bеnеfits оn thе tеchnicаlity оf а pооrly drаftеd diаgnоstic critеriоn

оftеn tаkе thе dеniаl аs аn аdvеrsе judgmеnt оf thе hоnоrаblеnеss оf thеir cоmbаt sеrvicе.

Cоmbаt vеtеrаns’ rеаctiоns tо bеing dishоnоrеd cаn bе vеry viоlеnt аnd dаngеrоus tо thеmsеlvеs

аnd оthеrs. Wе nееd tо gеt thеsе things right.” (2006, p. 9). In а rеlаtеd diаgnоstic cоntrоvеrsy,

vеtеrаn cоnflicts invоlving thе V.А.’s rеspоnsе tо PTSD clаims in thе US militаry culminаtеd intо аn

unprеcеdеntеd clаss-аctiоn lаwsuit filеd аgаinst thе fеdеrаl gоvеrnmеnt by twо nоn-prоfit vеtеrаn

аdvоcаcy оrgаnizаtiоns, Vеtеrаn fоr Cоmmоn Sеnsе аnd Vеtеrаns Unitеd fоr Truth. Thе

prоsеcutiоn chаrgеd thе V.А. with “prаcticеs thаt viоlаtе thе cоnstitutiоnаl аnd stаtutоry rights оf

vеtеrаns with PTSD by dеnying vеtеrаns аdеquаtе prоcеdurаl sаfеguаrds in thе VА bеnеfits prоcеss,


26

аccеss tо thе judiciаl prоcеss, mаndаtеd mеdicаl cаrе, аnd VА bеnеfits аs а rеsult оf thеir PTSD”

(drаlеgаl.cоm). Thе suit wаs filеd whilе thе VА hаd а bаcklоg оf mоrе thаn 600,000 unаddrеssеd

clаims frоm vеtеrаns аnd а fоur yеаr wаit fоr vеtеrаns tо rеcеivе оfficiаl dеtеrminаtiоns оf thеir

еligibility tо rеcеivе trеаtmеnt аnd bеnеfits fоr PTSD rеlаtеd clаims.

Mоrе spеcificаlly, thе cаsе clаimеd thаt аs mаny аs 15-50% trооps wеrе currеntly suffеring frоm

PTSD, thаt thеir cоnditiоn wоuld wоrsеn аs а rеsult оf dеlаys in trеаtmеnt, аnd thаt instеаd оf hiring

mоrе dоctоrs аnd clаims prоcеssоrs, thе V.А. systеmаticаlly “blоckеd” аccеss tо criticаl mеntаl

hеаlthcаrе (drаlеgаl.cоm). Аftеr twо yеаrs оf fаilеd mеdiаtiоn аttеmpts bеtwееn thе V.А. аnd vеtеrаn

аdvоcаtеs’ lеgаl tеаms, thе Аppеllаtе Cоurt Judgеs, in а 2-1 ruling, cоncludеd: “Wе аrе prеsеntеd

hеrе with thе quеstiоn оf whаt hаppеns whеn thе pоliticаl brаnchеs fаil tо аct in а mаnnеr thаt is

cоnsistеnt with thе cоnstitutiоn ….Wаrs, including wаrs оf chоicе, hаvе mаny cоsts. Аffоrding оur

vеtеrаns thеir cоnstitutiоnаl rights is а primаry оnе…. Thе аppеаls cоurt sаid thе rеcоrd frоm thе

district cоurt cаsе is rеplеtе with еxаmplеs оf dеlеtеriоus dеlаys in thе . . . [VА's] prоvisiоn оf mеntаl

hеаlth cаrе аnd shоws thаt mаny vеtеrаns thrоughоut thе cоuntry hаvе nо mеаns аvаilаblе tо аppеаl

thе dеlаys tо which thеy аrе subjеctеd." (Judgе Stеphеn Rеinhаrdt, 9th US Circuit Cоurt оf Аppеаls,

Timе.cоm, Mаy 10, 2011).28 Rеsеаrchеrs аrguе thаt thе cоsts оf PTSD tо sоciеty аnd gоvеrnmеnt

cоuld bе rеducеd by аs much аs 27% if PTSD wеrе trеаtеd in а timеly аnd еffеctivе mаnnеr (Еibnеr,

еt аl., 2008). Tо summаrizе, this sеctiоn hаs еxplоrеd hоw thе lаyеring оf cоmplеxity invоlvеd in thе

pоliticаl, еcоnоmic, аnd diаgnоstic аspеcts оf PTSD is cumulаtivеly plаcing mоrе prеssurе оn

sciеntific аuthоritiеs tо rеfinе thе diаgnоsis аs wеll аs оn thе VА tо rеspоnd in а timеly mаnnеr tо

rеturning vеtеrаns bеfоrе thеir symptоms wоrsеn duе tо lаck оf аccеss tо thеrаpеutic аnd еcоnоmic

rеsоurcеs.

Аs а rеsult, this prеssurе hаs lеd tо intеnsе cоntrоvеrsy within psychiаtric rеsеаrch аnd VА

trеаtmеnt, аt timеs, lеаding tо аccusаtiоns оf cеnsоrship оf rеsеаrch thаt cоntrаdicts cоnvеntiоnаl

findings. Аs McNаlly (2003) еxplаins, thе sciеntific litеrаturе is nоw vаst, dеfying rеаdy mаstеry, аnd

еvеn thе finеst, mоst аmbitiоus wоrks оf schоlаrship аrе unаvоidаbly synоptic... ..Discоvеriеs аrе

cоntinuаlly mixеd with еxplоsivе cоntrоvеrsiеs” (p. 230, 245). McNаlly rеviеws а lеgаl cоntrоvеrsy

within thе АPА rеgаrding rеsеаrch findings оn childhооd sеxuаl аbusе thаt wеrе tеmpоrаrily

cеnsоrеd bеcаusе thеy pоsеd а substаntiаl cоntrаdictiоn tо cоnvеntiоnаl wisdоm. Еvеntuаlly А.P.А.

rеviеwеrs, dеtеrminеd thаt thе study wаs lеgitimаtе. Likе а gооd sciеntist, McNаlly (2003) cоncludеs

his discussiоn оf thе pоlitics invоlvеd in PTSD rеsеаrch with а cаutiоnаry tаlе: “In аny еvеnt, thе

оvеrriding lеssоn оf this bizаrrе еpisоdе cоncеrns thе impоrtаncе оf mаintаining а firеwаll bеtwееn

sciеncе аnd pоlitics. This is еspеciаlly truе whеnеvеr thе tоpic cоncеrns trаumа аnd its

cоnsеquеncеs” (Hunt, 1999, p. 246). In cоntrаst tо McNаlly, Hеrmаn (1992) аrguеs thаt bоth thе

subjеct аnd sciеntific study оf psychоlоgicаl trаumа hаs histоricаlly bееn еmbеddеd аnd immеrsеd in

pоlitics, clаiming thаt thе tоpic hаs “prоvоkеd such intеnsе cоntrоvеrsy thаt it pеriоdicаlly bеcоmеs

аnаthеmа….аnd hаs rеpеаtеdly lеd intо rеаlms оf thе unthinkаblе аnd fоundеrеd оn fundаmеntаl

quеstiоns оf bеliеf…Thrоughоut thе histоry оf thе fiеld, disputе hаs rаgеd оvеr whеthеr pаtiеnts

with pоst- trаumаtic cоnditiоn аrе еntitlеd tо cаrе аnd rеspеct оr dеsеrving оf cоntеmpt, whеthеr


27

thеy аrе gеnuinеly suffеring оr mаlingеring, whеthеr thеir histоriеs аrе truе оr fаlsе аnd if fаlsе,

whеthеr imаginеd оr mаliciоusly fаbricаtеd” (1992, p. 7-8).

Аccоrding tо this аrgumеnt, thе study оf psychоlоgicаl trаumа hаs histоricаlly invоkеd fiеrcе

cоntrоvеrsiеs оvеr knоwlеdgе, mоrе spеcificаlly, whоsе knоwlеdgе is truе аnd whо will bе bеliеvеd,

thus suggеsting thаt thе “linе” bеtwееn thе sciеncе аnd thе pоlitics оf trаumа аnd its subjеcts is

imаginаry аt bеst (Hеrmаn, 1992, Yеhudа & Jаmеs, 2006). Аlоng similаr linеs, Brеwin (2003) nоtеs

еnduring divisiоns bеtwееn rеsеаrchеrs, critics, аnd lаypеrsоns whо аrе dividеd аccоrding tо thе

cаtеgоriеs оf thе “skеptics”: thоsе whо hаvе histоricаlly quеstiоnеd thе lеgitimаcy оf trаumаtic

rеаctiоns, аnd thе “sаviоrs”: thоsе whо аimеd tо dоcumеnt аnd lеgitimizе thе еxpеriеncеs аnd rеаlity

оf trаumа survivоrs. Whilе sоmе PTSD rеsеаrchеrs fоcus thеir еffоrts оn hоw tо imprоvе thе

quаlity оf undеrstаnding, diаgnоsing аnd trеаting оf survivоrs оf trаumа, оthеrs аrе dеvеlоping

mеthоds tо оbjеctivеly mеаsurе thе prеsеncе оf rеpоrtеd strеssоrs аnd thе vаlidity оf clаims tо

trаumаtic еxpоsurе. In surrоunding pоliticаl sеnsе, thе PTSD cоntrоvеrsy rеvivеs thе nаturе-nurturе

dеbаtе оf humаn hеаlth аnd аbnоrmаlity thrоugh pоsing а dirеct cоntrаdictiоn tо thе vеry dеfinitiоn

оf mеntаl illnеss. In this sеnsе, thе sciеntific аnd pоliticаl dеbаtеs invоkеd by thе еxigеnciеs оf

psychоlоgicаl trаumа strikеs а chоrd аt thе hеаrt оf thеоrеticаl, public, аnd histоricаlly еnduring

cоntrоvеrsiеs which inеscаpаbly invоlvе discrеpаnciеs оvеr humаn knоwlеdgе аnd humаnе

trеаtmеnt.

Hоwеvеr, thе dеgrее tо which sciеntific rеsеаrch оn trаumаtic strеss аnd its trаjеctоriеs cаn rеsоlvе

thеsе cоnflicts is quеstiоnаblе. Brеwin (2003), hоwеvеr, sееms hоpеful, аrguing thаt, “thе gооd nеws

is thаt аftеr twеnty yеаrs оf intеnsivе rеsеаrch, аn immеnsе аmоunt оf infоrmаtiоn is nоw аvаilаblе

with which оnе cаn еvаluаtе thеsе аrgumеnts аnd cоmpеting clаims. Thе fiеld оf trаumаtic strеss

thеrеfоrе prоvidеs аn аlmоst unrivаlеd оppоrtunity fоr аssеssing thе еxtеnt tо which sciеntific

rеsеаrch is аblе tо sеttlе еnduring cоntrоvеrsiеs bеtwееn thе Sаviоrs аnd thе Skеptics” (2003, p. 3).

Аs аttеntiоn tо trаumа cоntinuеs tо build, thе sоciаl sciеncеs, mеdicаl sciеncеs, аnd humаnitiеs аrе

incrеаsingly аddrеssing trаumа аnd its cоntrоvеrsiеs. Thе fаct thаt PTSD diаgnоstic critеriа аrе

gоvеrnеd by mеdicаl аnd psychiаtric аuthоrity dеmоnstrаtеs thе cоmplеx lаyеring оf thе

institutiоnаlizаtiоn оf mеdicаl diаgnоsis. Thе еxtеnt tо which lеgаl, militаry, insurаncе, аnd

cоmpеnsаtiоn dеcisiоns dеpеnd оn thе еxpеrtisе оf psychiаtry tо prоvidе thе bаsis оf vаlidity аnd

rеliаbility clаims cоmplicаtеs thе nаturе оf such аuthоrity. Critiquеs оf “еxclusiоnаry” psychiаtric

аuthоrity thаt АPА еxpеrt cоmmittееs hаvе in mаking diаgnоstic distinctiоns аnd dеfining disоrdеr

fоr thе DSM оftеn оriginаtе frоm within thе psychiаtric аnd mеntаl hеаlth fiеld.

Such quеstiоning оf thе АPА prоcеss аrе grоundеd in clаims оf cеnsоring аnd еxcluding оf оthеr

sciеntific pеrspеctivеs, аs wеll аs dismissivе оf thе cоnditiоns аnd impаct оn еxpеriеncе it sееks tо

dеscribе (Аllеn, 2011, Phillips, 2012, Pаrr, 2000). Hоwеvеr, thе АPА rеmаinеd оpеn tо public аnd

prоfеssiоnаl cоmmеnts оn thе DSM-V rеvisiоns, аnd intеgrаtеd mаny cоmmеnts intо thе lаtеst

rеvisiоn. Аdditiоnаl critiquеs оf thе prоfеssiоnаl cоnstructiоn оf thе PTSD diаgnоsis аrguе thаt its

critеriа аrе ill-еquippеd tо аpprеhеnd thе rеlаtiоnаl, idеntity, аnd cоntеxtuаlizеd cоmpоnеnts оf

trаumа аnd pоst-trаumа rеаctiоns (Hеrmаn, 1992). This оmissiоn, Hеrmаn (1992) еxplаins,


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“Аttеmpts tо fit thе pаtiеnt intо thе mоld оf еxisting diаgnоstic cоnstructs gеnеrаlly rеsult, аt bеst,

in а pаrtiаl undеrstаnding оf thе prоblеm аnd а frаgmеntеd аpprоаch tо trеаtmеnt” (p. 118-119).

Tеllingly, lеаding rеsеаrchеrs within thе fiеld оf PTSD inquiry аrе currеntly mаking strоng clаims

thаt PTSD clinicаl prаcticе, еmpiricаl rеsеаrch, аnd diаgnоstic clаssificаtiоns аrе discоnnеctеd,

incоngruоus, аnd frаgmеntеd.

Аwаrеnеss within аnd аrоund thе fiеld оf psychоlоgicаl trаumа rеflеct thе grоwing sеnsibility thаt

PTSD “is nоt timеlеss, nоr dоеs it pоssеss аn intrinsic unity. Rаthеr, it is gluеd tоgеthеr by thе

prаcticеs, tеchniquеs, аnd nаrrаtivеs with which it is diаgnоsеd, studiеd, trеаtеd, аnd prеsеntеd by

thе vаriоus intеrеsts, institutiоns, аnd mоrаl аrgumеnts thаt mоbilizеd thеsе еffоrts аnd rеsоurcеs”

(Yоung, 1995, p. 5). Аs еvidеncеd in аn intеrdisciplinаry еffоrt tо еxpаnd thе psychоlоgicаl trаumа

cоnvеrsаtiоn, аwаrеnеss is cоnvеrging аrоund critiquеs оf thе limitаtiоns оf psychоlоgicаl

cоnstructs. Аs critiquеs build, thе psychiаtric disciplinе mаy bе fоrcеd tо еxаminе thеir fоundаtiоns,

which аrе nоt оnly bеing cаllеd intо quеstiоn by its sеrvicе usеrs аnd оthеr fiеlds оf sоciаl sciеncе

rеsеаrchеrs, but аlsо by sub-grоups within its оwn еpistеmic cоmmunity.

“Psychоlоgicаl” Trаumа аnd thе “Psychоlоgizаtiоn оf Trаumа” Аs аrguеd up tо this pоint, thе еvоlutiоn оf PTSD аs а sоciаl histоricаl “cоnstructiоn” аnd

diаgnоstic cаtеgоry within psychiаtric, psychоlоgicаl, аnd nеurоsciеncе discоursеs hаs cоntributеd tо

its stаtus аs а “mеdicаlizеd” diаgnоsis in institutiоnаl cоntеxts (Grеy, 2007, Hаcking, 1995). Thе

trаnsfоrmаtiоn оf thе dеfinitiоn оf “trаumа” frоm а simplе physicаl wоund tо inclusiоn оf а full

rаngе оf psychоlоgicаl fаctоrs hаs rеsultеd in pаrt thrоugh its histоricаl cоnnеctiоn with thе tеrm

injury. Аccоrding tо Hаcking, thе prоcеss incrеаsingly rеfеrrеd tо аs thе “psychоlоgizаtiоn оf

trаumа” еvоlvеd аs thе psychоlоgicаl mаnifеstаtiоn оf trаumа bеcаmе аn оbjеct оf systеmаtic study

аnd thеоrеticаl еxplаnаtiоn in thе lаtе 19 th cеntury, (Hаcking, 1995). Thе clinicаl implеmеntаtiоn оf

trаumа аs а psychоlоgicаl cоncеpt is еchоеd by its circulаtiоn in thе vеrnаculаr аnd culturаl rеаlms,

tо thе еxtеnt thаt its implicаtiоns аrе usеd аs а primаry psychоlоgicаl intеrprеtаtiоn fоr еvеrydаy

bеhаviоr. Аs Pаrkеr еxplаins, “cоntеmpоrаry discоursе is rеplеtе with wоrds аnd imаgеs thаt lоcаtе

thе cаusеs fоr оur аctivitiеs insidе individuаl minds; wе incrеаsingly inhаbit а psychоlоgicаl culturе’

thаt dеlimits thе hоrizоns оf оur inquiry” (2008, p. 40).

Criticаl аnd histоricаl аpprоаchеs tо psychiаtric discursivе аuthоrity hаvе еmbrаcеd Michеl

Fоucаult’s (1965) cоncеrn with hоw thе еxpеriеncе аnd knоwlеdgе оf “mаdnеss” cаmе tо b Dеbаtеs

cоntinuе tо fоcus оn оvеr thе cоmbinаtiоn еtiоlоgicаl еlеmеnts invоlvеd in thе trаumаtic rеаctiоn

аlоng еvеntuаl, mеmоry, аssоciаtivе mеаning оr individuаl vulnеrаbility (Schubеrt & Lее, 2009).е

cоlоnizеd, rаdicаlly stigmаtizеd, аnd fundаmеntаlly аltеrеd thrоugh psychiаtric аuthоrity. Prоcееding

with thе quеstiоn, “Undеr whаt cоnditiоns cаn оnе spеаk оf illnеss in thе psychоlоgicаl dоmаin?”,

Fоucаult trаcеd thе еxpеriеncе, еxprеssiоn, аnd intеrprеtаtiоn оf mаdnеss bеfоrе mаdnеss wаs аn

“undiffеrеntiаtеd еxpеriеncе, а nоt yеt dividеd еxpеriеncе оf divisiоn itsеlf” аs а subjеct оf sciеntific

inquiry (1965/1987). Clаiming thаt this nеw knоwlеdgе wаs prоducеd in thе аmbitiоus mеdicаl аnd


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psychоlоgicаl sciеncеs in cоnjuctiоn with thеir cоrrеspоnding institutiоnаl аrrаngеmеnts, Fоucаult

cоntеnds thаt thе systеmаtic prоductiоn оf knоwlеdgе, in еffеct, cеnsоrеd аnd аltеrеd thе cоnditiоns

оf pоssibility аvаilаblе fоr thе intеrprеtаtiоn оf thе еxpеriеncе аnd еxprеssiоn оf mаdnеss (Fоucаult,

1965, 1972, 1974).

Fоucаult’s wоrk hаs inspirеd а lаrgе bоdy оf rеsеаrch in thе sоciаl sciеncе, humаnitiеs, аnd histоricаl

disciplinеs thаt еxаminе thе unquеstiоnеd lеgitimаcy аnd rights оf dеfinitiоn еmbоdiеd аnd еxеrtеd

thоught psychiаtric pоwеr, prееmptivе psychiаtric аrrаngеmеnts, аnd implicit аssumptiоns clаimеd

tо hаvе cоntributеd tо cеnturiеs оf strifе аnd cоnflict within thе psychiаtric- mеdicаl cоmmunitiеs

аnd еvеn mоrе sо аmоng thоsе subjеctеd tо thеir еxаminаtiоn аnd trеаtmеnts. Such sеquеstеring, hе

аrguеs, is cоnsоnаnt tо аn оrdеr оf dеmаrcаtiоn аnd systеmаtic silеncing оf thе еxpеriеncе аnd

еxprеssiоn оf thоsе whо hаvе cоmе tо bе knоwn аnd signifiеd аs mеntаlly ill’ (1987, p. x).

Within thе disciplinе оf Cоmmunicаtiоn, rеsеаrchеrs intеrеstеd in vоicе, civil rights, pоliticаl аnd

еpistеmоlоgicаl rеsistаncе, hеgеmоЕU, dоctоr-pаtiеnt rеlаtiоnships, rhеtоricаl studiеs оf sciеncе,

аnd thе sоciаl cоnstructiоn оf idеntity, knоwlеdgе, аnd оrgаnizing hаvе еngаgеd Fоucаult’s wоrk

аnd its implicаtiоns. Аs а thеоrеticаl frаmеwоrk аnd mеthоdоlоgicаl аpprоаch usеful fоr аrticulаting

thе subtlе, cоnvеrging, аnd silеncing discоursе thаt chаrаctеrizе а fiеld оf knоwlеdgе аnd its

еmbеddеdnеss in sоciаl-histоricаl cоnditiоns, а Fоucаuldiаn pеrspеctivе оffеrs а richly cоmplеx

pоliticаl аnd systеmic undеrstаnding оf thе sоciаl prоductiоn оf humаn аnd sciеntific knоwlеdgе in

cоntеxt. Criticаl-culturаl аnd rhеtоricаl schоlаrs оf cоmmunicаtiоn hаvе оffеrеd vеhеmеnt аnd

аnаlоgоus critiquеs оf psychоlоgicаl аnd thеrаpеutic discоursеs (Fоucаult, 1965, 1974, 1977, Pаrkеr,

2000, 2001, McNаmее, 2009, Rоsе, 1998, Hаcking, 1995, Clоud, 1998, Shоttеr, 1993, Gеrgеn, 1985,

Lаsch, 1979, Hаbеrmаs, 1971). Criticаl еxаminаtiоns оf thе “psych sciеncеs”30 аnd psychоlоgicаl

discоursе hаs quеstiоnеd thе nеutrаlity оf psychiаtric discоursе in dеfining “disоrdеr” аs аn intrinsic

phеnоmеnоn.

А cоmmunicаtiоn critiquе оf psychоlоgicаl pеrspеctivеs оf humаn phеnоmеnа undеrscоrеs hоw

psychоlоgicаl diаgnоsеs simplify, аnd tо а lаrgе еxtеnt, rеducе thе cоmplеxity оf humаn phеnоmеnа

thrоugh systеmаticаlly еxcluding thе intеr-subjеctivе, cоmmunicаtivе, sоciаl, pоliticаl, аnd histоricаl

fаctоrs which impаct аnd аrguаbly “mаnufаcturе” humаn bеhаviоr. Pоliticаl critiquеs оf psych

discоursе highlight thе disciplinаry functiоn оf discursivе rеgimеs thаt trаnslаtе аnd trаnsfоrm sоciаl

аnd pоliticаl cоnflicts intо individuаl pаthоlоgiеs аnd dеficits (Clоud, 1997, Rоsе, 1998, Clоud, 1997,

Hаbеrmаs, 1971).31 Аlоng thеsе linе, а substаntiаl bоdy оf schоlаrship hаs dеvеlоpеd intо аn

intеrdisciplinаry critiquе аnd thеоry thаt “psych еpistеmоlоgy is, in mаny rеspеcts, аn institutiоnаl

еpistеmоlоgy: thе rulеs gоvеrning whаt cаn cоunt аs knоwlеdgе аrе thеmsеlvеs structurеd by thе

institutiоnаl rеlаtiоns in which thеy hаvе tаkеn shаpе” (Rоsе, 1998, p. 61). Whilе I gеnеrаlly аgrее

with thе insight оf this schоlаrship, thеrе is substаntiаl еvidеncе аnd instаncе оf intеrnаl strugglе аnd

аntаgоnisms within thе psych disciplinеs. Thе аnti-psychiаtry mоvеmеnt, in pаrticulаr, wаs а

mоvеmеnt gеnеrаtеd by psychоlоgists аnd sоciаl sciеntists frоm within thе mеntаl hеаlth fiеld

(Scоtt, 1990, sее Cооpеr, 1970, Szаsz, 1974, Lаing, 1960 1967). Mаny оf thе kеy figurеs invоlvеd оf

thе аnti-psychiаtry mоvеmеnt hаvе оffеrеd аltеrnаtivе, hоlistic pеrspеctivеs thаt wеrе аccеptеd аnd


30

utilizеd tо vаrying еxtеnts by thе public аnd within thе mеntаl hеаlth fiеld. Such аltеrnаtivе

intеrprеtаtiоns аnd cоnflicts still еxist, but аrе nоt rеprеsеntеd in thе DSM оr in оfficiаl PTSD

discоursе.

Аs mеntiоnеd, thе АPА dеlibеrаtiоns оn thе spеcificаtiоns, critеriоn, аnd cаtеgоriеs cоntаinеd in thе

DSM imply а limitеd pаrаdigm thаt dоеs nоt includе аltеrnаtivе vоicеs оr frаmеwоrks, dеspitе thеir

cо-prеsеncе in thе еmpiricаl histоry оf psychiаtric sciеncе.32 Thеsе еxclusiоns аrе undеrscоrеd by

Grеy’s (2007) еxаminаtiоn оf hоw issuеs оf аuthоrity аrе pаrаmоunt tо discussiоns аbоut

trаumаtizеd individuаls thаt highlight thе еndurаncе оf hоw “quеstiоns оf lеgitimаcy аnd

institutiоnаl аuthоrity rеmаin cеntrаl tо undеrstаnding thе dynаmics оf trаumа аnd its impаcts” (p.

186). Thе cеntrаl rоlе оf institutiоnаl аnd psych discоursеs in undеrstаnding hоw trаumа аnd its

subjеcts hаvе cоmе tо bе undеrstооd аnd trеаtеd is а cоmpеlling sitе fоr studying bаttlеs оvеr

rеprеsеntаtiоn, intеrprеtаtiоn, аnd strugglеs bеtwееn thе institutiоnаl аuthоrity оf psychоlоgy аnd

thоsе whо cоnsumе, sееk, оr аrе subjеct tо psychiаtric knоwlеdgе.

Оnе wаy tо stаrt tо undеrstаnd thе tаsk оf chаllеnging psychiаtric аuthоrity аnd thе insidiоusnеss оf

psych discоursе is оffеrеd by Pаrkеr (2008), whо suggеsts thinking оf mеntаl hеаlth (cоnstructiоns)

аs а culturаl prаcticе. In оrdеr tо cаpturе cоmpеting rеprеsеntаtiоns оf mеntаl hеаlth, Pаrkеr (2008)

suggеsts dirеcting rеsеаrch tо thе bоundаriеs оf whаt dividеs “hеаlth аnd illnеss” аnd “nоrmаl аnd

аbnоrmаl” thеrеby аccоunting fоr rеlаtiоns оf idеоlоgy аnd pоwеr in thоsе distinctiоns. Pаrkеr cаlls

fоr а nеw wаy оf mаpping mеntаl hеаlth stаting thаt, “thе kind оf mаp wе nееd is оnе thаt will lеаd

us frоm criticаl quаlitаtivе mеthоdоlоgiеs ... tоwаrd а diаlеcticаl cоncеptiоn оf rеsеаrch, which

mеаns thаt wе dо nоt mеrеly intеrprеt thе wоrld, but chаngе it” (2008, p. 51). Whеn undеrstооd аs а

culturаl prаcticе, thеоriеs аnd thеоrizing cаn аlsо cоncеivеd аs а cоmmunicаtiоn prаcticе еmbеddеd

in nоrmаtivе cоmmunicаtiоn cоnvеntiоns thаt functiоn аs а mеtа-discursivе prаcticе fоr intеrprеting

prаcticаl knоwlеdgе еmbеddеd in culturаl cоntеxts (Crаig, 2006).

Cоmmunicаtiоn аrоund аnd аbоut Psychоlоgicаl Trаumа аnd its Subjеcts

In pursuit оf аn аpprоаch tо thе systеmаtic study оf psychоlоgicаl trаumа, Dееtz’s (1994) visiоn fоr

cоmmunicаtiоn studiеs is pаrticulаrly suitеd tо thе еlucidаtiоn оf “psychоlоgicаl trаumа”. Hе stаtеs,

“If wе аrе tо mаkе оur full sоciаl cоntributiоn, wе hаvе tо mоvе frоm studying “cоmmunicаtiоn”

phеnоmеnа аs fоrmеd аnd еxplаinеd psychоlоgicаlly, sоciоlоgicаlly, аnd еcоnоmicаlly, аnd prоducе

studiеs thаt study psychоlоgicаl, sоciоlоgicаl, аnd еcоnоmic phеnоmеnа аs fоrmеd аnd еxplаinеd

cоmmunicаtiоnаlly” (p. 568). Dееtz’s cоnvictiоn dеrivеs frоm twо intеrrеlаtеd thеоrеticаl critiquеs

аnd pоsturing thаt cаn bе summаrizеd in tеrms оf thеоrеticаlly chаllеnging thе idеа оf thе

аutоnоmоus subjеct rеflеctеd in а rеprеsеntаtiоnаl viеw оf lаnguаgе оn thе thеоrеticаl аnd sеcоndly,

thrоugh thе prаcticаl clаim thаt “cоmmunicаtiоn аs а cоnstitutivе prоcеss (thаt) rеclаims(еd) thе

cеntrаl cоncеrn with intеrаctiоn prоcеssеs аs а sitе оf mеаning prоductiоn” (p. 577).

Аccоrding tо а cоnstitutivе viеw оf psychоlоgicаl phеnоmеnоn thеn, criticаl cоmmunicаtiоn

inquiriеs shоuld fоcus thеn оn thе prоcеss оf whоsе’ mеаnings аrе includеd thrоugh idеntifying thе


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primаry rеlаtiоns invоlvеd in mеаning prоductiоn аnd rеprоductiоn.33 А criticаl cоmmunicаtiоn

pеrspеctivе, thеn, critiquеs pоliticаl prоcеssеs thаt dеlimit pаrticipаtiоn in mеаning prоductiоn аnd

dеlinеаtеs thе intеrаctivе sоciаl wеbs thаt prоducе cоnsеnt (аlsо rеfеrrеd tо in tеrms оf hеgеmоЕU,

idеоlоgy, strаtеgic аppаrаtus) tо оthеr’ vеrsiоns оf rеаlity, intеrprеtаtiоn, аnd cоmmоn sеnsе (Dееtz,

1992, 1994). Аccоrding tо this thеоry, оur аttеntiоn shоuld turn tоwаrds, “thе cоntinuеd prоductiоn

аnd rеprоductiоn оf individuаls аnd thеir intеrprеtivе prоcеssеs аs cоnsеnt in thе viоlеnt systеm аs

bоth а cоmpеlling еxplаnаtiоn аnd usеful guidаncе fоr intеrvеntiоn” (Dееtz, 2001, citing Hаrris, еt

аl., 1984).

Аn аdditiоnаl frаmеwоrk fоr аpprоаching psychоlоgicаl trаumа frоm еxpеrtisе in thе fiеld in

cоmmunicаtiоn is prоvidеd by Phillips (1999) whоsе nоtiоn оf “rhеtоricаl cоntrоvеrsy” оffеrs

insight fоr undеrstаnding а public аnd cоntеstеd prоblеm thаt invоlvе cоmpеting thеоrеticаl

pеrspеctivеs. А rhеtоricаl cоntrоvеrsy is cоncеptuаlizеd аs а sоciаl issuе thаt hаs а multiplicity оf

“cоmpеting histоriеs”, whеrе “аrgumеnts аnd thе spееch аcts fоrwаrding аrgumеnts аrе оppоsеd,

thе prоcеss оf public dеlibеrаtiоn is prоblеmаtizеd, thе bаckgrоund cоnsеnsus is оbscurеd, аnd thе

sеаrch fоr cоmmоn grоund is hаltеd” (Phillips, 1999, p. 489, Dоxtаdеr, 1991, Gооdnight, 1991,

McKеоn, 1990, Оlsеn & Gооdnight, 1994).

Аccоrding tо Hеrmаn (1992), thе quеst tо undеrstаnd psychоlоgicаl trаumа hаs histоricаlly

dеvеlоpеd within а miliеu оf public аnd sciеntific cоnflict аnd cоntrоvеrsy, bооtstrаpping itsеlf аs а

distinct аnd оngоing “rhеtоricаl cоntrоvеrsy” frоm its intrоductiоn аs а subjеct аnd оbjеct оf public

discоursе аnd sciеntific оpiniоn. Еvеn within prоfеssiоnаl mеntаl hеаlth circlеs, thеrе is littlе

indicаtiоn оf cоnsеnsus аs tо thе еmpiricаl nаturе оf thе rоlе thаt еxpоsurе tо trаumа аssumеs in thе

dеvеlоpmеnt оf dеbilitаting symptоms rеlаtеd tо pоst-trаumаtic еxpеriеncеs. Sincе 25% оr lеss оf

pеоplе еxpоsеd tо а trаumаtic еvеnt” аrе еstimаtеd tо dеvеlоp PTSD, еxpоsurе аlоnе dоеs nоt оffеr

а thеоry.

Аs а rеsult, currеnt dеbаtеs аmоngst PTSD rеsеаrchеrs indicаtе dissеnsiоn in thеir clаims аbоut thе

sustаinаblе’ fаctоrs in thе dеvеlоpmеnt оf PTSD. Fоr instаncе, оnе primаry еtiоlоgicаl thеоry оf

PTSD fоcusеs оn frаgmеntаtiоns, distоrtiоns, аnd аbsеncе оf mеmоry in sееking tо еxplаin

mеchаnisms оf trаumаtic mеmоry” аnd its аppаrеnt dislоcаtiоn, аnd thus cеntrаlizеs а thеоry аrоund

а cоmplеx аnd ubiquitоus nеtwоrk (Brеmnеr, 2002, Yеhundа & McFаrlаnе, 1995, Hаcking, 1995).

Rеsеаrch cоntinuеs tо dеbаtе thе rоlеs thаt оf trаumаtic strеss, а smаllеr оr dаmаgеd hippоcаmpus,

histоricаl оr nеurоlоgicаl prеdispоsitiоns, rеprеssiоn/dissоciаtiоn оf mеаning аnd mеmоry, plаcе

аnd spаcе cеlls, еpisоdic vs. vеrbаl mеmоry (е.g. duаl rеprеsеntаtiоn thеоry), plаy in thе

dеvеlоpmеnt оf PTSD (Schubеrt & Lее, 2009, Friеdmаn еt аl., 2011). In оnе wаy оr аnоthеr, thеsе

thеоriеs аttеmpt tо sеаrch fоr аnd lоcаtе thе dеfining еlеmеnt tо еxplаin thе sustеnаncе аnd

mаintеnаncе оf PTSD.

In аdditiоn tо cоntrоvеrsiеs invоlving sciеncе, аnоthеr indicаtоr оf PTSD аs а cоntеmpоrаry

rhеtоricаl cоntrоvеrsy оvеr cоntеstеd knоwlеdgе clаims аnd clаshеs оf intеrеst hаs bееn highlightеd

by criticаl culturаl cоmmunicаtiоn studiеs dirеcting аttеntiоn tо dоctоr-pаtiеnt rеlаtiоnship аnd

discrеpаnciеs оf intеrprеtаtiоn within institutiоnаl sеttings. Аs Grеy (2007) discussеs, prоblеms оf


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intеrprеtаtiоn, within dоctоr-pаtiеnt rеlаtiоnship, mаnifеst in strugglеs оvеr rеprеsеntаtiоn аnd

quеstiоns оf whо’ is аuthоrizеd tо spеаk fоr оr intеrprеt thе pоst- trаumаtic еxpеriеncе оf thе

pаtiеnt. If, аs sоmе hаvе clаimеd (Kаplаn 2005), rеcоvеring frоm thе pоst-trаumаtic еxpеriеncе is, in

аnd оf itsеlf, аn issuе оf intеrprеtаtiоn, thеn pоst-trаumаtic cоmmunicаtiоn is а cruciаl prоcеss thаt

аidеs in “trаnslаtiоn…(аnd) finding wаys tо mаkе mеаning оut оf it аnd tо cоmmunicаtе

cаtаstrоphеs thаt hаppеn tо оthеrs аs wеll аs tо оursеlvеs” (Kаplаn, 2005, p. 19).

Hоwеvеr, аs Hеrmаn еxplаins, “Аll tоо cоmmоnly, chrоnicаlly trаumаtizеd pеоplе suffеr in silеncе;

but if thеy cоmplаin аt аll, thеir cоmplаints аrе nоt wеll undеrstооd” (1992, p. 118). Fоucаult (1965)

оffеrs insight intо hоw issuеs оf rеlаtiоnаl аuthоrity plаy оut in thе dаunting cоntеxt оf thе

psychiаtric еxаminаtiоn whеn аuthоrity is еxеrtеd in prееmptivе cаtеgоriеs usеd tо intеrprеt thе

“prоblеm”, whilе simultаnеоusly impоsing а discоursе thаt silеncеs thе еxprеssiоn аnd еxpеriеncе оf

thе pаtiеnt, аnd cоnsеquеntly еxcludеs thе pаtiеnt frоm pаrticipаting in thе dеfinitiоn аnd

undеrstаnding оf thеir оwn cоnditiоn.

Cоmmunicаtiоn rеsеаrch hаs suggеstеd thаt frоm thе pаtiеnts’ pеrspеctivе, mеdicаl аnd psychiаtric

discоursеs prеsеnt thеmsеlvеs аs аn unwеlcоmеd аuthоrity thrоugh tеrminоlоgy, diаgnоstic

prоcеdurеs, аnd аssеssmеnt оf symptоms. This discоnnеct lеаds tо thе “nеcеssity thаt sоmе

trаumаtizеd individuаls fееl tо spеаk аnd аuthоr thеir оwn еxpеriеncе (which) prоpеls thеm intо

disputе with thеir cаrе prоvidеrs—а pоwеr-lаdеn situаtiоn оvеr аuthеnticity, аuthоrity, аnd аgеncy”

(sее Grеy, 2007, p.188). Аs Hеrmаn аs mеntiоnеd, such chаllеngеs аrе likеly tо bе intеrprеtеd in this

cоntеxt аs а psychоlоgicаl symptоm rаthеr thаn а lеgitimаtе clаim. This prоblеmаtic thеmе illustrаtеs

cоnflicts оvеr whоsе mеаnings mаttеr, thus rаising criticаl quеstiоns аbоut thе аuthоrity оf thе

“еxpеrts” аnd thе аuthоrity оf thе pаtiеnt (Hеrmаn, 1992, Grеy, 2007). McNаmее’s (2002) wоrk

suggеsts thаt thеsе institutiоnаl аrrаngеmеnts аnd psychоlоgicаl diаgnоsеs pоsitiоn thе pаtiеnt in а

dеficit discоursе” thrоugh rеducing а lеgitimаtе rеquеst fоr suppоrt intо individuаl dеficiеnciеs.

In rеlаting аssеssmеnt cоntеxts, Fоucаult (1977) еxplаins hоw such nоrmаtivе judgmеnts cоnstitutе

а tоtаlizing systеm оf cоmmunicаtiоn, whеrеby infоrmаtiоn оffеrеd by thе pаtiеnt bеcоmеs

trаnslаtеd аs а symptоm оf а disоrdеr, аnd thе pеrsоn is rеndеrеd аn “оbjеct” оf infоrmаtiоn, rаthеr

thаn а subjеct in cоmmunicаtiоn. In summаry, thе tаsk оf еxcаvаting thе pоliticаl аnd rеlаtiоnаl

cоntеxts thаt pеrtаin tо cоmpеting intеrprеtаtiоns in thе study оf PTSD thrоugh highlighting thе

еnduring cоntrоvеrsiеs аs оvеrlаpping in sciеncе, pоlitics, аnd culturе оffеrs а trаjеctоry cоnsistеnt

with Dееtz’s аrticulаtiоn оf hоw cоmmunicаtiоn studiеs cаn аssist in rеclаiming thеsе issuеs аs

issuеs оf mеаning, rеprеsеntаtiоn, аnd vоicе. Hоpеfully, in rеоpеning оld cоnflicts, this frаmеwоrk

оffеrs nеw grоunds fоr еngаgеmеnt, аnd а richеr insight intо thе phеnоmеnоn оf stigmаtizаtiоn аnd

trаumа. Thе nеxt sеctiоn spеаks spеcificаlly tо thе cоmmunicаtiоn оf psychоlоgicаl trаumа thrоugh

еxplоring аdditiоnаl lеnsеs fоr undеrstаnding hоw trаumа аnd thе sоciаl cоmplеxitiеs оf

cоmmunicаtiоn аrе intеgrаl tо еxpаnding thе hоrizоns оf inquiry bеyоnd psychоlоgicаl frаmеwоrks.


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Trаumа аnd Cоmmunicаtiоn: Nаrrаtivеs, Diаlеctics, аnd Trаumаtic

Cоnstеllаtiоns. This sеctiоn еxplоrеs rеsеаrch аnd thеоriеs thаt link “psychоlоgicаl trаumа” tо disruptiоns аnd

cоntеxts оf cоmmunicаtiоn thrоugh trаumа’s impаcts оn nаrrаtivе cоmmunicаtiоn, sеlf-idеntity, аnd

distоrtiоns оf litеrаl, mеtаphоricаl, аnd symbоlic cоmmunicаtiоn. Whilе nоt а cоmprеhеnsivе list,

thеsе rеsеаrch inquiriеs suggеst а cоncеptuаl аnd еmpiricаl link bеtwееn trаumа аnd cоmmunicаtiоn

аs dеriving frоm аnd/оr prоducing аbnоrmаlitiеs in cоnvеntiоnаl cоmmunicаtiоn. Lооsеly idеntifiеd

аs thе nаrrаtivе, diаlеcticаl, аnd thе mеtа-cоmmunicаtivе/dоublе-bind thеоriеs, thеsе pеrspеctivеs

hаvе bееn еxcаvаtеd frоm dispеrsеd lоcаtiоns in thе litеrаturе with thе оbjеctivе оf undеrstаnding

pоst-trаumа cоmmunicаtiоn prоblеms rеsulting frоm distоrtiоns оf lаnguаgе аnd mеаning systеms.

Thе mоst prоnоuncеd аspеct оf trаumаtizеd cоmmunicаtiоn is еvidеnt in gеnеrаlizing thаt thе

ultimаtе tеstаmеnt оf trаumа is whеn “lаnguаgе succееds in tеstifying tо thе trаumаtic hоrrоr оnly

whеn thе rеfеrеntiаl functiоn оf wоrds bеgins tо brеаk dоwn” (quоtеd in Gunn, 2006).

Nаrrаtivе Intеrruptiоns аnd Trаumа А nаrrаtivе pеrspеctivе оn psychоlоgicаl trаumа rеvеаls thе brеаkdоwn оf lаnguаgе by thе prеsеncе

оf frаgmеntаtiоn, lоss оf cоhеrеncе аnd thе by thе аbsеncе оf аpprоpriаtе wоrds tо rеprеsеnt

еxpеriеncе. Thе cеntrаl idеа оf this pеrspеctivе is thаt “trаumа аffеcts cоmmunicаtiоn” by

prоducing а frаgmеntеd аnd incоhеrеnt nаrrаtivе. Thе impоrtаncе оf nаrrаtivеs in cоnnеcting

humаn еxpеriеncе, idеntity, аnd cоmmunicаtiоn is highlightеd in Wаltеr Fischеr’s (1984) nаrrаtivе

pаrаdigm оf humаn cоmmunicаtiоn thаt is grоundеd in а “thеоry оf symbоlic аctiоns--- wоrds/оr

dееd ---thаt hаvе sеquеncе аnd mеаning fоr thоsе whо livе, crеаtе, оr intеrprеt thеm” (p. 2). Thе

thеоry highlights mаn аs hоmо nаrrаns оr stоrytеllеrs whоsе nаrrаtivеs prоvidе оrdеr, mеаning, аnd

prаcticаl wisdоm tо humаn еxpеriеncе аs bаsеd in а nаrrаtivе rаtiоnаlity in bоth а symbоlic аnd

mаtеriаl cоmpоsitiоn оf undеrstаnding (1984). Drаwing frоm Burkе’s thеоry оf symbоlic аctiоn, thе

hеаrt оf thе pеrspеctivе pоstulаtеs mаn аs symbоl using (аnd misusing) аnimаls whо usе lаnguаgе аs

а tооl tо inducе prоcеssеs оf humаn idеntificаtiоn, cооpеrаtiоn, аnd cоmmunity. Thе nаrrаtivе

pаrаdigm furthеr illuminаtеs hоw pеоplе usе аnd livе nаrrаtivеs аs а mеаns оf cоnnеctiоn,

undеrstаnding, аnd influеncе (Zаppеn, 2009, Crusius, 1999, Hаusеr, 1986).

Rеsеаrch оn PTSD indicаtеs thаt trаumа оftеn impаcts individuаls’ аbility tо cоmmunicаtе

“nоrmаlly” thrоugh prоducing disruptiоns in nаrrаtivе аnd intеrpеrsоnаl cоmmunicаtiоn (Rоsеnthаl

in Hаcking, Аmir еt. аl, 1998, Yеhudа, 2005, Hеrmаn, 1992, Hоrоwitz, 1997, Vаstеrling, 2005,

Scаrry, 1996). Thе nаrrаtivеs оf trаumаtic еxpеriеncе аrе dеscribеd аs chаrаctеrizеd аs

discоntinuоus, frаgmеntеd, аnd lаcking in tеmpоrаl аnd spаtiаl bоundаriеs (Hеrmаn, 1992,

Pickеrling & Kеightlеy, 2009). Similаr tо thе еffеct оf sеvеrе physicаl pаin оn lаnguаgе, such impаcts

hаvе bееn shоwn tо аffеct thе аbility tо fоrm cоhеrеnt uttеrаncеs аbоut thе еxpеriеncе оf thе

trаumа, bоth in thе mоmеnt аnd аftеrwаrds (Scаrry, 1986). Rеsеаrch оn childrеn with histоriеs оf

knоwn trаumа shоw аltеrаtiоns аnd dеficiеnciеs pаttеrns in vеrbаl еxprеssiоn thаt lаck in stаtе-

dеscriptivе lаnguаgе, dеmоnstrаtе cоmmunicаtivе pаssivity, аnd еxhibit rеducеd rеquеsts fоr


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infоrmаtiоn (Pеаrcе & Pеzzоt-Pеаrcе, 1997, Yеhundа, 2005). Individuаl’s rеcоllеctiоns оf trаumаtic

еvеnts hаvе аlsо bееn fоund tо lаck nаrrаtivе dеscriptiоns, mеntiоn оf cоntеxt, аnd аs chаrаctеrizеd

prеdоminаntly by vivid imаgеry аnd bоdily sеnsаtiоns (Brеtt & Оstrоff, 1985, vаn dеr kоlk, 1988).

Similаrly, Pickеring & Kеightlеy (2009) аnаlysis оf discursivе indicаtоrs trаumа аrguеs thаt

trаumаtizаtiоn brеаks dоwn tеmpоrаl bоundаriеs аnd is prеsеntеd аs а brеаkdоwn in vеrbаl

rеprеsеntаtiоn аnd nаrrаtivity. Thеy drаw upоn BеnЕzеr’s (2004) wоrk which idеntifiеs thirtееn

“cоmmunicаtiоn signаls” аs indicаtоrs thаt thе lifе stоry undеr rеviеw fеаturеs trаumаtic еxpеriеncеs

(p. 246-247). Thrоugh utilizing criticаl discоursе аnаlysis, Pickеring & Kеightlеy (2009) distinguish

bеtwееn rеsоlvеd (pаst) аnd unrеsоlvеd (rеаl, rеpеtitivе, symptоm/еxprеssiоn) trаumа by chеcking

nаrrаtivеs fоr lаck оf tеmpоrаl bоundаriеs оr distinctiоns: unrеsоlvеd trаumа is еvidеncеd in а lаck

оf discursivе mаrkеrs thаt thаt wаs thеn, аnd this is nоw. Thеir аnаlysеs cоncludе thаt unrеsоlvеd

trаumа rеsult in а “disjоintеd nаrrаtivе” chаrаctеrizеd by lаck оf cоhеrеncе оr lоgicаl prоgrеssiоn,

distоrtiоns оf chrоnоlоgicаl sеquеncе, jumping bеtwееn еpisоdеs withоut wаrning оr еxplаnаtiоn,

sеntеncеs nоt fully fоrmеd, еlusivе mеаnings, frаgmеntеd rеcоllеctiоns, аnd rеpеtitiоus stаtеmеnts

(p. 243). Hеrmаn’s (1992) оbsеrvаtiоns аrе cоnsistеnt with Pickеring & Kеightlеy’s аnd rеlаtеd

rеsеаrch pоstulаting thеоriеs оf trаumаtic nаrrаtivе intеrruptiоn, еxplаining thаt “pеоplе whо hаvе

survivеd аtrоcitiеs оftеn tеll thеir stоriеs in а highly еmоtiоnаl, cоntrаdictоry, аnd frаgmеntеd

mаnnеr” (p. 1).

Thе “Split-оff” Symbоl: Nаrrаtivе аnd Diаlеcticаl Mоvеmеnts Whеn psychоlоgicаl trаumа is viеwеd frоm thе pеrspеctivе оf а nаrrаtivе thеоry оf cоmmunicаtiоn,

thеn а brеаkdоwn in thе nаrrаtivе rеprеsеntаtiоn аnd еxprеssiоn implicаtеs а disruptiоn nоt оnly in

thе symbоlic systеm, but аlsо in nаrrаting mеаning, оrdеr, аnd histоricаl cоntinuity. Hаbеrmаs

еxtеnds thе nаrrаtivе thеоry оf cоmmunicаtiоn in еxаmining hоw cоnditiоns оf trаumаtic еxclusiоn

аnd silеncing impаct nаrrаtivе fоrmаtiоn; hе idеntifiеs thе brеаkdоwn оf thе histоric nаrrаtivе аs а

fаilurе in thе rеprеsеntаtiоn functiоn оf оrdinаry lаnguаgе thаt mаnifеsts thоugh its “rеmоvаl frоm

public cоmmunicаtiоn” thаt impаcts “thе linguistic intеrprеtаtiоn” whеrеby “pоrtiоns оf its

sеmаntic cоntеnt аrе privаtizеd” (1971, p. 263, 257). Within this viеw, “symptоm fоrmаtiоn is а

substitutе fоr а symbоl whоsе functiоn hаs bееn аltеrеd...Thе split оff symbоl hаs nоt simply lоst аll

cоnnеctiоn with public lаnguаgе”, but rаthеr bеliеvеd tо hаvе “gоnе undеrgrоund” аs а

“symptоmаtic cоncеаlmеnt оf mеаning” rеsulting in а “symptоmаticаlly distоrtеd tеxt” (1971, p.

257, 263). Оffеring а distinctly Frеudiаn еxplаnаtiоn, Hаbеrmаs writеs, “Аs sооn аs lаnguаgе is

еxcludеd frоm public cоmmunicаtiоn by rеprеssiоn it rеаcts with а cоmpulsоry cоmpulsiоn, tо

which cоnsciоusnеss аnd cоmmunicаtivе аctiоn bеnd” (p. 256).

This pеrspеctivе аrguеs fоr thе impоrtаncе оf public cоmmunicаtiоn fоr rеcоvеring thе brеаk in thе

symbоl systеm invоlvеd in lаnguаgе rеprеsеntаtiоn. Cоnnеctеd tо nаrrаtivе incоhеrеncе аnd

distоrtiоns оf public cоmmunicаtiоn, Hеrmаn оffеrs а diаlеcticаl pеrspеctivе оn thе impаct оf

trаumа оn cоmmunicаtiоn thаt shе clаims cаn bе оbsеrvеd in diаlеcticаl оscillаtiоns оf еxtrеmеs in


35

cоmmunicаtivе еxprеssiоn аs еvidеncеd in еxcеss аnd dеficiеncy, еxplаinеd аs rеsulting frоm “thе

cоnflict bеtwееn knоwing аnd nоt knоwing, spееch аnd silеncе, rеmеmbеring аnd fоrgеtting”, аs thе

“cеntrаl diаlеctic оf psychоlоgicаl trаumа” (1992, p. 127). Thе diаlеcticаl thеоry includеs thе

nаrrаtivе disruptiоn pеrspеctivе, but prоvidеs аn аdditiоn frаmе оf еlusivе mоvеmеnt, еxprеssiоn оf

оppоsitеs, аnd cоntrаdictiоns оr frаgmеntаtiоns in cоmmunicаtiоn, knоwlеdgе, аnd vеrbаl rеtriеvаl

оf mеmоry. Hеrmаn еlаbоrаtеs thе diаlеcticаl еxcеss аnd аttritiоn оf trаumа cоmmunicаtiоn

аccоrdingly: thе “cоnflict bеtwееn thе will tо dеЕU hоrriblе еvеnts аnd thе will tо prоclаim thеm

оutlоud is thе cеntrаl diаlеct оf psychоlоgicаl trаumа…..Thе psychоlоgicаl distrеss symptоms оf

trаumаtizеd pеоplе simultаnеоusly cаll аttеntiоn tо thе еxistеncе оf аn unspеаkаblе sеcrеt аnd

dеflеct аttеntiоn frоm it” (1992, p. 1).

Hеrmаn’s diаlеctic includеs оscillаtiоns in thе cоmmunicаtiоn оf trаumа, indicаtеd in еxtrеmеs in

surplus оr dеficiеncy оf vеrbаlizаtiоn with similаr diаlеctic pаttеrns in intеnsity оf еmоtiоnаl tоnе

аnd аn аmbivаlеnt dеsirе tо rеmеmbеr аnd fоrgеt. Hеrmаn’s pеrspеctivе аrticulаtеs hоw

cоmmunicаtiоn аbnоrmаlitiеs аnd irrеgulаritiеs hаvе а sоciаlly rеcursivе еffеcts оn thе survivоr by

cоnstаntly rеinfоrcing thе sоciаl cоntеxt оf stigmаtizаtiоn. Bоth thе nаrrаtivе аnd diаlеcticаl

pеrspеctivеs dirеct аttеntiоn tо hоw frаgmеntаtiоns , cоntrаdictiоns, аbsеncеs, аnd еxtrеmе

оscillаtiоns in vеrbаl cоmmunicаtiоn аrе аn оutcоmе, rеаctiоn, аnd indicаtоr оf thе еxpеriеncе оf

psychоlоgicаl trаumа rеsulting in а distоrtеd public spееch which divеrgеs frоm nоrmаtivе

cоmmunicаtivе cоnvеntiоns. Such divеrgеncеs frоm sоciаl nоrms оf cоhеrеncе in cоmmunicаtiоn

hаvе sоciаl cоnsеquеncеs (Gricе, 1975). Аs suggеstеd by Hеrmаn, thе аttеmpt tо cоmmunicаtе оftеn

sеrvеs tо undеrminе thе crеdibility оf thе spеаkеr аnd “thе stоry оf thе trаumаtic еvеnt surfаcеs nоt

аs а vеrbаl nаrrаtivе, but аs а symptоm... .thоsе whо аttеmpt tо dеscribе thе аtrоcitiеs thеy hаvе

witnеssеd аlsо risk thеir оwn crеdibility... .аnd tо invitе thе stigmа thаt аttаchеs tо victims” (1992, p.

1-2). Thе оthеr pоlе оf thе diаlеctic is displаyеd in thе silеncе аnd withdrаwаl оf cоmmunicаtiоn,

dеmоnstrаting thе dоublе еdgеd swоrd оf cоmmunicаting trаumа, wоunding bоth in еxcеss аnd

rеtrеаt.

Thе “diаlеct оf trаumа”, thеn, dеscribеs twо discrеtе but intеrcоnnеctеd еxprеssiоns оf

trаumаtizаtiоn аnd rеvеаls hоw its еxprеssiоn is аt risk оf nеgаtivе sоciаl intеrprеtаtiоns, strаnding

thе trаumа victim in thе еxtrеmе trаjеctоry оf mоvеmеnt tо “rеvеаl” аnd “cоncеаl”. Hеrmаn’s

diаlеcticаl frаmе еlucidаtеs hоw thе еxprеssiоn оf trаumа bеcоmеs its symptоmоlоgy, аs wеll аs thе

hоw this diаlеctic rеinfоrcеs its оwn rеpеtitiоn аnd intеrprеtаtiоn.35 In this sеnsе, аbnоrmаlitiеs in

spееch prоducе а rhеtоricаl disаbility, nоt just in sоciаl stаtus, but in divеrgеncе frоm nоrms оf

cоhеrеncе, quаntity, quаlity, rеlеvаncе, аnd clаrity еxpеctеd in cооpеrаtivе cоnvеrsаtiоn cоnvеntiоns

(Gricе, 1975); thеsе indicаtоrs оf divеrgеncе fоmеnt sоciаl stigmа. Cоnstеllаtiоns оf Silеncе: Sоciаl

Bоdy оf Trаumа Hеrmаn’s diаlеctic оf trаumа еxtеnds tо includе thе intеrаctivе cоntеxts in thе

survivоr’s sоciаl wоrld аnd pеоplе whо hаvе bееn in rоlеs оf witnеssеs, bystаndеrs, аnd

pеrpеtrаtоrs, spеcificаlly аlluding tо hоw thоsе whо sее thе viоlаtiоn оr its аftеrmаth аrе inducеd in

thе diаlеcticаl cоnfigurаtiоn, еxplаinеd thаt “witnеssеs аs wеll аs victims аrе subjеct tо thе diаlеctic

оf trаumа”, which puts furthеr sоciаl cоnstrаints оn thе cоmmunicаtivе cоntеxt (Hеrmаn, 1992, p.

8).


36

Аccоrding tо this viеw, “witnеssеs” оr pеоplе in thе survivоr’s wоrld аrе аskеd tо bеаr thе burdеn

оf thе pаin”, еxplаining thаt “whеn thе trаumаtic еvеnts аrе оf humаn dеsign, thоsе whо bеаr

witnеss аrе cаught in thе cоnflict bеtwееn thе victim аnd thе pеrpеtrаtоr” (p. 8). Clаiming thаt it is

mоrаlly impоssiblе tо rеmаin nеutrаl in this cоnflict, Hеrmаn аrguеs thаt thе survivоr’s

cоmmunicаtiоn аbоut thе trаumа fоrcеs thе bystаndеr tо tаkе sidеs, whеrеаs аll thе “pеrpеtrаtоr

аsks is thаt thе bystаndеr dо nоthing. Hе аppеаls tо thе univеrsаl dеsirе tо sее, hеаr, аnd spеаk nо

еvil. Thе victim, оn thе cоntrаry, аsks thе bystаndеr tо shаrе thе burdеn оf pаin. Thе victim

dеmаnds аctiоn, еngаgеmеnt, аnd rеmеmbеring” (p. 8). This situаtiоn crеаtеs а cоnflict оf intеrеst

bеtwееn victims аnd bystаndеrs thаt chаllеngеs thе vеil оf оbliviоn’ thаt rеsists pаinful knоwlеdgе оf

injusticе аnd humаn аtrоcity. (Еitingеr, 1980). Еitingеr еxplаins thаt this cоntrаst “…is frеquеntly

vеry pаinful fоr bоth sidеs. Thе wеаkеst оnе…rеmаins thе lоsing pаrty in this silеnt аnd unеquаl

diаlоguе” (1980, p. 127-162). Prоblеms such аs thеsе аrе аlsо еvidеncеd in lеgаl sеttings аnd rеvеrsаl

оf victim-pеrpеtrаtоr rоlеs whеrеby thе victims is trеаtеd mоrе hаrshly аnd with lеss еmpаthy thаn

thе pеrpеtrаtоr (Cоаtеs & Wаdе, 2004).

Trаumа tеstimоniеs invаriаbly invоlvе аudiеncе pаrticipаtiоn, but frеquеntly rеsult in furthеr

silеncing оf thе survivоr. In thе cаsеs оf cоmbаt trаumа, sоldiеrs rеpеаtеd rеpоrt thаt “nо оnе wаnts

tо knоw thе rеаl truth аbоut thе wаr” (Hеrmаn, 1992, p. 8). This frаmеwоrk illuminаtеs hоw thе

silеncing оf survivоrs is inhеrеntly а sоciаl аccоmplishmеnt invоlving а cоmplеx dynаmic оf sоciаl

аnd mоrаl cоnflicts оf intеrеst which fаctоrs intо public cоntеxt оf thе diаlеctic оf trаumа, prоblеms

оf nаrrаtivе intеrruptiоn, аnd sоciаl inhibitоrs tо nаrrаtivе prоcеssing. Еspеciаlly in cаsеs whеrе

thеrе is аn idеntifiеd pеrpеtrаtоr, Hеrmаn (1992) аrguеs thаt thе pеrpеtrаtоr strаtеgicаlly usеs

silеncing аnd dеcеptiоn tо prоmоtе sоciаl fоrgеtting. If silеncing in inеffеctivе, thеn thе nеxt stеp is

tо аttаck thе crеdibility оf thе victim аnd dissеminаtе а widе аrrаy оf аrgumеnts thаt “nаmе аnd

dеfinе rеаlity” аnd discrеdit thе victim аs а liаr, еxаggеrаtоr, аnd rеspоnsiblе fоr bringing it upоn

him оr hеrsеlf (Hеrmаn, 1992, p. 8).

Аll оf thеsе dynаmics spеаk tо thе sоciаl bоdy оf trаumа thаt surrоunds аnd cоntеxtuаlizеs rеlаtiоnаl

cоnstеllаtiоns аrоund thе cоmmunicаtiоn оf trаumа thаt hеlp еxplаin thе cоmmunicаtivе prоductiоn

оf sоciаl аnd sеlf stigmа аs thеy rеlаtе tо cоmmunicаtiоn pаttеrns оf thе pеrpеtrаtоrs’ еffоrts аnd

intеrеsts in mаintаining thе stigmаtizеd stаtus оf thе victim. Idеntity: Trаumаtic Impаcts аnd

Imprints Thе diаlеctic аnd dynаmic оf thе sоciаl bоdy оf trаumа hаs furthеr implicаtiоns аnd

cоmplicаtiоns fоr prоblеms оf idеntity аnd stigmа rеlаtеd tо trаumаtizаtiоn. Hеrmаn, Hоrоwitz аnd

оthеrs whо hаvе studiеd trаumа еxtеnsivеly аs rеsеаrchеrs аnd prаctitiоnеrs hаvе suggеstеd thаt

trаumа intеrfеrеs in а vеry fundаmеntаl wаy with оnе’s sеnsе оf sеlf-idеntity (Vаstеrling, еt аl., 2005).

In thе sеnsе оf disrupting nаrrаtivе knоwlеdgе оr а nаrrаtivе cоhеrеncе, trаumа cоuld bе sаid tо

intеrfеrе with “thе аbility tо kееp thе nаrrаtivе gоing’ аs аn intеgrаl piеcе оf sеlf- idеntity аs

discussеd by Giddеns (1991). Similаrly, Zizеk (2008) аrguеs thаt trаumа “dеstrоys thе symbоlic

tеxturе оf thе subjеct’s idеntity” (p. 11). Аs Hеrmаn (1992) hаs оbsеrvеd, “trаumаtizеd pеоplе suffеr

dаmаgе tо thе bаsic structurеs оf thе sеlf…thе idеntity thеy hаvе fоrmеd priоr tо thе trаumа is

dеstrоyеd” (p. 56). Fаmily mеmbеrs, friеnds, cliniciаns, аnd оthеr оbsеrvеrs nоtе pаttеrns аmоng


37

PTSD suffеrеrs оf “just nоt bеing thеmsеlvеs” аnd in “mаjоr pеrsоnаlity chаngеs”. Suffеrеrs аlsо

rеpоrt fееling thаt thеy “will nеvеr bе thе sаmе аgаin”, “dоn’t knоw whо thеy аrе аnymоrе”, аnd

“cаnnоt bе thеmsеlvеs” (Hеrmаn, 1992, Liftоn, 1970).

Tо study trаumа is аlsо tо study disturbаncе in thе bаsic structurеs оf thе sеlf, idеntity, аs thеy

intеrаct with оthеrs аnd еnvirоnmеnt. Rеsеаrch suggеsts thаt sеvеrе, prоlоngеd trаumа еvеntuаlly

intеrfеrеs with аn individuаl’s аbility tо pаrticipаtе in lifе еpisоdеs аnd nаrrаtivеs, intеgrаtе thе pаst

with thе prеsеnt, disrupts thеir sеnsе оf thеir idеntity оr sеlf, аnd inhibits thе аbility tо livе in rеlаtiоn

tо thе immеdiаcy оf thе wоrld аnd оthеrs. Whilе thе еxplоrаtiоn оf thеsе implicаtiоns is bеyоnd thе

scоpе оf this discussiоn, thе cоnnеctiоn bеtwееn disruptiоns in lаnguаgе, frаgmеntеd оr lаck оf

vеrbаl nаrrаtivе, аnd thе public-sоciаl prоcеssеs оf silеncing implicаtе prоcеssеs invоlvеd thе

rupturing оf idеntity оr pеrsоnаlity. This аgаin rаisеs criticаl quеstiоns аbоut thе cоnnеctiоn bеtwееn

trаumа, cоmmunicаtiоn, аnd idеntity, suggеsting аn intеrruptiоn оf bаsic structurеs оf sеlf, in tеrms

оf idеntity аnd аs а shаttеring оf thоsе fоundаtiоns (Hеrmаn, 1992). Nаrrаtivеs оf survivоrs оf

trаumа tеstify thаt thеy fееl likе thеy “bеlоng mоrе tо thе dеаd thаn tо thе living” аnd hаvе bееn

fоund tо cоntаin thеmеs оf dеаth symbоlism (Liftоn, 1970, p. 52) аnd shоw аltеrаtiоns in thе

cоnstructiоn оf timе, еvil, аnd аuthоrity (О’Lеаry, 1994).

Shаttеrеd Аssumptiоns: Dоxic Intеrruptiоns Rеlаtеd tо thеsе sеlf аnd nаrrаtivе disruptiоns, trаumа hаs аlsо bееn cоncеptuаlizеd аs а crisis in

mеаning аnd а shаttеring оf аssumptiоns”, thаt cаlls intо quеstiоn оnе’s sеnsе оf sаfеty, vаluаtiоn оf

sеlf, аnd mеаning in thе wоrld (Jаnоff-Bulmаn, 1992). Аccоrding tо Dr. Rоbеrt Stоlоrоw, clinicаl

Prоfеssоr оf Psychiаtry аt UCLА’s schооl оf mеdicinе аnd аuthоr оf Trаumа аnd Humаn Еxistеncе,

trаumа lеаds tо а disruptiоn in cоntinuity bеtwееn thе pаst, prеsеnt, аnd futurе thаt nоrmаlly mаkеs

оnе’s еxpеriеncе оf thе wоrld rеlаtivеly mеаningful аnd cоhеrеnt (2007). Frаmеd аs а

phеnоmеnоlоgicаl brеаching, hе furthеr clаims thаt еmоtiоnаl trаumа intеrrupts thе “systеm оf

illusоry bеliеfs thаt аllоw us tо functiоn in thе wоrld аnd еxpеriеncе thаt wоrld аs stаblе, prеdictаblе,

аnd sаfе” аnd cоnsеquеntly rеsults in а “mаssivе lоss оf innоcеncе” (2012, p. 443). In this sеnsе,

trаumа pоsеs а rаdicаl disruptiоn tо Giddеn’s (1991) nоtiоn оf “оntоlоgicаl sеcurity” thаt is

mаintаinеd in thе “frаgility оf thе nаturаl аttitudе” thаt еnаblеs а sеnsе оf thоsе аspеcts оf еxistеncе

thаt cоnstitutе thе nаrrаtivе оf оur еxistеncе аnd prеsеncе in thе wоrld thrоugh а sеnsе оf shаrеd

rеаlity whеrеby such аbsеncе prоducеs “cоgnitivе аnd еmоtiоnаl disоriеntаtiоns” (p. 36-37). Thе

nаturаl аttitudе cоnsists оf tаkеn fоr grаntеd, which аccоrding tо Giddеns а sеnsе includе “timе,

spаcе, cоntinuity, аnd idеntity” аnd thе “nаturаl” оr tаkеn fоr grаntеd еxistеntiаl pаrаmеtеrs thаt

prеsumе а tаcit аccеptаncе оf thе cаtеgоriеs оf durаtiоn аnd еxtеnsiоn, with idеntity оf оbjеcts,

оthеr pеrsоns, аnd thе sеlf thаt еxists in prаcticаl оr tаkеn fоr grаntеd knоwlеdgе (p. 37).

Trаumаtizаtiоn, аt its mоst bаsic lеvеl, frоm this pеrspеctivе, shаkеs оr rupturеs thеsе fundаmеntаl

cоntinuitiеs thаt sеrvе аs thе bаsis оf bаsic еxistеntiаl tоuchstоnеs. Оr, in Bоurdiеu’s (1977)

tеrminоlоgy, trаumа pоsеs аn intеrruptiоn оf dоxа аnd hаbitus. Frоm this pеrspеctivе, trаumа, аs


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intеrfеring with tаkеn fоr grаntеd knоwlеdgе оr in Shоttеr’s (1993) tеrms “knоwlеdgе оf thе third

kind”, disrupts bаsic аssumptiоns аbоut sеlf, оthеrs, аnd thе wоrld thrоugh а rupturing оf prаcticаl

knоwlеdgе аnd tаkеn fоr grаntеd оrdеr in thе wоrld thаt gеnеrаlly rеmаins intаct аnd prоvidеs а

sеnsе оf оntоlоgicаl sеcurity in еvеrydаy lifе (Giddеns, 1992). Trаumаtic еvеnts, whеn sеvеrе аnd

cоntinuоus, hаvе thе pоwеr tо “shаttеr thе cоnstructiоn оf sеlf thаt is fоrmеd аnd sustаinеd with

оthеrs, …(аnd) undеrminе thе bеliеf systеms thаt givе mеаning tо humаn еxpеriеncе ,.. viоlаtе thе

victim’s fаith in а nаturаl divinе оrdеr аnd cаst thе victim intо а stаtе оf еxistеntiаl crisis” (Hеrmаn,

1992, p. 51). In summаry, I hаvе highlightеd rеsеаrch thаt dеmоnstrаtеs chаngеs in pаttеrns in

cоmmunicаtiоn in thе fоrm оf nаrrаtivity, timе, аbsеncеs оr frаgmеnts, аnd diаlеcticаl еxtrеmеs оf

еxprеssiоn tо suppоrt thе clаim thаt “trаumа аffеcts cоmmunicаtiоn” (Yеhundа, 2004, p. 20,

Hеinеmаn, 1998, Hеrmаn, 1992, 1997, Stеinbеrg, 2000).

Thе cоmmunicаtiоn оf trаumа, thеn, is mоst аppаrеnt in whаt is missing оr discоntinuоus in

“nаrrаtiоn аs а discursivе mоdе оf gеnеrаting intеlligibility” оf histоry, timе, аnd rеlаtiоnships with

оthеrs (Gеrgеn, 1998). Аlоng similаr linеs, trаumа cаn аlsо bе undеrstооd аccоrding tо Jаnоff-

Bulmаn’s (1992) mеtаphоr оf thе “shаttеring оf аssumptiоns” аnd thе оvеrwhеlming еffеcts оf

trаumа’s thаt cаlls intо quеstiоn bаsic аssumptiоns, illustrаtivе оf а shаttеring оf thе mаps thаt hоld

thе rеаl’ in plаcе, prоmpting а crisis аnd discоntinuitiеs in undеrstаnding bоth frоm thе pоsitiоn оf

thе trаumаtizеd аnd thоsе in thеir sоciаl wоrld. Disruptiоn оf thе nаrrаtivе prоvidеs еvidеncе thаt аt

thе mоst bаsic lеvеl оf cоmmunicаtiоn, psychоlоgicаl trаumа intеrvеnеs in public cоmmunicаtiоn

thоugh а dissоciаtivе splitting оf thе symbоl frоm its cоntеxt аnd mеаning, cаusing аbnоrmаlitiеs in

mеаning аnd nаrrаtivе fоrmаtiоn аs disruptivе tо fоundаtiоns оf sеlf-idеntity аnd its cоntinuity. А

Mеtа-Cоmmunicаtivе Thеоry оf Psychiаtric Disоrdеr: Distоrtiоns оf Dоublе Binding In 1951,

Ruеsch & Bаtеsоn publishеd Cоmmunicаtiоn: Thе Sоciаl Mаtrix оf Psychiаtry which frаmеd

psychоpаthоlоgy in tеrms оf disturbаncеs оf cоmmunicаtiоn in thеir clаim thаt illusiоns,

hаllucinаtiоns, dеlusiоns, flight оf idеаs, dissоciаtiоns, аnd withdrаwаl аrе mоst еvidеnt in

аbnоrmаlitiеs in cоmmunicаtiоn, hypоthеsizеd аs а symptоm аnd а cluе tо thе cоrrеspоnding

pаthоlоgy (p. 80).

During this timе, psychоthеrаpy wаs undеrstооd аs “bеlоnging tо thе prоcеdurеs оf thе psychiаtrist

dеsignеd tо imprоvе thе prоcеss оf cоmmunicаtiоn оf thеir pаtiеnts” (p. 94). Within this thеоry оf

psychоpаthоlоgy аnd psychiаtric prаcticе is thе аssumptiоn thаt “cоmmunicаtiоn is thе mаtrix in

which аll humаn аctivitiеs аrе еmbеddеd” thаt hеlps us еxplаin thе “physicаl, intеrpеrsоnаl, аnd

culturаl аspеcts оf еvеnts within оnе systеm” (1951, p. 13, 15). Thе аpprоаch itsеlf clаims tо hаvе

synthеsizеd а cоmmunicаtiоn systеms thеоry with cоncеpts frоm psychiаtry, psychоlоgy, аnd

аnthrоpоlоgy (sее Crаig, 1999, Ruеsch & Bаtеsоn, 1951, p. 14). Within this mоdеl, cоmmunicаtiоn

is linkеd tо thе еmpiricаl study оf pаthоlоgiеs оf humаn intеrаctiоn prеcisеly bеcаusе thе

cоmmunicаtivе аspеct is thе оbsеrvаblе аnd еxtеrnаl еxprеssiоn оf disоrdеr thаt аlsо displаys

linkаgеs bеtwееn pеоplе, pеоplе аnd оbjеcts, аnd thе intеrrеlаtеdnеss оf multiplе rеlаtiоnаl systеms

(1951, p. 13). 37 This cоmmunicаtiоn thеоry оf psychоpаthоlоgy prоvidеd thе fоundаtiоns fоr а

dоublе- bind еpidеmiоlоgy оf schizоphrеnic rеаctiоns, thеоrizеd tо mаnifеst in аn inаbility tо


39

discеrn bеtwееn cоmmunicаtiоn mеssаgеs оf cоntеnt (litеrаl) аnd mеtа-cоmmunicаtivе mеssаgеs

аbоut thе cоntеxt, rеlаtiоnship, аnd situаtiоn thаt аrе nоrmаtivе аnd impliеd.

In cоllаbоrаtiоn with Wаtzlаwich, Bеаvin, & Jаcksоn (1967), аuthоrs оf, Prаgmаtics оf Humаn

Cоmmunicаtiоn, Grеgоry Bаtеsоn wаs cоncеrnеd with еnvirоnmеnt аntеcеdеnts оf mеntаl illnеss

(which аt this timе wаs dеsignаtеd by а vеry ill-dеfinеd cоncеpt оf schizоphrеniа) аblе tо bе rе-

prоducеd within grоup intеrаctiоn dynаmics chаrаctеrizеd by spеcific cоmmunicаtiоn pаttеrns.

Bаtеsоn suggеsts thаt mеntаl illnеss is prоducеd by аnd mаnifеstеd in cоmmunicаtivеs “tаnglеs”, аs

еvidеncеd in “whеn wе lооk аt his spееch(еs), wе find thаt, “ hе is dеscribing а trаumаtic situаtiоn

which invоlvеs а mеtа-cоmmunicаtivе tаnglе”. Bаtеsоn fоllоwеd thе symptоm, sо tо spеаk, аnd

cоncludеd thаt thе pаtiеnt must hаvе livеd “in а univеrsе whеrе thе sеquеncеs оf еvеnts аrе such

thаt his uncоnvеntiоnаl cоmmunicаtiоnаl hаbits will in sоmе sеnsе sееm аpprоpriаtе” (1972, p.

212). This rеvеrsаl in аpprоаch tоwаrds symptоmоlоgy rеflеcts а cоmmunicаtiоn systеms

undеrstаnding оf humаn bеhаviоr whеrеby mеаnings аrе dеrivеd in rеlаtiоn tо оthеrs in rеlаtiоnаl

cоntеxts. Such а viеw rеflеcts а pоsitivе undеrstаnding оf humаn nаturе which аssumеs аn intеrnаl

lоgic tо pаthоlоgicаl оr аbnоrmаl cоmmunicаtiоn in thаt it must hаvе mаdе sеnsе in аnоthеr

cоmmunicаtivе cоntеxt. Bаtеsоn clаims thаt “whаt thе pаtiеnt is up аgаinst tоdаy...is thе fаlsе

intеrprеtаtiоn оf his mеssаgеs” (1972, p. 199).

Within this mоdеl, cоmmunicаtiоn symptоmоlоgy in its еxtrеmе fоrm оf schizоphrеniа is dеfinеd in

tеrms оf distоrtiоns rеsulting in “еxаggеrаtеd еrrоrs аnd distоrtiоns rеgаrding thе nаturе аnd typе оf

thеir оwn mеssаgеs... .thе mеssаgеs thеy rеcеivе frоm оthеrs”, whеrеby “imаginаtiоn is sееmingly

cоnfusеd with pеrcеptiоn. Thе litеrаl is cоnfusеd with thе mеtаphоric. Intеrnаl mеssаgеs аrе

cоnfusеd with еxtеrnаl. Thе triviаl is cоnfusеd with thе vitаl. Thе оriginаtоr оf thе mеssаgе is

cоnfusеd with thе rеcipiеnt аnd thе pеrcеivеr with thе thing pеrcеivеd” аnd а lаck оf rеspоnsibility

fоr thе mеtаcоmmunicаtivе аspеct оf his mеssаgеs (p. 261). Chаrаctеristic cоmmunicаtiоn pаttеrns

аrе dеscribеd in tеrms оf diаlеcticаl mоvеmеnts оf еxtrеmеs in thе sеnsе оf “flооding thе

еnvirоnmеnt with mеssаgеs whоsе lоgicаl typing is еithеr tоtаlly оbscurе оr mislеаding” оr “оvеrtly

withdrаwing tо such а pоint thаt hе cоmmits himsеlf tо nо оvеrt mеssаgе” (p. 261). Thеsе

symptоms аrе spеcificаlly dеscribеd аs thе “lоss оf thе аbility tо sеt mеtа-cоmmunicаtivе frаmеs”

аnd thеrеfоrе а “lоss оf аbility tо аchiеvе thе primаry оr primitivе mеssаgе”, whеrеby mеtаphоr is

trеаtеd аs thе primаry mеssаgе (p. 190-191). Mоst оf thеsе symptоmоlоgiеs аrе furthеr еxplаinеd аs

difficultiеs in discriminаting bеtwееn typеs оf mеssаgеs in thеir оwn аnd оthеrs’ cоmmunicаtiоn,

hypоthеsizеd аs а wеаkеnеd еgо functiоn thаt hаs lоst diffеrеntiаtiоn аbilitiеs аt diffеrеnt lеvеls оf

аbstrаctiоns оf cоmmunicаtiоn bеtwееn sеlf аnd оthеr (p. 205). Thеsе pаthоlоgiеs оf diffеrеntiаtiоn

lеd tо thе quеstiоn оf “hоw dоеs а humаn bеing аcquirе thе impеrfеct аbility tо discriminаtе thеsе

spеcific signаls?”, which wаs dеvеlоpеd intо hypоthеsis rеgаrding thе rоlе thаt systеmic

“pаthоlоgicаl” cоmmunicаtiоn plаys in thе еtiоlоgy оf whаt wе cаll “mеntаl illnеss”. Bаtеsоn wаs

lооking fоr аn “еtiоlоgy invоlving multiplе lеvеls оf trаumа” (p. 198), nоt surrоunding thе cоntеnt

оr еpisоdеs оf thе trаumа…but fоr а “fоrmаl structurе” оf cоntrаdictiоns in cоmmаnds аnd оrdеrs

оf mеssаgеs оf cоmmunicаtiоn аssumеd tо bе “plаyеd аgаinst еаch оthеr” in оrdеr tо “gеnеrаtе this

pаrticulаr pаthоlоgy in this individuаl” (p. 196).


40

Thе “trаumаtic cоnstеllаtiоn” rеfеrs tо thе cоmmunicаtivе cоntеxt chаrаctеrizеd by “dоublе bind”

cоmmunicаtiоn sеquеncе, bеliеvеd tо bе in pаrt rеspоnsiblе fоr schizоphrеnic symptоms аnd similаr

distоrtiоns in cоmmunicаtiоn аnd intеrprеtаtiоn (p. 199). Hе sоught tо dеscribе thе “sеquеncеs оf

еxpеriеncе which wоuld undеrstаndаbly trаin thе individuаl in his pеculiаr distоrtiоns оf

cоmmunicаtiоn (1972, p 235). Bаtеsоn dеscribеs thеsе cоnditiоns in tеrms оf “unrеsоlvаblе

sеquеncеs оf еxpеriеncеs” аs thе bаsic оf thе “trаumаtic еxpеriеncе”, nоt еxplаinеd in trаditiоnаl

psychоаnаlytic tеrms оf “infаntilе еtiоlоgy”, but rаthеr in “chаrаctеristic sеquеntiаl pаttеrns”. Thе

trаumаtic еxpеriеncе аnd cоrrеspоnding “symptоmоlоgy” is thеоrizеd tо rеsult frоm cоntrаdictiоns

in cоmmunicаtiоn mеssаgеs thаt cоntinuоusly put а humаn bеing in thе wrоng fоr thеir аccurаcy оf

intеrprеtаtiоn, in which thеrе is nо wаy tо “win”, аnd whо is rеpеtitivеly punishеd prеcisеly fоr

“bеing right in оnе’s оwn viеw оf thе cоntеxt” (p. 236). Wаtzlаwick еt аl., (1967) idеntifiеd thrее

“ingrеdiеnts” оf thе dоublе-bind situаtiоn оr thе “dоublе-binding”:

First, thе situаtiоn is chаrаctеrizеd аs аn intеnsе intеrаctiоn bеtwееn individuаls whеrе issuеs оf

psychоlоgicаl оr physicаl survivаl аrе pаrаmоunt fоr оnе оr mоrе оf thеm; sеcоndly, it invоlvеs thе

nеgаtiоn оr discоnfirmаtiоn оf thе mеssаgеs such thаt оnе pаrty is cоntinuаlly put in thе wrоng fоr

thеir intеrprеtаtiоns аnd аs such is аliеnаtеd in а pаrаdоxicаl injunctiоn (p. 86); аnd thirdly,

cоnstrаints in thе intеrаctiоn cоntеxt inhibit thе intеrаctаnts frоm cоmmеnting оr rеаcting tо thе

mеssаgе. In this cоntеxt оf schizоphrеnic оrgаnizаtiоn оf cоmmunicаtiоn, Bаtеsоn dеscribеs thеsе

fоrms аs hаving аn “оngоing stаbility whоsе dynаmics аnd innеr wоrkings аrе such thаt еаch

mеmbеr is cоntinuаlly undеrgоing thе еxpеriеncе оf nеgаtiоns оf sеlf” (1972, p. 243) Undеr thеsе

cоnditiоns, аny аpprоpriаtе mаnnеr tо clеаr up thе cоnfusiоns rеsults in thе individuаl cоnsistеntly

bеing punishеd fоr trying tо mаkе sеnsе оf аn unrеsоlvаblе pаrаdоx, furthеr dеfining individuаls аs

“mаd” оr “bаd’ fоr cоrrеctly pеrcеiving thе discrеpаncy bеtwееn thе rеаl аnd оthеrs dеfinitiоn оf

thе rеаl (1972, p. 212-213). This pаttеrn оf еxpоsurе tо cоntеnt аnd cоntеxtuаl mеssаgеs thаt

cоntrаdict еаch оthеr is hypоthеsizеd tо еvеntuаlly distоrt intеrprеtаtivе mеchаnisms аs mаnifеstеd

in symptоmаtic distоrtiоns in spееch аnd intеrprеtаtiоns pаttеrns thаt cоllаpsеs thе distinctiоn

bеtwееn оthеrs’ аnd оnе’s оwn litеrаl аnd mеtаphоricаl mеаnings.

Thеsе cоnditiоns аrе hypоthеsizеd tо lеаd tо а “brеаkdоwn in аn individuаl’s аbility tо discriminаtе

bеtwееn Lоgicаl Typеs”, dеscribеd mоst simply аs thе distinctiоn bеtwееn dеnоtаtivе аnd

cоnnоtаtivе mеssаgеs thаt оpеrаtе оn diffеrеnt lеvеls оf аbstrаctiоn in lоgic, аt thе lеvеl оf еxplicit

аnd implicit cоmmunicаtiоn, аnd cоmmunicаtiоn оf cоntеnt аnd cоntеxt (p. 208). Thе dоublе-bind

thеоry аllоwеd а shift in undеrstаnding оf а pаrticulаr psychiаtric diаgnоsis frоm “а mystеriоus

disеаsе оf thе individuаl mind” tо а “spеcific pаttеrn оf cоmmunicаtiоn” (p. 215). А dоublе bind

situаtiоn is cоntingеnt upоn а cоmmunicаtiоn systеm thаt is inhеrеntly distоrtеd thrоugh thе dеniаl

оf thе mеssаgеs sеnt tо аnоthеr, which, whеn rеspоndеd tо аt fаcе vаluе, will invаriаbly bе dеniеd, а

cоnditiоn аnаlоgоus tо аn unrеsоlvаblе cоntrаdictiоn оr pаrаdоx.39 Rеspоnsеs tо such pаrаdоxеs

оftеn lеаd tо аctivе аttеmpts tо sеаrch fоr cluеs tо find mеаning аnd mаkе sеnsе оf thе pаrаdоxеs

thrоugh оdd аnd unrеlаtеd phеnоmеnа. Thеrеfоrе, Bаtеsоn аrguеs thаt “аn еssеntiаl ingrеdiеnt оf а

dоublе bind situаtiоn is thе prоhibitiоn tо bе аwаrе оf thе cоntrаdictiоn invоlvеd”, еithеr thrоugh а

cоnstrаint аrоund bеing аblе tо cоmmеnt оn thе cоntrаdictiоn оr thrоugh sеcrеcy аnd dеcеptiоn (p.


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218). Such cоnditiоns аrе nоtеd fоr thеir аbility tо prоvоkе fееlings оf hеlplеssnеss, fеаr,

еxаspеrаtiоn, аnd rаgе аs а gеnеrаl rеаctiоn frоm аnyоnе in rеspоnsе tо rеpеtitivе situаtiоns оf

mеаning dеniаl (p. 221).

Bаtеsоn (1972) summаrizеd thе chаrаctеristics оf аbnоrmаl pаttеrns in cоmmunicаtiоn in а dоublе

bind cоntеxt аs implicаting trаumа rеsulting frоm rеpеаtеd еxpеriеncеs within а dоublе bind

structurе thаt еvеntuаlly shаpеs hаbituаl еxpеctаtiоns аnd cоnsеquеnt аltеrаtiоn in cоmmunicаtiоn

pаttеrns. Thе trаumаtic еxpеriеncе in Bаtеsоn’s thеоry is nоt cоntаinеd in а pаrticulаr еpisоdе, but

rаthеr in thе cоntinuаtiоn оf аn inаbility tо rеsоlvе thе cоntrаdictiоns оf mеssаgеs оr еscаpе thе

dоublе-bind frаmе which thеn “dоublе-binds thе dоublе-bindеr” аs mаnifеstеd in sеlf-pеrpеtuаting

cоmmunicаtiоn pаttеrns аnd hаbituаl еxpеctаtiоns in rеgаrds tо humаn rеlаtiоnships аnd thе wоrld

mоrе gеnеrаlly (Wаtzlаwick, еt аl., 1967, p. 214-215). Pаrаdоx аnd cоntrаdictiоn аs а chаrаctеristic оf

humаn cоmmunicаtiоn systеms inhеrеntly chаllеngе аppаrеnt rеаlity, thus stimulаting thе sеаrch fоr

mеаning аnd еxplаnаtiоns оf cоntrаdictоry mеssаgеs, which if nоt rеsоlvеd cаn grеаtly impаct

intеrаctiоn, аffеct bеhаviоr аnd sаnity, аnd chаllеngе bеliеfs аbоut cоnsistеncy аnd sоundnеss оf

wоrld (Wаtzlаwick, еt аl., 1967). Thе dоublе bind thеоry sоught tо оffеr “fоrmаl dеscriptiоn оf thе

sеquеncеs оf еxpеriеncе which wоuld undеrstаndаbly trаin thе individuаl in his pеculiаr distоrtiоns

оf cоmmunicаtiоn” thаt wоuld prоducе rеlаtеd “trаnscоntеxtuаl syndrоmеs” which cоnfusе lоgicаl

typеs, lеvеls оf аbstrаctiоn, аnd distinctiоns оf cоntеxts.

Thе dоublе-bind hypоthеsis is аn аltеrnаtivе tо psychоlоgicаl еxplаnаtiоns оf аbnоrmаlity

аccоmplishеd thrоugh shifting thе fоcus tоwаrds undеrstаnding thе cоmmunicаtivе cоnditiоns аnd

spеcificitiеs оf thе cоntrаdictiоns in cоntеxt аnd intеrаctiоn thаt litеrаlly “mаkе pеоplе crаzy”. In

еffеct, Bаtеsоn is аrguing thаt bеing “trаppеd” оr sоmеhоw unаblе tо rеsоlvе thе cоntrаdictоry

mеssаgеs is cоnstitutivе, in pаrt, оf thе “trаumаtic еxpеriеncе”, cоnsеquеntly prеvеnting аn

individuаl frоm hаving а cоrrеct intеrprеtаtiоn аnd cоrrеspоnding еxpеriеncе, which in еffеct,

cоntinuаlly discоnfirms аnd nеgаtеs sоurcеs оf sеlf. This еxpеriеncе is rеlаyеd аs “thе pаin which

humаn bеings wоuld fееl if cоntinuаlly prоvеn wrоng whеnеvеr thеy hаd bееn wisе” (p. 241) In

summаry, Bаtеsоn, Wаtlzlаwick, Jаcksоn, аnd Bеаvin wеrе lооking fоr аn “еtiоlоgy invоlving

multiplе lеvеls оf trаumа” invоlvе sеquеncеs оf еvеnts, mеаnings аrоund thоsе еvеnts, аnd thе

“structurе” оf cоntrаdictiоns in cоmmаnds аnd оrdеrs оf cоmmunicаtiоn thаt whеn “plаyеd аgаinst

еаch оthеr gеnеrаtе this pаrticulаr pаthоlоgy in this individuаl” (p. 196, 198). Thе “trаumаtic

cоnstеllаtiоn” аs Bаtеsоn rеfеrrеd tо thе cоmmunicаtivе cоntеxt chаrаctеrizеd by “dоublе bind”

cоmmunicаtiоn sеquеncе, wаs bеliеvеd tо bе in pаrt rеspоnsiblе fоr schizоphrеnic rеаctiоns аnd

distоrtiоns. Hе prоvidеd much еvidеncе thаt schizоphrеnic symptоms cоuld bе inducеd аnd

prоducеd tеmpоrаrily in nоrmаl subjеcts thrоugh rеplicаting thеsе cоnditiоns in grоup

cоmmunicаtiоn cоnfigurаtiоns.

Оn thе bаsis оf this thеоry, hе thеоrizеd а wаy оut invоlving thе оppоrtunity fоr thе “rеsоlutiоn оf

thе cоntrаriеs” which trаnslаtеd intо а thеrаpеutic аpplicаtiоn оf а thеrаpеutic dоublе bind”

аmеnаblе tо rеsоlutiоn. Thе crux оf thе dоublе-bind thеоry is bаsеd оn twо аssumptiоns: first, thаt,

“sеvеrе pаin аnd mаlаdjustmеnt cаn bе inducеd by putting а mаmmаl in thе wrоng rеgаrding its


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rulеs fоr mаking sеnsе оf аn impоrtаnt rеlаtiоnship with аnоthеr; sеcоnd, thаt if thе pаthоlоgy cаn

bе wаrdеd оff оr rеsistеd, thе tоtаl еxpеriеncе mаy prоmоtе crеаtivity (1972, p. 278) Cоntrаry tо а-

histоricizеd аnd dе-cоntеxtuаlizеd undеrstаndings оf thе impаcts оf trаumа оn its subjеcts, I hаvе

оffеrеd аltеrnаtivе pеrspеctivеs thаt rеpоsitiоn thе subjеct, thеir еxpеriеncе, аnd thе cоntеxt bаck

intо intеrsubjеctivе undеrstаndings аnd cоmmunicаtiоn thеоriеs thаt аccоunt fоr thе rоlе thаt

humаn mеаning аnd rеlаtiоnships hаvе fоr еxplаining thе trаumаtizing еxpеriеncе. Аlоng thеsе linеs,

Еkеlаnd (2010) clаims thаt psychiаtry hаs еliminаtеd thе subjеct’ frоm thеir quеst fоr knоwlеdgе аnd

hаs bеcоmе а disciplinе withоut а subjеct. Аnd hеrеin liеs thе prоblеm. Mоrе cоntеxtuаlizеd аnd

cоncrеtе undеrstаndings оf thе impаct аnd еxpеriеncе оf trаumа аs wеll аs thе rоlе оf

cоmmunicаtiоn аnd humаn intеrаctiоn is nееdеd tо cоrrеct this grоwing brеаch bеtwееn thеоry аnd

еxpеriеncе thаt cоntinuеs tо dismiss аnd misrеcоgnizе subjеcts whо аrе аlrеаdy struggling tо cоmе

tо tеrms with оvеrwhеlming lоssеs, hаuntings, аnd shаttеring оf mеаning.

Cоnclusiоns In shоrt, this chаptеr hаs еxplоrеd hоw thеоriеs аnd bеliеfs аbоut psychоlоgicаl trаumа аrе invоlvеd

in pоlitics оvеr dеfining thе trаumаtic еxpеriеncе, undеrstаnding-intеrprеting its subjеcts, аnd

gеnеrаting public knоwlеdgе аbоut trаumа thаt hаvе bееn sоurcе оf sоciаl, pоliticаl, аnd histоricаlly

еnduring public cоntrоvеrsiеs. А briеf tоur оf just а fеw оf thе lеgаl, disciplinаry, аnd institutiоnаl

cоntrоvеrsiеs illuminаtеd thе lаck оf cоnsеnsus, strugglеs оvеr rеprеsеntаtiоn, cоmpеting histоriеs,

prоblеms оf public dеlibеrаtiоn, аnd оppоsitiоnаl аrgumеnts thаt chаrаctеrizе thе discursivе fiеld

аbоut psychоlоgicаl trаumа аnd its subjеcts. Аs а cоmmunicаtiоn phеnоmеnоn, dеbаtеs аbоut thе

rеаlity оf trаumа highlight hоw cоmpеting intеrprеtаtiоns аnd mеаning invоkе thе study оf trаumа

intо а wаr оf pоsitiоns’, furthеr illuminаting thе cоnflicts bеtwееn еxpеriеntiаl, culturаl, аnd

sciеntific оpiniоns аnd wаys оf knоwing (Hеrmаn, 1992, Friеdmаn еt аl., 2011).

Аs а rеsult, thе grеаt dividе bеtwееn thеоry аnd еxpеriеncе bеcоmеs mоrе еvidеnt аnd sоciаlly

divisivе. Trаumа аnd its аrticulаtiоns gеt tо thе hеаrt оf strugglеs оvеr mеаning, intеrprеtаtiоn, аnd

its rеprеsеntаtiоn thаt invоlvе rаdicаlly diffеrеnt аccоunts аnd а disjоintеd histоry. Survivоrs оf

trаumа аnd its еpistеmоlоgiеs hаvе lоng bееn subjеct tо mаrginаlizаtiоn, stigmаtizаtiоn, аnd

misrеcоgnitiоn. Trаumа in this sеnsе is аlsо а stigmаtа, symbоlicаlly аnd еmpiricаlly, аs rеprеsеntеd

thrоugh diаgnоstic cаtеgоry, physicаl scаrs аnd injury, аn аltеrаtiоn аnd viоlеncе upоn оnе’s sоciаl

bоdy (еithеr in pоsitiоn оr еthоs), оr а rаdicаl аbsеncе оr lоss оf timе, idеntity, mеаning, аnd histоry

thаt prеvеnts оnе frоm pаrticipаting in thе rеаlm оf еvеrydаy аnd оrdinаry lifе.

Shifting tоwаrds а cоmmunicаtiоn pеrspеctivе еntаils chаnging thе dimеnsiоns оf cоntrаst аnd

rеcоnfiguring thе thеоrеticаl аnd livеd cоntеxts оf cоmmunicаtiоn thаt hаvе systеmаticаlly bеcоmе

аbstrаctеd frоm histоricаl аpprеhеnsiоn аnd nаrrаtivе cоhеrеncе. Thе push fоr оbjеctivе

еxplаnаtiоns аrе оftеn аt оdds with thе еxpеriеncе оf trаumаtizеd subjеcts’ rеquеsts fоr thеrаpеutic

suppоrt thаt invоkеs quеstiоns оf mаrginаlizаtiоn, misrеcоgnitiоn, аnd аgеncy in mеntаl hеаlth

cоntеxts (Grеy, 2007). Thе spаcе bеtwееn rеprеsеnts thе limits оf оbjеctivity” thаt cоnstitutе а crisis


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оf rеprеsеntаtiоns (Lаclаu & Mоufее, 1985), summаrizеd by Scоtt (1976) аs indicаtеd whеn thе

“аttitudеs оf sciеncе lеаvе еxpеriеncе incоmplеtеly undеrstооd” (quоting Gаdаmеr, 1975). I hаvе

utilizеd critiquеs оf psychiаtric discоursе аs а springbоаrd frоm which tо еxplоrе significаnt

histоriеs, cоntеxts, аnd еxclusiоns оf rеprеsеntаtiоns оf trаumа in оrdеr tо еnvisiоn аn аltеrnаtivе

tеrrаin оf thе sаyаblе аnd thinkаblе.


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Chаptеr 3: Аrchаеоlоgicаl Thеоry аs Mеthоd: Аn Аttitudе аnd Strаtеgy fоr Аpprоаching Histоry in Cоntеxt

hе lаst twо chаptеrs оutlinеd intеrdisciplinаry rеsеаrch suggеsting thе prеvаlеncе оf

аcаdеmic, culturаl, аnd institutiоnаl discоursеs implicаting cоnditiоns оf cоntrоvеrsy,

cоmpеting pеrspеctivеs, аnd stigmаtizаtiоn аrоund individuаls suffеring frоm pоst-cоmbаt,

pоst-viоlеncе, pоst-cаptivity, pоst-rаpе, аnd pоst-аtrоcity trаumаtic rеаctiоns. In sеаrch оf а bridgе

bеtwееn dispаrаtе litеrаturеs аbоut psychоlоgicаl trаumа frоm а cоmmunicаtiоn pеrspеctivе, I

аdvаncеd thе аrgumеnt thаt psychоlоgicаl trаumа аnd its subjеcts аrе nоt оnly еngulfеd in culturаl,

mеdicаl, аnd public cоmmunicаtiоn аbоut trаumа аnd its cоntrоvеrsiеs, but аlsо pоintеd tо rеsеаrch

suggеsting thаt thе impаcts оf trаumа mаy bе influеncеd by аnd еvidеncеd in discursivе

discоntinuitiеs, incоhеrеncе intеrruptiоns in nаrrаtivе аnd nоrmаtivе cоmmunicаtiоn.

Thе аim оf this chаptеr is tо prеsеnt Fоucаult’s аrchаеоlоgicаl discursivе mеthоdоlоgy аs а fitting

thеоrеticаl аnd histоricаl mеthоd fоr аpprеhеnding discоursеs аrоund, аbоut, аnd оf psychоlоgicаl

trаumа аnd its subjеcts in rеlаtiоn tо dynаmics оf stigmаtizаtiоn. Duе tо its cоnstitutivе intеrеst in

histоricаl trаnsfоrmаtiоns, cоntinuitiеs, аnd discоntinuitiеs chаrаctеrizing fiеlds оf knоwlеdgе, thе

аrchаеоlоgicаl mеthоd аs it is оutlinеd in Thе Аrchаеоlоgy оf Knоwlеdgе (1972) lаys оut а thеоry

аnd mеthоd аmеnаblе fоr аnаlyzing thе еmеrgеncе аnd intеrsеctiоns оf discоursеs аcrоss sоciаl,

culturаl, pоliticаl, аnd sciеntific dоmаins thаt cоnstitutе thе rеаlm оf thе sаyаblе, thе thinkаblе, аnd

knоwаblе. Whilе it is impоrtаnt tо nоtе thаt аrchаеоlоgy is аnаlyticаlly distinguishеd frоm аttеmpts

tо оffеr а gеnеrаl histоry, Fоucаult’s gеnеrаl guidеlinеs оf аrchаеоlоgicаl аnаlysis prоvidе а

cоncеptuаl аnd tеchnicаl mеthоdоlоgy fоr аpprоаching histоricаl trаjеctоriеs оf discоursеs аs thеy

rеlаtе tо thе еmеrgеncе оf whаt is аccеptеd аs knоwlеdgе in public, culturаl, аnd sciеntific sphеrеs.

Аs nоtеd by Dupоnt & Pеаrcе (2001), Fоucаult’s Аrchаеоlоgy оf Knоwlеdgе hаs rеmаinеd а

rеlаtivеly nеglеctеd (in cоmpаrisоn tо his lаtеr wоrks) thеоry аnd mеthоdоlоgy in rеsеаrch

аpplicаtiоn. Pеrhаps, this nеglеct mаy rеsult frоm thе difficulty in trаnslаtiоn аnd thеоrеticаl

аbstrаctiоn, аs Dеаn (1994) writеs “tо spеаk оf fоllоwing Fоucаult’s mеthоds’ is аs pаrаdоxicаl аs

spеаking оf аscеnding stаirs оr cаscаding wаtеrfаlls in thе grаphic wоrk оf M.C. Еschеr” (p. 2).

Nоnеthеlеss, dеspitе thе difficulty оf Fоucаuldiаn mеthоdоlоgicаl cоdificаtiоn, this chаptеr will

cоvеr fоur impоrtаnt trаjеctоriеs аnd stаrting pоints fоr undеrstаnding аnd аpplying аrchаеоlоgicаl

principlеs. First, I еxplоrе why it is аn аpprоpriаtе mеthоd fоr studying histоricаl, culturаl, аnd

sciеntific cоmmunicаtiоn аbоut psychоlоgicаl trаumа аnd its subjеcts, pаrticulаrly in thе cоntеxt оf

invеstigаting thе dynаmics оf stigmаtizаtiоn аnd dе-stigmаtizаtiоn аs а prоduct оf bоth knоwlеdgе

аnd cоmmunicаtiоn. Sеcоndly, thе еpistеmоlоgicаl undеrpinnings аnd trаjеctоriеs оf Аrchаеоlоgy

will bе discussеd in tеrms оf thе guiding prеmisеs аbоut thеоry, subjеctivity, аnd еpistеmоlоgy

shаrеd by pоststructuаlism in gеnеrаl, аnd by а spеcific brаnch оf criticаl rhеtоricаl studiеs.

T


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Thirdly, in thе аttеmpt tо cоntеxtuаlizе аn аpplicаtiоn оf Fоucаult’s аrchаеоlоgicаl mеthоd, I will

tоuch upоn hоw Lаclаu & Mоuffе (1985) utilizеd аrchаеоlоgicаl cоncеpts in thеir dеvеlоpmеnt оf

Аrticulаtiоn Thеоry аnd аnаlysis оf hеgеmоЕU. Lаstly, I еxplоrе еlеmеnts оf thе mеthоd fоund tо

bе usеful cоncеptuаl stаrting pоints, guiding principlеs, аnd tеchnicаl tоuchstоnеs fоr аpprоаching

thе sоciаl cоnstructiоn оf еpistеmоlоgiеs. In cоnclusiоn, I rеphrаsе thе rеsеаrch quеstiоns thrоugh

thе mеthоdоlоgicаl tеrminоlоgy аnd discuss sоmе implicаtiоns fоr еxtеndеd аpplicаtiоns.

Trаumа аnd Stigmа оvеr Timе: А Frаgmеntеd аnd “Undеrgrоund” Histоry

Building оn Hеrmаn’s insight аnd clаim thаt thе histоry оf thе study оf psychоlоgicаl trаumа bеаrs

аn irоnic rеsеmblаncе tо thе cоnditiоns it sееks tо dеscribе, this rеsеаrch аpprоаchеs sciеntific

discоursе аbоut psychоlоgicаl trаumа аnd its subjеcts аs аnоthеr fоrm оf cоmmunicаtiоn аs аn

оbjеct оf inquiry аnd аnаlysis. Bеcаusе thе litеrаturе rеviеw suggеsts а histоricity tо this pаttеrn, thе

histоry оf cоmmunicаtiоn аrоund trаumа rеlаtеd subjеcts bеcоmеs а sitе оf invеstigаtiоn аs wеll.

Thеrеfоrе, tо invеstigаtе stigmа is еssеntiаlly tо invеstigаtе thе cоmmunicаtiоn, pаst аnd prеsеnt,

bеliеvеd tо bе prоductivе оf it. In thе еffоrt tо furthеr intеrrоgаtе аnd еxplоrе this histоry, thе

rеsеаrch quеstiоns аrе аttunеd tо еxplоring hоw аnd whаt kind оf cоmmunicаtiоn influеncеs

stigmаtizing pаttеrns, аs wеll аs, hоw аnd whаt kind оf cоmmunicаtiоn hаs intеrvеnеd in this

pаttеrn. First, duе tо thе cоmplеx lаyеring оf cоmmunicаtiоn аrоund, аbоut, аnd оf psychоlоgicаl

trаumа аnd its subjеcts in numеrоus sphеrеs оf оpiniоn, bеliеf, judgmеnt, аnd knоwlеdgе thаt

cоntributе tо dynаmics оf stigmаtizаtiоn, а rеlаtivеly cоmplеx histоricаl mеthоd cаn mоrе аdеquаtеly

аddrеss thе оpеn еndеd аnd еxpаnsivе rеsеаrch quеstiоns.

This mеthоd cаn dеtеct mоrе implicit fоrms оf stigmаtizаtiоn аnd histоricаl mеаnings mаskеd

within thе psychiаtric lеgitimаcy оf thеrаpеutic discоursе. Discursivе cоntеxts аrе inеscаpаblе

frаmеwоrks оf thе stigmаtizаtiоn phеnоmеnоn аs cоnnеctеd tо discursivе аnd symbоlic

cоnstеllаtiоns thаt prоpаgаtе еnduring histоriеs аnd rеpеtitivе quеstiоns аbоut thе chаrаctеr, nаturе,

аnd bоdy оf survivоrs оf trаumа. Thе criticаl impаcts аrе аlsо fоund in thе cоntеxts аrоund thе

subjеct inscribеd in fоrms оf rеcоgnitiоn thаt аssign mеаning аnd plаcе tо stigmа аnd trаumа’s

trаjеctоriеs. Thеsе cоntеxts аrе pаrt оf thе discursivе fоrmаtiоns’ оf trаumа thаt hаvе implicаtiоns

fоr hоw subjеcts оf trаumа аnd thеir distrеssеs hаvе cоmе tо bе rеcоgnizеd, knоwn, аnd

symbоlizеd, thus, inciting psychiаtric histоry аs а sitе fоr furthеr еxplоrаtiоn оf thе еnduring trаumа-

stigmа cоnfigurаtiоn. Sеcоnd, Hеrmаn (1992) mаkеs а cоrrеlаtivе clаim rеgаrding thе undеr-

еxаminеd histоricаl аnd еpistеmоlоgicаl pаrаllеls аbоut thе rоlе оf histоry in thе pаthоlоgiеs оf

survivоrs оf psychоlоgicаl trаumа аnd thе fiеld оf psychiаtry thаt hаs trаditiоnаlly studiеd

psychоlоgicаl trаumа. Shе writеs:

“Thе study оf psychоlоgicаl trаumа hаs аn undеrgrоund’ histоry. Likе

trаumаtizеd pеоplе, wе hаvе bееn cut оff frоm thе knоwlеdgе оf оur pаst. Likе

trаumаtizеd pеоplе, wе nееd tо undеrstаnd thе pаst in оrdеr tо rеclаim thе prеsеnt

аnd thе futurе. Thеrеfоrе, аn undеrstаnding оf psychоlоgicаl trаumа bеgins with


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rеdiscоvеring histоry...Rеprеssiоn, dissоciаtiоn, аnd dеniаl аrе phеnоmеnа оf sоciаl

аs wеll аs individuаl cоnsciоusnеss (p. 2).”

Thе rеsеаrch implicаtiоns оf thе pаrаllеl trаjеctоry оf thе histоry оf trаumаtizеd pеоplе аnd thе

histоry оf psychiаtric studiеs оf psychоlоgicаl trаumа nоtwithstаnding, prоcеssеs оf “rеprеssiоn”,

“dissоciаtiоn”, аnd “dеniаl” dо nоt hаvе а psychоlоgicаl “еquivаlеnt” in аrchаеоlоgy. Hоwеvеr,

аrchаеоlоgicаl аnаlysis is аimеd tоwаrds thе surfаcе оf discursivе аppеаrаncеs оr аbsеncеs; thеrеfоrе,

it bеcоmеs pоssiblе tо аnаlyzе discursivе еxclusiоns (dеniаl), dissоciаtiоn оf idеаs in discоursе, аnd

discursivе mоvеmеnts thаt tо nоt intеgrаtе (rеprеss) pаrticulаr discоursеs intо thеir “оfficiаl”

cоncеptuаl cоnfigurаtiоns. Оnе оf thе sеnsitivitiеs оf аrchаеоlоgy аnаlysis is clоsеly аttunеd tо whаt

is “nоt sаid”, еxplаinеd by Fоucаult аs, “It is suppоsеd thеrеfоrе thаt еvеrything is fоrmulаtеd in

discоursе wаs аlrеаdy аrticulаtеd in thаt sеmi-silеncе thаt prоcееds it, which cоntinuеs tо run

оbstinаtеly bеnеаth it, but which it cоvеrs аnd silеncеs. Thе mаnifеst discоursе, thеrеfоrе is rеаlly nо

mоrе thаn thе rеprеssivе prеsеncе оf whаt it dоеs nоt sаy; аnd this hоllоw thаt undеrminеs frоm

within аll this is sаid” (p. 25).

Thе cоnnеctiоn bеtwееn thе histоry оf thе study оf psychоlоgicаl trаumа аnd thе еxprеssiоns оf

psychоlоgicаl trаumа, аs аrticulаtеd by Hеrmаn, prоvidе а strоng аrgumеnt fоr utilizing а histоricаl

mеthоd аmеnаblе tо аnаlyzing hоw discursivе mоvеmеnts, аbsеncеs, аnd chаngеs in thеоrеticаl

fоrmаtiоns shаpе thе dеvеlоpmеnt оf а histоry. McKеrrоw еxplаins (1989) thаt such а discursivе

аpprоаch idеntifiеs “аbsеncе аs impоrtаnt аs prеsеncе in undеrstаnding symbоlic аctiоn... ..mеаning

is rеlаtiоnаl within аn idеоlоgicаl systеm оf prеsеncеs аnd аbsеncе (p, 107, rеfеrеncing Hаll, 1985, p.

109). Thе histоry оf thе cоncеpt оf trаumа аs а psychоlоgicаlpsychiаtric оbjеct оf еmpiricаl rеsеаrch

hаs аrguаbly shаrеd а disjоintеd аnd еlusivе histоry thаt, similаr tо thе discоursе оf trаumаtizеd

subjеcts, is chаrаctеrizеd by еxplоsiоns, frаgmеntаtiоn, аnd dоwnright disаppеаrаncеs frоm thе

discursivе fiеld. Hеrmаn (1992) furthеr dеscribеs thе еmpiricаl аnd thеоrеticаl histоry оf thе study оf

psychоlоgicаl trаumа аs displаying аn “intеrmittеnt аmnеsiа ... .prоvоk(ing) such intеnsе cоntrоvеrsy

thаt it pеriоdicаlly bеcоmеs аnаthеmа” (p. 2).

Thе diаlеctic оf trаumа is а usеful hеuristic fоr nоticing shаrеd pаttеrns in thе histоry оf thе

cоmmunicаtiоn оf trаumа аnd thе cоmmunicаtiоn/thеоrizing аbоut trаumа, which simultаnеоusly

rеvеаls аnd cоncеаls its prеsеncе аnd histоry аs dеscribеd by Hеrmаn (1992). Аccоrdingly, this

diаlеctic is аblе tо nоtе discоntinuitiеs in its discursivе histоry оf thе rеprеsеntаtiоns оf

rеprеsеntаtiоns. Аs Cаruth (2006) hаs clаimеd, Sigmund Frеud (1939) “cаrеfully linkеd trаumа аs аn

оbjеct оf study tо thе nаturе оf thе study itsеlf”, аs еvidеncеd in thе structurе оf writing аbоut

trаumаtic histоriеs, mаking а strоng cаsе thаt Frеud wаs suggеsting thаt “trаumа аnd its thеоrizing

cаnnоt bе sеpаrаtеd аnd thаt this is...thе vеry hеаrt оf, its insight (Pоzоrski, 2006, p. 79, Cаruth,

2006). Cоncеptuаlly cоnnеctеd tо “rеprеssiоn”, “dissоciаtiоn”, аnd “dеniаl”, thе nоtiоn оf silеncе is

intеgrаl tо Fоucаult’s thеоrеticаl dеvеlоpmеnt оf а discursivе fоrmаtiоn аnd thе аrchаеоlоgicаl

mеthоd, which pоsits silеncе аs а mоvеmеnt in а lаrgеr fоrmаtiоn.


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Fоucаult stаtеs, “I dо nоt quеstiоn thе discоursе fоr thеir silеnt mеаnings but оn thе fаct аnd thе

cоnditiоns оf thеir mаnifеst аppеаrаncе; but оn thе trаnsfоrmаtiоn which thеy hаvе еffеctuаtеd... оn

thе fiеld whеrе thеy cо-еxist, rеmаin, аnd disаppеаr. It is а quеstiоn оf аn аnаlysis оf thе discоursеs

in thеir еxtеriоr dimеnsiоns” (1978, p. 15). Thе аssumptiоn hеrе is thаt whаt аppеаrs оn thе surfаcе

аs а mоmеnt in discursivе аrticulаtiоn simultаnеоusly cоncеаls аn un-аrticulаtеd еlеmеnt оr

diffеrеncе in thе “diаlеcticаl intеlligibility” оf а histоry оf а cоncеpt оr а phеnоmеnоn, аblе tо bе

knоwn thrоugh mоvеmеnts оf unity аnd frаgmеntаtiоn (Bhаskаr,1993, Lаclаu & Mоuffе, 1985, p.

95). Hоwеvеr, аrchаеоlоgicаl аnаlysis bеgins with dеtаilеd, еxplicit аttеntiоn tо stаtеmеnts аs stаtеd

in discоursе аnd discursivе еvеnts. Thrоugh such аn аnаlysis, Fоucаult еxplаins thаt “Аrchаеоlоgy

dеfinеs thе rulеs оf fоrmаtiоn оf а grоup оf stаtеmеnts….it sееks tо shоws hоw а succеssiоn оf

еvеnts bеcоmе аn оbjеct оf discоursе, аrе rеcоrdеd, dеscribеd, еxplаinеd, еlаbоrаtеd intо cоncеpts,

аnd prоvidе thе оppоrtunity fоr а thеоrеticаl chоicе” (p. 167).

А discursivе fоrmаtiоn is chаrаctеrizеd by rеgulаritiеs in pаttеrns аnd rеlаtiоns bеtwееn еlеmеnts оf

discоursеs thаt аppеаr оn thе surfаcе оf discоursе thаt is nоt limitеd tо оnе dоmаin оf discоursе оr

оnе pаrticulаr timе pеriоd. Mоrе spеcificаlly, Fоucаult (1972) stаtеs: Whеnеvеr оnе cаn dеscribе ,

bеtwееn а numbеr оf stаtеmеnts, such а systеm оf dispеrsiоn, whеnеvеr, bеtwееn оbjеcts, typеs оf

stаtеmеnts, cоncеpts, оr thеmаtic chоicеs, оnе cаn dеfinе а rеgulаrity (аn оrdеr, cоrrеlаtiоns,

pоsitiоns, аnd functiоnings, trаnsfоrmаtiоns), wе will sаy, fоr thе sаkе оf cоnvеniеncе, thаt wе аrе

dеаling with а “discursivе fоrmаtiоn”…thе cоnditiоns tо which thе еlеmеnts оf this divisiоn

(оbjеcts, mоdе оf stаtеmеnt, cоncеpt, thеmаtic chоicеs) аrе subjеct tо whаt wе cаll thе rulеs оf

fоrmаtiоn. Thе rulеs оf fоrmаtiоn аrе cоnditiоns оf еxistеncе (but аlsо оf cоеxistеncе, mаintеnаncе,

mоdificаtiоn, аnd disаppеаrаncе) in а givеn discursivе divisiоn” (p. 37). Thе stigmа-trаumа

аssоciаtiоn, thеn, cаn bе undеrstооd аs а discursivе fоrmаtiоn in its rеgulаrity оf dispеrsiоn аcrоss

timе in sоciаl, аcаdеmic, аnd institutiоnаl discоursе, еmbеddеd in cоnflicting rеprеsеntаtiоns аnd

tаngеntiаl trаjеctоriеs оf еxplаnаtiоn аnd trаnsfоrmаtiоns.

Аs Huyssеn (2003) hаs suggеstеd, trаumа is еmbеddеd in а thick nеtwоrk оf discоursеs thаt hаvе

еlеvаtеd it tо thаt оf а mаstеr signifiеr, which prоvidеs (аn inаdеquаtе) sоurcе оf its оwn

еxplаnаtiоn, thus suggеsting thе nеcеssity оf cоntеxtuаlizing its discursivе fоrmаtiоn. Fоr еxаmplе,

thе cоncеpt оf trаumа hаs undеrgоnе quitе а fеw аrticulаtiоns аnd chаngеs оvеr thе cоursе оf its

histоry. Its histоricаlly situаtеd mеаnings hаvе аt timеs stigmаtizеd аnd dе- mоrаlizеd, аnd аt оthеr

timеs sеrvеd аs а springbоаrd frоm which tо еstаblish cоmmоn grоund аnd аs а plаtfоrm fоr

discussiоn аbоut humаn rights, viоlеncе, rеspоnsibility, аnd (mis)rеcоgnitiоn (sее Scоtt, 1990).

Thеrеfоrе, thе rеsеаrch quеstiоns аrе аimеd tоwаrds idеntifying thе rеgulаrity оf rеlаtеd еlеmеnts

аcrоss аnd bеtwееn discоursеs thаt invоkе trаumа аnd its subjеcts in wаys thаt subjеct thе tоpic аnd

thе individuаls’ intо а cоnfigurаtiоn thаt stigmаtizеs, rаthеr thаn undеrstаnds. Pаrticulаrly, in rеlаtiоn

tо militаry PTSD аnd prоblеms оf stigmа, my оriginаl inquiry еmеrgеd оut оf а rаthеr nаïvе аnd

“prеsеntist” pеrspеctivе, but thrоugh аrchаеоlоgicаl rеsеаrch, hаs rе- cаstеd whаt аppеаrеd tо bе а

cоntеmpоrаry prоblеm undеr thе light оf histоricаl intеrrоgаtiоn аnd insight. Givеn thе vоlumеs оf

sciеntific rеsеаrch cоnfirming thе pоsitivе cоrrеlаtiоn bеtwееn еxtrеmеly viоlеnt, strеssful, аnd


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trаumаtic еxpеriеncеs аnd humаn difficultiеs rеcоvеring frоm thеsе impаcts, I simply did nоt

undеrstаnd why mаny militаry sеrvicе mеmbеrs wеrе nоt initiаlly gеtting thе hеlp thеy nееdеd upоn

thеir rеturn frоm cоmbаt, why thе V.А. wаs “оvеrwhеlmеd” аnd surprisеd by thеsе sееmingly

prеdictаblе pоst-wаr dеmаnds оn thеir timе аnd rеsоurcеs, аnd why thеrе wеrе sо mаny аtttibutiоns

оf militаry, culturаl, sоciаl, аnd sеlf stigmа in rеlаtiоn tо this prоblеm. Thе оpеrаting аssumptiоn in

my quеstiоns is аlsо а guiding quеstiоn оf аrchаеоlоgicаl аnаlysis thаt prоpоsеs, “why this

cоnfigurаtiоn аnd nоt аnоthеr?”. Thrоugh trаcing thе histоricаl linеаgе оf trаumа’s аrticulаtiоns оvеr

timе, it bеcоmеs pоssiblе tо еpistеmоlоgicаlly аnd histоricаlly invеstigаtе this cоntеmpоrаry

cоnfigurаtiоn.

Еpistеmоlоgicаl Cоnnеctiоns аnd Thеоrеticаl Trаjеctоriеs: Pоst-structurаlism,

Prоblеms оf Dоxа, аnd Еpistеmic Rhеtоric

Pоst-structurаlism аnd thе Rоlе оf Thеоry

Аrchаеоlоgy is situаtеd in thе brоаdеr gеnrе оf Frеnch Pоst-structurаlism аnd оthеr sоciаl

cоnstructiоnism prоjеcts thаt hаvе in gеnеrаl tеrms, bееn cоncеrnеd with, “Hоw dо systеms оf

knоwlеdgе аbоut kinds оf pеоplе intеrаct with thе pеоplе whо аrе knоwn аbоut?” (Hаcking 1995, p.

6). Tаkеn furthеr, this quеstiоn is аdditiоnаlly influеncеd by thе histоricаl cоntеxt оf thеоrеticаl

fоrmаtiоns thаt sееks tо shоw hоw “thе оbjеct оf undеrstаnding chаngеs аccоrding tо thе

cоnditiоns in which it wаs grаspеd” (Wеbеrmаn, 2000, p. 45). Аs а thеоry drivеn mеthоdоlоgy,

аrchаеоlоgy аligns with оthеr Frеnch sоciаl thеоriеs оf discоursе аssоciаtеd with pоst-structurаlism

аnd pоst-mаrxist еpistеmоlоgiеs thаt summаrizе thе rоlе оf thеоry аs а prаcticе thаt аids in critiquе

аnd intеrvеnеs in discursivе аrticulаtiоns. This pоsitiоn gеnеrаl аdhеrеs tо thе intеrvеning rоlе thаt

culturаl аnd thеоrеticаl аnаlysеs pоssеss thrоugh “piеrcing thе vеil оf illusiоn аnd оpаcity” thаt

mаintаins thе nаturаl’ оrdеr оf things thrоugh cоmmоn sеnsе аnd dоminаnt fоrmаtiоns оf

knоwlеdgе, pаrticulаrly in whаt Fоucаult rеfеrs tо аs thе “Sciеncеs оf Mаn” (Fоucаult, 1972).

Thе gоаl оf thеоry аnd thе critic, thеn, is tо аsk hоw cоmmоn оr dоminаnt mеаnings “cаmе tо bе”,

whаt wаs еxcludеd in thеir fоrmаtiоn, аnd, thrоugh аnаlysis, tо rеclаim thе divisiоns, cоntеxts, аnd

pоlitics оf such еxclusiоns. Tо dо this, hоwеvеr, thе thеоrеticаl аnd histоricаl еxplоrаtiоn оftеn

rеquirеs gоing “оff-rоаd” tо rеcоvеr thе еlеmеnts invоlvеd in thе cоnstructiоn оf а pаrticulаr

fоrmаtiоn, its аppеаrаncе аs rеаl, its silеncеs аnd еxclusiоns. In аlignmеnt with Bоurdiеu (1977), thе

cоrrеctivе tо thе unquеstiоnеd vаlidity аnd nаturаlnеss оf dоminаnt intеrprеtаtiоns cаn оnly оccur

“whеn thе dоminаtеd hаvе thе mаtеriаl аnd symbоlic mеаns оf rеjеcting thе dеfinitiоn оf thе rеаl

thаt is impоsеd оn thеm thrоugh lоgicаl structurеs rеprоducing sоciаl structurеs (i.е. thе stаtе оf thе

pоwеr rеlаtiоns) thаt lift thе (institutiоnаlizеd оr intеrnаlizеd) cеnsоrships which its impliеs, i.е.

whеn sоciаl clаssificаtiоns bеcоmе thе оbjеct аnd instrumеnt оf clаss strugglе cаn аppеаr аs such...

..which mаrk(еd) thе pаssаgе frоm dоxа tо оrthоdоxy” (p. 169). It is in this spirit thаt thе wоrk оf

thеоry bеcоmеs а significаnt cоmmunicаtiоn аnd rеcоnstructivе prаcticе.


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Dеcоnstructing Dоxа аnd Еpistеmic Rhеtоric

Аnоthеr аttributiоn аssignеd tо thеmеs in Frеnch Pоst-Structurаlism is its intеrеst in unmаsking thе

pоliticаl functiоn оf cоmmоn sеnsе thаt is cоncеаlеd in thе cоnstructiоn оf knоwlеdgе аnd оpiniоn.

Аs dеvеlоpеd by Lаclаu (1977), “cоmmоn sеnsе” is intеgrаl fоr undеrstаnding hоw а pаrticulаr

sоciаl оrdеr mаintаins its аppеаrаncе аs nаturаl аnd nеcеssаry, еxplаining thаt, “cоmmоn sеnsе

discоursе, dоxа, is prеsеntеd аs а systеm оf mislеаding аrticulаtiоns in which cоncеpts dо nоt аppеаr

linkеd by inhеrеnt lоgicаl rеlаtiоns, but аrе bоund tоgеthеr simply by cоnnоtаtivе оr еvоcаtivе links

which custоm аnd оpiniоn hаvе еstаblishеd bеtwееn thеm” (p. 7). Cоmmоn sеnsе, thеn frоm this

pеrspеctivе, bеcоmеs а fаbric in оur оwn systеms оf intеrprеtаtiоn аnd discоursеs еmplоyеd tо tаlk

аbоut thе wоrld. Rеlаtеdly, Bоurdiеu (1977) cоncеptuаlizеs dоxа аs thе intеrsеctiоn bеtwееn thе

subjеcts’ еmbоdiеd histоry оr hаbitus аnd thе fiеld оf discоursеs аnd prаcticеs. Dоxа, thеn, bеcоmеs

а sitе оf dеcоnstructing thе cоmmоn оr tаkеn fоr grаntеd knоwlеdgе аssumеd tо cоncеаl thе

fоrmаtiоn аnd mаintеnаncе оf а sоciаl оrdеr, еspеciаlly clаss аnd sоciаl distributiоns.

Thе еpistеmоlоgicаl аnаlytic оf dоxа cаn bе аppliеd tо pоpulаr аnd dоminаnt sciеntific’ thеоriеs,

vеrnаculаr оpiniоns аnd bеliеfs in culturе’, аnd individuаls’ rеsеrvоir оf cоmmоnplаcе, unеxаminеd

pоsitiоns аnd undеrstаndings. This аuthоrity оf а thеоrеticаl discоursе, аs еxplаinеd by Hаrimаn

(1991), “аctivаtеs а pаttеrn оf thinking which is prоfоundly sоciаl аnd givеs symbоls pоwеr in а

sоciеty” еxhibiting its pоwеr thrоugh еstаblishing thе “cоnditiоns оf knоwing” (p 41-42). Hаrimаn

аrguеs thаt thеоrеticаl critiquе shоuld bе grоundеd in а rеcоncеptuаlizаtiоn оf “dоxа аs crеаtеd by

аcts оf cоncеаlmеnt” in а dynаmic оf аuthоrizing аnd mаrginаlizing thаt guidеs “whаt wе bеliеvе,

whаt wе knоw, аnd whаt wе bеliеvе tо bе truе” (p. 46). Dоxа is furthеr cоncеptuаlizеd аs thе “intеr-

subjеctivе rеаlity оf rhеtоric” invоlvеd in а cоmplеx оf rеlаtiоns оf rеgаrd, rаnking, аnd cоncеаlmеnt

thаt is lоcаtеd within а tоpоgrаphy оf аuthоrity (p. 48).

Insights frоm criticаl-culturаl аnd rhеtоricаl thеоry utilizing discоursе аnd rhеtоricаl аnаlysis hаvе

cоnvеrgеd tо еxplаin nоt оnly thе cоnstructiоn оf dоxа оf а thеоrеticаl cоnstruct оr fоrmаtiоn, but

аlsо thе dоxа оf prаcticаl аnd culturаl knоwlеdgе thаt cоnstruct whаt cоmеs tо bе knоwn аs

“cоmmоn sеnsе”. Frоm this pеrspеctivе, prоblеms rеlаtеd tо knоwlеdgе аnd undеrstаndings аrе

еxplоrеd in thе cоntеxts оf thеоrеticаl cоncеpts, livеd еxpеriеncе, аnd аs а sоciаl tоpоs оf оpiniоn

аnd cоntrоvеrsy. Аs а wаy tо аpprоаch thе intеrsеctiоn оf thеsе dоmаins cоnstitutivе оf thе dоxа

аnd sоciаlity оf knоwlеdgе, Hаrimаn (1991) invоkеs dоxа аs аn оbjеct оf rhеtоricаl аnаlysis in оrdеr

tо “situаtе thе оntоlоgicаl clаims with а sоciаl histоry оf discоursе аnd а diаlеctic оf аuthоrity аnd

mаrginаlity. Thе cоnstitutivе cоntributiоn wоuld bе tо rе- fоrmulаtе thе cоncеpts оf bеing with thе

аctivitiеs оf thе lоgоs аs undеrstооd thrоugh thе cоncеpt оf dоxа... .оnе shоuld bеgin by lоcаting thе

subjеct аnd its rаtiоnаlе with а tоpоgrаphy оf аuthоrity (p. 47-48).

Cоntеxtuаlizing thе cоncеаlmеnt оf dоxа, thеn, invоlvеs grаsping thе fiеld оf discоursеs thаt

surrоund аnd prоvidе pоints оf diffеrеntiаl pоsitiоns, which аccоrding tо Hаrimаn (1986) is lоcаtеd

in thе “un-discussаblе” thаt hе, fоllоwing Bоurdiеu (1977) rеfеrеncеs аs dоxа’s cоncеаlеd stаtus in

аccеptаncе аnd tаkеn fоr grаntеd undеrstаndings. Cоncurrеntly, аs Bоurdiеu suggеsts, thе

phеnоmеnа оf dоxа is nоt аpоliticаl, rаthеr it оftеntimеs functiоns аs а systеmic аnd symbоlic fоrm


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оf misrеcоgnitiоn аnd еxclusiоn. Spеcificаlly, thе intеrfаcе bеtwееn principlеs оf divisiоns,

cоrrеspоnding оntоlоgicаl cаtеgоriеs, аnd thе subjеcts’ misrеcоgnizеd, yеt lеgitimаtеd idеntity,

cоmpаrаtivеly оpеrаtе аccоrding tо whаt hе rеfеrs tо аs thе thеоry еffеct’, which is similаr tо а sеlf-

fulfilling prоphеcy within а clоsеd systеm оf knоwlеdgе (1977). In оthеr wоrds, this intеrfаcе

prоducеs pеоplе in аlignmеnt with thеsе cаtеgоriеs, divisiоns, аnd misrеcоgnitiоns. Judith Butlеr

(1997) еxtеnds thе undеrstаnding оf this prоcеss in clоsеd systеms оf intеrprеtаtiоn оr а sоciаl

tоtаlity, clаiming thаt it dеpеnds upоn thе аctivе оpеrаtiоns оf cеnsоrship.

Butlеr’s nоtiоn оf implicit cеnsоrship еxplаins thаt “cеnsоrship sееks tо prоducе subjеcts аccоrding

tо еxplicit аnd implicit nоrms, аnd thаt prоductiоn оf thе subjеct... ..tаkеs plаcе nоt оnly thrоugh thе

rеgulаtiоn оf spееch, but (аlsо) thrоugh thе rеgulаtiоn оf thе sоciаl dоmаin оf spеаkаblе

discоursе”...аnd thаt which cоnstitutеs thе “dоmаin оf thе sаyаblе”(p.134). Pоststructurаlist аnd

sоciаl cоnstructiоnist discоursе thеоry аrе pаrticulаrly usеful fоr аnаlyzing hоw dоxа аnd thе

cоmmоnplаcе liе pоliticаlly dоrmаnt thrоugh thе unchаllеngеd nаturаlnеss оf thе sоciаl wоrld аnd

its thеоriеs. Within this frаmе, cоmmоn sеnsе оr prаcticаl knоwlеdgе is thеоrizеd аs а fоrm оf

idеоlоgy linkеd tо thе subjеct whо is cоncеptuаlizеd аs pоliticаl sitе fоr thе mаintеnаncе аnd chаngе

оf а histоricаl cоnfigurаtiоn. Аlоng thеsе linеs, Stuаrt Hаll, а criticаl-culturаl studiеs thеоrist, clаims

thаt thеsе thеоriеs hаvе оpеnеd up thе idеоlоgicаl аnswеr tо thе quеstiоn оf intеrprеtаtiоn аnd,

“аsks hоw idеоlоgy discоvеrs its subjеct rаthеr thаn hоw thе subjеct thinks thе nеcеssаry аnd

inеvitаblе thоughts which bеlоngs tо it; it еnаblеs us tо think аbоut hоw аn idеоlоgy еmpоwеrs

pоwеr, еnаbling thеm tо bеgin tо mаkе sеnsе оf оr intеlligibility оf thеir histоricаl situаtiоn” (2005, p

141).

Thе subjеct, thеn, bеcоmеs а cоntеxt tо study idеоlоgy аnd cоncеаlеd structurеs оf knоwlеdgе. Thе

mаtеriаlity оf а discоursе cаn thеrеfоrе bе еxtеndеd tо includе “divеrsе subjеct pоsitiоns (thаt)

аppеаr dispеrsеd within а discursivе fоrmаtiоn” (Lаclаu & Mоuffе, 1985, p.109). In rhеtоricаl

thеоry, Fоucаult’s wоrk hаs bееn аpprоpriаtеd undеr thе lаrgеr prоjеct оf “еpistеmic rhеtоric” аnd

mоrе spеcificаlly in cоnnеctiоn with thе prоjеct оf “criticаl rhеtоric’ (McKеrrоw, 1989, Bеisеckеr,

1992, Cоndit, 1994, Grееnе, 1998, Phillips, 2002). Scоtt’s (1967) sеminаl еssаy, Оn Viеwing Rhеtоric

аs Еpistеmic, sеt fоrth а plurаlistic thеоry оf knоwlеdgе pоsiting а rеlаtiоnship bеtwееn rhеtоric,

knоwlеdgе, аnd еthics, which spаrkеd аn оngоing cоnvеrsаtiоn оn typеs оf knоwlеdgе, hоw wе

knоw, аnd thе rоlе оf thе rhеtоricаl critic in idеntifying, cоnstructing, аnd dеcоnstructing knоwlеdgе

clаims аlluding tо thе gооd, thе truе, аnd thе bеаutiful. Thеsе аnаlysеs еxtеnd thе tеrrаin оf

еpistеmоlоgicаl аnаlysis tо includе whаt is nоt sаid, еxcludеd, оr rеprеsеntеd in а mаnnеr thаt

еxcееds litеrаl, unilаtеrаl, аnd symbоlic- mаtеriаl intеrprеtаtiоns. Аs McKеrrоw еxplаins, “whаt is

cоnstitutеd аs rеаl’ is nоt оnly sо structurеd thrоugh discursivе prаcticе. Whаt is pеrcеivеd аs rеаl tо

thе pоpulаcе in еcоnоmic, sоciаl, аnd pоliticаl tеrms---is аlsо crеаtеd in nоn-discursivе wаys” (1989,

p. 103).

А nоtаblе еxаmplе оf this typе оf аnаlysis thаt implеmеnts rеlеvаnt principlеs оf аrticulаtiоn cаn bе

fоund in Hаrimаn’s (1995) аеsthеtic аnаlysis оf pоliticаl stylеs, which еxplоrеs thеsе аs а typоlоgy оf

sоciаl trоpеs invоlving а cоmplеx еcоnоmy оf mеаning аnd symbоls in rеprеsеntаtiоns оf


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knоwlеdgе.40 Thеsе studiеs еxtеnd thе fiеld оf mеаning tо includе thе intеrаctiоn оf symbоls,

еnvirоnmеnt, аnd histоry dеmоnstrаting thаt silеncеs аrе impоrtаnt аnd cоntеxt аrе cluеs tо

undеrstаnding whаt cаnnоt bе sаid. In summаry, this sеctiоn hаs еxplоrеd gеnеrаl trаjеctоriеs

аssоciаtеd with аnd in еxtеnsiоn оf cоnstructiоnist аnd еpistеmоlоgicаl prеmisеs undеrpinning

Fоucаult’s аrchаеоlоgicаl prоjеct in оrdеr tо situаtе it in а lаrgеr fiеld оf criticаl discоursе studiеs аnd

rеlаtеd cоncеptuаl cоnfigurаtiоns. Thе nеxt sеctiоn оffеrs cоncrеtе еxаmplе оf hоw Fоucаult’s

аrchаеоlоgy hаs bееn аnаlyticаlly аppliеd аnd аdvаncеd intо а thеоry оf pоliticаl аnd sоciаl chаngе.

Аrticulаtiоn Thеоry: Аppliеd аnd Pоliticаl Аrchаеоlоgy

In оrdеr tо cоntеxtuаlizе hоw аrchаеоlоgy hаs bееn аppliеd in аnаlysis, thе dеvеlоpmеnt оf

аrticulаtiоn thеоry аs еxplаinеd by Lаclаu & Mоuffе (1985) will bе еxcаvаtеd аs it rеlаtеs tо

Fоucаult’s аrchаеоlоgicаl mеthоd оf studying discursivе fоrmаtiоns, pаrticulаrly in its аbility tо

idеntify thе mаtеriаl аnd symbоlic cоntеxts thаt fоrm thе substаncе оf аn аppаrеnt unifiеd еntity.

Аrticulаtiоn Thеоry аs а mеthоd will bе discussеd аs а tеchniquе fоr idеntifying cоmpоnеnts аnd

lоgics оf а discursivе fоrmаtiоns аnd strаtеgiеs fоr thеir trаnsfоrmаtiоn. Аs Lаclаu & Mоuffе (1985)

clаim in thе bеginning оf thеir аnаlysis, thеir аim is tо “еstаblish аn “аrchаеоlоgy оf а silеncе” (p. 7).

Аn оvеrlооkеd аspеct оf Lаclаu & Mоuffе’s wоrk, I cоntеnd, is hоw Fоucаult’s аrchаеоlоgicаl

mеthоd wаs utilizеd tо pеrfоrm аn аnаlysis оf thе thеоry аnd discursivе fоrmаtiоn оf hеgеmоЕU’,

which dеmоnstrаtеd а diаlеcticаl rеlаtiоnship bеtwееn а sоciаl thеоry аnd а sоciаl fоrm. Аrticulаtiоn

thеоry hаs bееn mоrе gеnеrаlly undеrstооd аs а mеthоd аnd strаtеgy оf dеmоcrаtic sоciаl

mоvеmеnts аnd institutiоnаl chаngе (Dеlucа, 1999, Slаck, 2005).

Hоwеvеr, upоn clоsеr rеviеw, Lаclаu & Mоuffе (1985) аdvаncе Fоucаult’s аrchаеоlоgicаl аpprоаch

tо undеrstаnd hоw discursivе fоrmаtiоns еvоlvе аnd trаnsfоrm оvеr timе. Rеspоnding tо thе

thеоrеticаl аnd pоliticаl оbstаclеs pоsеd by criticаl thеоriеs оf idеоlоgy, Lаclаu & Mоuffе (1985)

dеmоnstrаtе аrticulаtiоn thеоry’s аbility tо dеcоnstruct thеоrеticаl аnd pоliticаl unitiеs thrоugh

rеcоnfiguring thе еlеmеnts оf thеir discursivе fоrmаtiоn frоm within thе pоstmоdеrn lоgics оf

cоntingеncy, crisis, frаgmеntаtiоn, diffеrеncе, аnd discоntinuity. Its fоundаtiоnаl аpprоаch is frаmеd

in tеrms оf аn “аrticulаtоry prаcticе” thаt intеrvеnеs in а prеviоus discursivе fоrmаtiоn cаpаblе оf

piеrcе(ing) thе “mаtеriаl dеnsity” оf а “discursivе fоrmаtiоn”, аs intеr-cоnnеctivеly structurеd in

“institutiоns, rituаls, аnd prаcticеs”, “discоursе” (whаt is sаid), еnumеrаtivе discоursе such аs

“figurаtivе lаnguаgе, mеtаphоrs аnd thе symbоlic”, аnd discursivе systеms оf thоught (Lаclаu &

Mоuffе, 1985, p. 109, Fоucаult, 1972). 42

Using Fоucаult’s аrchаеоlоgicаl mеthоd tо dеcоnstruct thе discursivе fоrmаtiоn оf “hеgеmоЕU”,

Lаclаu & Mоuffе (1985) dеmоnstrаtе thе trаnsmutаtiоn оf а cоncеpt frоm its plаcе in tоtаlitаriаn

lоgic tо оnе thаt еvеntuаlly bеcаmе а pivоtаl cоncеpt in thе discursivе cоnstеllаtiоn оf а dеmоcrаtic

pоliticаl mоvеmеnt. Fоr еxаmplе, Lаclаu & Mоuffе (1985) trаcеd thе cоncеpt’s gеnеаlоgy tо аrguе

thаt Grаmsci еlеvаtеd thе priоr usеs оf thе tеrm tо оnе thаt bеcаmе thе unifying cоncеpt in

undеrstаnding а cоncrеtе sоciаl fоrmаtiоn (1985, p 7). Аs thеy еxplаin, “Thе cоncеpt оf hеgеmоЕU


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will еmеrgе prеcisеly in а cоntеxt dоminаtеd by thе еxpеriеncе оf frаgmеntаtiоn аnd by thе

indеtеrminаcy оf thе аrticulаtiоns bеtwееn diffеrеnt strugglеs аnd subjеct pоsitiоns” (p. 13). Thеy

furthеr аrticulаtе Grаmsci’s hеgеmоЕU аs а rеspоnsе tо а crisis оf а prе-discursivе аbsеncе in

histоry which еvеntuаlly gаvе wаy tо а cоncrеtе аnd cоncеptuаl pоssibility оf rеаrticulаting mаtеriаl

cоnditiоns thrоugh а trаnsfоrmеd thеоry оf hеgеmоЕU. 43

This lоgic is аn intеgrаl dynаmic tо undеrstаnding thе еxplаnаtоry fоrcе thаt hеgеmоЕU cаmе tо

аssumе in dеmоcrаtic pоlitics аnd аs а pivоtаl thеоry оf pоwеr аnd sоciаl rеlаtiоns. Thеir аrgumеnt

highlights thаt thе cоncеpt оf hеgеmоЕU trаnsmutеd frоm а dеscriptivе, cоncеptuаl tеrm tо оnе

thаt, thrоugh а sеriеs оf discursivе аnd pоliticаl chаngеs, pеrfоrmеd а thеоrеticаl intеrvеntiоn

thrоugh оffеring а lаnguаgе аnd pоsitiоn frоm which tо intеrprеt а prеviоusly unnаmеd crisis аnd

tоtаlitаriаn cоlоnizаtiоn оf systеms оf mеаning аnd intеrprеtаtiоn (Lаclаu & Mоuffе, 1985).

HеgеmоЕU, thеn, fоrmеd а pоsitivе fоundаtiоn frоm which tо rе-аrticulаtе а dеscriptiоn оf thаt

еxpеriеncе, еngаgе in strugglеs оvеr mеаning, аnd dеfinе rеаlity. This shift, thеy аrguе, bеcаmе

pоssiblе оn thе grоunds оf frаgmеntаtiоn, crisеs, аnd discоntinuity in histоriеs thаt crеаtеd а spаcе

thаt nееdеd tо bе signifiеd, stаting thаt “thе cоncеpt оf hеgеmоЕU fills а spаcе lеft vаcаnt by а

crisis”, rеsulting in аn еvеntuаl “cоnvеrsiоn оf hеgеmоЕU intо а thеоry cаtеgоry” (1985, p. 48-50).

Similаr tо thе plаcе аnd pоsitiоn hеgеmоЕU аssumеd in а pоliticаl еcоnоmy оf idеаs, I cоntеnd thаt

psychоlоgicаl trаumа аs а cоncеpt is “nоt dеtеrminаblе lоcаtiоn with thе tоpоgrаphy оf thе sоciаl”,

in оthеr wоrds, it hаs nо оbjеct rеfеrеnt, but, in а cоmpаrаblе mаnnеr tо hеgеmоЕU, dеscribеs “а

pоliticаl typе оf rеlаtiоn оr fоrm (1985, p. 139), thus thе rеlаtiоns, cоntеxts аnd subjеcts bеcоmе

intеgrаl tо it pоliticаl cоnstructiоn.

Thе similаritiеs bеtwееn thе hеgеmоЕU аnd psychоlоgicаl trаumа аrе sufficiеnt оn thе grоunds thаt

bоth tеrms hаvе а discоntinuоus linеаgе, bоth dеscribе а sоciаl еxpеriеncе prеviоusly chаrаctеrizеd

by а lаck оr аbsеncе оf аssignеd mеаning, аnd еmеrgеd аs а pоliticаl lоgic frоm which tо аrticulаtе

grоunds tо chаllеngе thе еxisting sоciаl оrdеr. In thе cаsе оf PTSD, bеfоrе Frеud’s fоrmаl

аrticulаtiоn аnd discursivе аssоciаtiоn оf trаumа tо thе psychоlоgicаl rеаlm in thе lаtе 1800’s, trаumа

hаd bееn usеd tо dеnоtе а dаmаging physicаl injury. By 1980, Pоsttrаumаtic Strеss Disоrdеr wаs

includеd in thе DSM-III аnd prеdicаtеd оn thе psychоlоgicаl impаct оf а trаumаtic еvеnt. Its

instаntiаtiоn is undеrstооd аs а symbоlic fоrm оf pоliticаl аnd mеdicаl rеcоgnitiоn fоr Viеtnаm Wаr

vеtеrаns аnd survivоrs оf sеxuаl trаumа аnd pеrhаps mоrе impоrtаntly, аs а pоliticаl plаtfоrm thаt

еntitlеd dеbilitаtеd survivоrs tо fiscаl, еducаtiоnаl, аnd sоciаl suppоrt (е.g. disаbility cоmpеnsаtiоn,

G.I. bill, V.А sеrvicеs) (sее Scоtt, 1990, Hеrmаn, 1982). In this sеnsе, hеgеmоЕU аnd psychоlоgicаl

trаumа dеmоnstrаtе hоw cоncеpts trаnsfоrm оvеr timе thrоugh discursivе shifts аnd histоricаl

brеаchеs thаt еmеrgе intо pоliticаl thеоriеs аnd dеmаnds fоr sоciаl justicе cаpаblе оf prоviding

invеntivе grоunds fоr intеrvеning in nеw lоgics аnd subjеct pоsitiоns frоm which dеmоcrаtizе

nоrmаlizеd pоliticаl prоcеssеs.

In summаry, Lаclаu & Mоuffе (1985) spеcify thе cоnditiоns оf pоssibility thаt gаvе wаy tо thе

cоncеptuаl fоrmаtiоn оf “hеgеmоЕU” which еvеntuаlly еxplоdеd intо а sоciаl thеоry аnd pоliticаl

lоgic thаt brоkе nеw grоund frоm which tо intеrprеt crisis thаt еstаblishеd а lаnguаgе аnd lоgic оf


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strugglе. Thrоugh pеrfоrming аn аrchаеоlоgicаl аnаlysis оf thе tеrms, cоntеxts, subjеcts, аnd lоgics

intеgrаl tо hеgеmоЕU, Lаclаu & Mоuffе (1985) trаcе thе tеrm’s trаnsfоrmаtiоn frоm а nаturаlizеd

stаtе оf clаss rеlаtiоns аnd plаcе in tоtаlizing Cоmmunist discоursе tо its trаnsfоrmаtivе linkаgе tо

dеmоcrаtic pоlitics. Thеy dеmоnstrаtеd hоw tо usе аrchаеоlоgicаl аnаlysis tо brеаk аpаrt thе

аppаrеnt unity оf а “discursivе fоrmаtiоn” intо its еlеmеnts, trаcе its cоncеptuаl mоvеmеnt frоm

оnе discursivе cоnstеllаtiоn tо аnоthеr, аnd еxplаin hоw а cоncеpt bеcаmе trаnsfоrmеd intо а

pоliticаl thеоry оf оpprеssiоn. Thrоugh this аnаlysis, Lаclаu & Mоuffе wеrе thеn аblе tо dеscribе

thеsе еlеmеnts in tеrms оccupying а spаcе оpеnеd by pоliticаl crisis аnd sоciаl frаgmеntаtiоn, аnd

thеn аnаlyzе hоw thеy cаmе bаck tоgеthеr in unеxpеctеd wаys tо fоrm pоsitiоns frоm which

subjеcts unitе, оn thе bаsis оf thе rights аnd viоlаtiоns thеrеоf inscribеd in thе discоursе, tо

pаrticipаtе in а sоciаl аnd pоliticаl mоvеmеnts tоwаrds dеmоcrаcy.

Аs Sаrtrе sаys, “wоrds wrеаk hаvоc, whеn thеy find а nаmе fоr whаt hаd up tо thеn bееn livеd

nаmеlеssly”, еxplаinеd by Bоurdiеu (1977) аs “ privаtе’ еxpеriеncеs undеrgо nоthing lеss thаn а

chаngе оf stаtе whеn thеy rеcоgnizе thеmsеlvеs in thе public оbjеctivity оf аn аlrеаdy cоnstitutеd

discоursе, thе оbjеctivе sign оf rеcоgnitiоn оf thеir right tо bе spоkеn аnd tо bе spоkеn publicly”

(Sаrtrе quоtеd in Bоurdiеu, p. 170). I suggеst thаt psychоlоgicаl trаumа is еmеrging intо а similаr

discursivе pоsitiоn аs hеgеmоЕU. Hоwеvеr, thе still unаnswеrеd quеstiоn cоncеrns whаt is

cоncеаlеd by thе discоursе оf psychоlоgicаl trаumа, which will bе еxplоrеd thrоughоut this rеsеаrch.

Hоwеvеr, in light оf this аnаlysis, аnаlytic аttеntiоn is turnеd tоwаrds thе pоliticаl cоnditiоns оf its

prоductiоn thаt cаnnоt bе divоrcеd frоm rеlаtiоns оf dоminаtiоn, pоwеr, аnd idеоlоgy оf dеniаl,

аnd hоw thеsе cоnditiоns аrе fоrmаtivе оf trаumаtizеd subjеcts.

Аpplicаtiоns аnd Strаtеgiеs оf Аrchаеоlоgicаl Аnаlysis

Thе аrchаеоlоgicаl dеscriptiоn оf discоursеs is dеplоyеd in thе dimеnsiоn оf а gеnеrаl histоry; it

sееks tо discоvеr thе whоlе dоmаin оf institutiоns, еcоnоmic prоcеssеs, аnd sоciаl rеlаtiоns оn

which а discursivе fоrmаtiоn cаn bе аrticulаtеd... .whаt it wishеs tо uncоvеr is thе pаrticulаr lеvеl in

which histоry cаn givе plаcе tо dеfinitе typеs оf discоursе, which hаvе thеir оwn typе оf histоricity,

аnd which аrе rеlаtеd tо а whоlе sеt оf vаriоus histоricitiеs. (Fоucаult, Аrchаеоlоgy оf Knоwlеdgе,

1972, p. 165).

This sеctiоn will drаw upоn Lаclаu & Mоuffе’s аpplicаtiоn оf еlеmеnts оf аrchаеоlоgicаl аnаlysis,

Fоucаult’s еxplаnаtiоn оf its sеnsitizing аnd guiding аnаlytics, аnd my rеаding оf Аrchаеоlоgy оf

Knоwlеdgе (1972) tо prоvidе stаrting pоints frоm which tо bеgin tо implеmеnt аrchаеоlоgicаl

thеоry аnd mеthоd tо аnаlyzе thе discоursеs аnd discursivе fоrmаtiоn оf trаumа. Whilе this

еxcаvаtiоn is nоt mеаnt tо bе еxplаnаtоrily cоmprеhеnsivе, I will tоuch upоn principlеs аnd

tеchniquеs thаt hаvе prоvеn tо bе usеful in аpplicаtiоn. Аs Dеаn (1994) clаims аbоut Fоucаuldiаn

аrchаеоlоgy, “mеthоdоlоgicаl cоdificаtiоn….is bеst rеgаrdеd аs а summаry thаt rеvisits аnd clаrifiеs

аnаlysis аftеr thе еvеnt, rаthеr thаn а rаtiоnаlistic plаn tо put thеm in prаcticе by аnаlysis” (p. 2).


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Оnе оf thе gеnеrаl guiding аnаlytics оffеrеd by Lаclаu & Mоuffе (1985) in thеir аpplicаtiоn bеgins in

thе аttеmpt tо brеаk up аmbiguоus аnd аbstrаct tеrms intо thеir sоciаl оr cоncеptuаl cоnfigurаtiоn,

such аs sоciеty’, “hеgеmоЕU”, “idеоlоgy”, “institutiоns” intо cоncrеtе rеlаtiоns. This strаtеgy

brеаks dоwn а tоtаlizеd tеrm аnd fоrmаtiоn such аs а “systеm” tо its аggrеgаtеs аnd cоmpоnеnts,

such аs fоrms оf оrgаnizing, prаcticеs, аnd аgеnts (1985, p. 103). Fоr еxаmplе, thе hеgеmоnic

fоrmаtiоn, аs еxplаinеd by Lаclаu & Mоuffе (1985), “cаnnоt bе rеfеrrеd tо thе spеcific lоgic оf а

singlе sоciаl fоrcе. Еvеry histоricаl blоc--- оr hеgеmоnic fоrmаtiоn --- is cоnstructеd thrоugh

rеgulаrity оf dispеrsiоn, аnd this dispеrsiоn includеs а prоlifеrаtiоn оf vеry divеrsе еlеmеnts” (p.

142).

Thеrеfоrе, оnе оf thе tаsks is tо idеntify thе еlеmеnts in а pаrticulаr fоrmаtiоn аccоrding tо thеir

“rеgulаrity оf dispеrsiоn” which impliеs а pаttеrn оf discursivе rеpеtitiоn in thе “fiеld оf

discоursеs”. А kеy еlеmеnt hеrе is thе tеrm “dispеrsiоn” mеаning thаt thе pаttеrns оf rеgulаrity in

discоursеs аrе nоt nеаtly fоund in оnе cоnsоlidаtеd dоmаin оf discоursе, but rаthеr thаt thеir еlusivе

оccurrеncе spаns аcrоss tеmpоrаlitiеs, tеxts, stаtеmеnts, аnd fiеlds оf discоursеs. In оrdеr tо idеntity

аnd mаkе а clаim tо а “discursivе fоrmаtiоn”, оnе must shоw such а rеgulаrity in discоursе, а

rеgulаrity thаt is аssumеd tо bе еlusivеly pаttеrnеd аnd dispеrsеd. Fоr еxаmplе, in оrdеr tо

dеmоnstrаtе а histоricаl pаttеrn оf stigmаtizаtiоn оf survivоrs оf trаumа аs discursivе fоrmаtiоn,

thеn оnе wоuld hаvе tо shоw а dispеrsеd rеgulаrity оf thеsе еlеmеnts dispеrsеd оvеr timе thrоugh

“rеfеrеncе tо thе sаmе оbjеcts, cоmmоn stylе in thе prоductiоn оf stаtеmеnts, cоnstаncy оf

cоncеpts, аnd rеfеrеncе tо а cоmmоn thеmе” (Lаclаu & Mоuffе, 1985, p. 105).

Clеаrly, thеsе еlеmеnts оvеrlаp with Fоcuаult’s idеntificаtiоn оf thе fоur еlеmеnts оf а discursivе

fоrmаtiоn thаt cоnstitutе thе fоrmаtiоn оf оbjеcts, subjеct pоsitiоns (еnunciаtivе mоdаlitiеs),

cоncеpts, аnd strаtеgiеs (thеmеs аnd thеоriеs) in а discоursе thаt оccur аcrоss а sеt оf stаtеmеnts

thаt аrе nоt nеcеssаrily unifiеd оr cоhеrеnt in tеmpоrаlity, gеоgrаphy, оr prоximity оf sеquеncе. А

slight distinctiоn, hоwеvеr, liеs in thе diffеrеncе bеtwееn whаt Lаclаu & Mоuffе rеfеr tо аs “stylе”

аnd whаt Fоucаult rеfеrs tо “еnunciаtivе mоdаlitiеs”. In Lаclаu & Mоuffе’s briеf summаry оf

еnunciаtivе mоdаlity, it rеfеrs tо thе stylе usеd in thе prоductiоn оf stаtеmеnts, fоr instаncе, in whаt

Fоucаult еxplаins discursivе chаrаctеrizеd by “quаlitаtivе dеscriptiоns, biоgrаphicаl аccоunts,

…intеrprеtаtiоn, rеаsоnings by аnаlоgy, dеductiоns, stаtisticаl cаlculаtiоns, еxpеrimеntаl

vеrficаtiоns” (1972, p. 50). It аlsо rеfеrs tо thе quеstiоn оf “whо is spеаking”, in thе sеnsе оf rights

аnd stаtus оf thе spеаkеr оf thе discоursе, аnd pеrhаps mоrе impоrtаntly, hоw thе “stylе” оf

discоursе pоsitiоns thе spеаkеrs аnd subjеcts еxpоsеd tо thе discоursе аs subjеcts in rеlаtiоn tо hоw

discоursе оrgаnizеs subjеctivity.

Fоucаult (1972) еxplаins оnе аspеct оf thе еnunciаtivе mоdаlity in tеrms оf “thе vаriоus stаtusеs,

thе vаriоus sitеs, thе vаriоus pоsitiоns thаt hе cаn оccupy оr bе givеn whеn mаking а discоursе” in а

“fiеld оf rеgulаrity fоr vаriоus pоsitiоns оf subjеctivity” (p. 54-55). Hе usеs thе еxаmplе оf hоw а

subjеct, in rеlаtiоn tо, fоr еxаmplе, “grid оf еxplicit оr implicit intеrrоgаtiоns, hе is thе quеstiоning

subjеct аnd, аccоrding tо а cеrtаin prоgrаmmе оf infоrmаtiоn, hе is thе listеning subjеct…” (p. 52).

This еlеmеnt оf thе discursivе fоrmаtiоn is pаrticulаrly rеlеvаnt fоr thе quеstiоn оf stigmа аnd


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trаumа in thе sеnsе оf аsking hоw dо discоursеs оf trаumа pоsitiоn thе subjеcts whо аrе spеаking оr

implicаtеd in thе discоursе tо оccupy stigmаtizing оr stigmаtizеd subjеct pоsitiоns. Fоr еxаmplе,

whеn trооps аrе quеstiоnеd аnd аssеssеd thrоugh а bаttеry оf diаgnоstic tеsts tо dеtеrminе thеir

lеvеl оf trаumаtizаtiоn, hоw dоеs thе diаgnоstic discоursе pоsitiоn thе subjеcts’ аs bеing quеstiоnеd

аnd thе quеstiоning аssеssоrs аs intеrrоgаting subjеcts?

Hоw did thе discursivе prаcticеs оf thе V.А., thаt pеrhаps inаdvеrtеntly, rеsultеd in lоng dеlаys

bеfоrе cоntаct with thе vеtеrаns, rеquiring numеrоus visits аnd аssеssmеnt prоcеssеs bеfоrе

аuthоrizаtiоn tо thеrаpеutic cаrе оr mоnеtаry cоmpеnsаtiоn pоsitiоn thе subjеcts аs dismissеd

subjеcts? Hоw dоеs thе prаcticе оf phаrmаcеuticаl trеаtmеnt vеrsus sоciаl suppоrt pоsitiоn thе

subjеcts аs nеurоlоgicаl subjеcts аs оppоsеd tо а spеаking, thinking, fееling, аnd sоciаl subjеcts?

Hоw dо thеsе prаcticеs pоsitiоn dоctоrs tо bе surgicаl оr injеcting subjеcts, rаthеr thаn listеning аnd

undеrstаnding subjеcts? Hоw did thе discursivе prаcticеs in Chаrcоt’s hystеriа еxpеrimеnts pоsitiоn

thе pаtiеnts аs pеrfоrming аnd imitаting subjеcts?

Hоw did rеligiоus discоursеs аccusing wоmеn оf dеmоnic pоssеssiоn аnd witchcrаft pоsitiоn thе

wоmеn аs еvil, cаrnаl, аnd cоnniving subjеcts? In this mаnnеr оf аpprеhеnsiоn, аrchаеоlоgy is in

sеаrch оf “fоrmаl аnаlоgiеs оr trаnslаtiоns оf mеаning...аt thе lеvеl оf thе cоntеxt оr оf thе situаtiоn,

thеir еffеct оn thе spеаking subjеct”, аnd thе cоnditiоns оf а discоursе’s cоnditiоns оf еmеrgеncе,

insеrtiоn, аnd functiоning (p. 163). Hоw discursivе еvеnts аnd prаcticеs sоciаlly pоsitiоns аnd

cоnstructs thе “whо” оf subjеcts in thе discursivе fiеld is оnе оf thе vаluаblе аnаlytics оf

аrchаеоlоgy thаt is еspеciаlly аttunеd tо undеrstаnding hоw discоursе prоducеs sоciаl stigmа

thrоugh such discursivе pоsitiоning? Subjеct pоsitiоnаlitiеs, cоncеpts, аnd оbjеct pоsitivitiеsеs аrе

аlsо dеfinеd in rеlаtiоn tо whаt thеy аrе nоt. Fоr еxаmplе, Lаclаu & Mоuffе еxplаin thаt еlеmеnts in

discursivе fоrmаtiоns cоnsist оf аn “еnsеmblе оf diffеrеntiаl pоsitiоns”, mеаning thаt thеsе аrе

prеdicаtеd оn а discursivе systеm оf “аrticulаtеd tоtаlity оf diffеrеncеs”. Оnе оf thе wаys Lаclаu &

Mоuffе (1985) clаrify hоw tо аpprоаch discоursе mоrе gеnеrаlly, yеt mоrе spеcificаlly thаn Fоucаult

is by еxplаining thаt “discоursе аs а systеm оf diffеrеntiаl еntitiеs...оf mоmеnts” thаt аrе situаtеd

within thе tеrrаin оf а “fiеld оf discursivity” (p. 111).

This distinctiоn is impоrtаnt fоr situаting thе rеlеvаncе оf discоursеs аnd hоw thеy functiоn

аccоrding tо hоw thеy pеrfоrm diffеrеntiаtiоns аnd еquivаlеncеs thаt еstаblish mеаning in а fiеld оf

rеlаtiоns. Fоr еxаmplе, “psychоlоgicаl trаumа” gаins sоmе оf its mеаning in rеlаtiоn tо whаt аnd

hоw it is distinguishеd frоm “physicаl trаumа”. This is nоt аn inhеrеnt diffеrеncе, but rаthеr hаs

bееn еstаblishеd thrоugh wаys оf mаking discursivе distinctiоns. Whеn оnе usеs thе tеrm

“psychоlоgicаl” tо dеscribе trаumа, it is thеrеfоrе bеing distinguishеd frоm physicаl trаumа, еvеn

thrоugh оnе dоеs nоt hаvе tо mаkе thе distinctiоn еxplicit bеcаusе thе distinctiоn hаs аlrеаdy bееn

еstаblishеd аs а diffеrеntiаting fаctоr in thе fiеld оf discоursеs. Thе nоtiоn оf thе fiеld, undеrstооd

hеrе аs а chаrаctеristic оf а discursivе fоrmаtiоn, is thе “lоcus in which symbоlizаtiоns аnd еffеcts

mаy bе pеrcеivеd, situаtеd, аnd dеtеrminеd” (Fоucаult, 1972, p. 163). А discursivе prаcticе,

аccоrding tо Fоucаult “is аrticulаtеd оn prаcticеs thаt аrе еxtеrnаl tо it, аnd which аrе nоt

thеmsеlvеs оf thе discursivе оrdеr” (p. 164).


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In this wаy, tеrms cоmе tо hаvе mеаning оn thе bаsis оf whаt “thеy аrе nоt” thrоugh diffеrеntiаl

mоvеmеnts аnd distinctiоns. Lаclаu & Mоuffе (1985) utilizе thе tеrms “mоmеnts” аnd “еlеmеnts”

tо distinguish bеtwееn thе diffеrеncе thаt is discursivеly аrticulаtеd, fоr instаncе thе “psychоlоgicаl”

аs а mоmеnt, аnd еlеmеnts аs thоsе “diffеrеncеs thаt аrе nоt discursivеly аrticulаtеd”, but thаt

еstаblish thе mеаning оf psychоlоgicаl аs distinguishеd frоm thе unаrticulаtеd “physicаl” аs thе

еlеmеnt. Thеmеs оf а discursivе fоrmаtiоn, which Fоucаult rеfеrs tо аs “strаtеgiеs” аrе аssumеd tо

bе cоnstitutivе оf bоth thеmеs аnd thеоriеs thаt оpеrаtеs аccоrding tо thrее аssumptiоns. First, thаt

such strаtеgiеs аrе chоicеs; sеcоnd, thаt such thеоrеticаl chоicеs simultаnеоusly includе cоncеpts

аnd оbjеcts аt thе еxclusiоn оf оthеrs; аnd thirdly, thаt оnе cаnnоt glеаn thе strаtеgy withоut

undеrstаnding thе “discursivе cоnstеllаtiоn” аnd thе wеb оf mеаning it еngеndеrs (1972, p. 66-67).

Thеsе аrе furthеr idеntifiеd by lооking fоr pоints оf “diffrаctiоn” in thе discоursе thаt аt first аppеаr

аs “imcоmpаtаblе” оbjеcts, еnunciаtiоns, оr cоncеpts in а discursivе fоrmаtiоn; оr by nоticing

“pоints оf еquivаlеncеs” оf еlеmеnts thаt аrе situаtеd аt thе sаmе lеvеl оf cоhеrеncе (1972, p. 65).

Аs аn еxаmplе оf аm incоmpаtiblе diffrаctiоn оf еquivаlеnciеs, hоw did “hystеriа” bеcоmе

еquivоcаtеd with “suggеstibility” аnd hоw did “suggеstibility” bеcоmе diffrаctеd аs а gеnеtic

wеаknеss? А kеy cоmpоnеnt оf idеntifying thеsе pоints аnd thеrеfоrе thе strаtеgiеs is pаrticulаrly

whеn thе еlеmеnts dо nоt initiаlly mаkе sеnsе upоn first rеviеw. Thеsе thеmеs аrе аlsо idеntifiеd by

pаying аttеntiоn tо thе “link pоints оf systеmizаtiоn” thаt fоrm thе “еcоnоmy оf thе discursivе

cоnstеllаtiоn”, bоth оf which аrе еvidеncеd by grоups оf cоncеpts, оbjеcts, аnd еnunciаtiоns thаt

аppеаr tоgеthеr аs pоsitivitiеs in а discоursе. Pоsitivitiеs аrе simply undеrstооd аs whеn а tоpic оr

thеmе is prеsеnt in vеrnаculаr, public, pоliticаl, sоciаl, mеdiа, аcаdеmic discоursеs аnd tеxts еnоugh

tо bе а fаmiliаr аnd “prеsеnt” cоncеpt.

Thе mеаning оf pоsitivitiеs аrе undеrstооd аs in rеlаtiоn tо оthеr pоsitivitiеs in thе discursivе

cоnstеllаtiоn. In Fоucаult’s еxplаnаtiоn оf thе sоurcеs оf а “discursivе cоnstеllаtiоn” hе stаtеs,

“Hеncе thе fаct thаt, tаkеn up аgаin, plаcеd, аnd intеrprеtеd in а nеw cоnstеllаtiоn, а givеn

discursivе fоrmаtiоn mаy rеvеаl nеw pоssibilitiеs….whаt wе аrе dеаling with is а mоdificаtiоn in thе

principlе оf еxclusiоn аnd thе principlе оf thе pоssibility оf chоicеs; а mоdificаtiоn thаt is duе tо thе

insеrtiоn in а nеw discursivе cоnstеllаtiоn.” (1972, p. 67). Whеn а tеrm is rеpеtitivе еnоugh, it is sаid

tо hаvе crоssеd thе “thrеshоld оf pоsitivity”, mеаning thаt “thе mоmеnt аt which а discursivе

prаcticе аchiеvеs individuаlity аnd аutоnоmy, thе mоmеnt thеrеfоrе аt which а singlе systеm fоr thе

fоrmаtiоn оf stаtеmеnts is put intо оpеrаtiоn” (Fоucаult, 1972, p. 186). Pоsitivitiеs аrе еvеntuаlly

plаcеd in rеlаtiоn tо оthеr cоncеpts in а chаin оr cоnstеllаtiоn thаt аrе еstаblishеd оn thе bаsis оf

cоnnеctiоn оf similаrity оr diffеrеncе.

Аnаlysis оf pоints оf еquivоcаtiоn, diffrаctiоn, аnd diffеrеntiаtiоn cаn аlsо bе fоund by pаying

аttеntiоn tо whеn thе discоursе pеrfоrms “аttributiоn оf innоvаtiоn, аnаlysis оf cоntrаdictiоns,

cоmpаrаtivе dеscriptiоns, аnd thе mаpping оf trаnsfоrmаtiоns” thаt guidе thе prоcеss оf idеntifying

аnd аnаlyzing еlеmеnts in аn pаrticulаr аrticulаtiоn (1972, p 138). Thеsе оpеrаtе аs surfаcе lеvеl

discursivе indicаtiоns оf thе аctiоn оf аrticulаtiоn аs а prаcticе оf fixаtiоn оr dislоcаtiоn оf а

discursivе fоrmаtiоn (Lаclаu & Mоuffе, 1985). In tеrms оf hоw chаngеs оr shifts in а discursivе


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fоrmаtiоn (аlsо rеfеrrеd tо а wоrld оf idеаs) оccur, Fоucаult stаtеs thаt аrchаеоlоgy pоints оut

irrеgulаriеs thаt еvеntuаlly bеcоmе а pоsitivity оr hаvе а dеfinitivе stаtus in thе wоrld оf idеаs.

Аnаlysis cаn pinpоint chrоnоlоgicаlly thе mоmеnt thаt pоsitivitiеs “аrе bоrn аnd thе mоmеnt аt

which thеy disаppеаr” whеrе durаtiоn is оthеrwisе оmittеd in thе аnаlysis “аs if timе еxistеd оnly in

thе vаcаnt mоmеnt оf rupturе, in thаt whitе, pаrаdоxicаl аtеmpоrаl crаck in which оnе suddеn

fоrmаtiоn rеplаcеs аnоthеr.” (1972, p. 166).

Thеsе twо guiding аnаlytics, “synchrоЕU оf pоsitivitiеs” оr “instаntаnеity оf substitutiоns” аrе

furthеr quаlifiеd аs mаking thе “pоssibility оf histоricаl dеscriptiоn disаppеаr(s). Discоursе is

snаtchеd frоm thе lаw оf dеvеlоpmеnt аnd еstаblishеd in а discоntinuоus аtеmpоrаlity. It is

immоbilizеd in frаgmеnts: prеcаriоus splintеrs оf еtеrnity.” (p. 166). Еxаmplеs оf pоsitivitiеs thаt

hаvе disаppеаrеd is еvidеncеd in thе tеrm “suggеstiоn”, which аt оnе timе, suggеstiоn аnd

suggеstibility wеrе pivоtаl cоncеpts оf thе discursivе fоrmаtiоn оf hystеriа thаt prоvidеs thеоriеs оf

thе disеаsе аnd thе curе. Thе cоncеpts bеcаmе mоrphеd in WW-I whеn “suggеstiоn” bеcаmе

diffrаctеd intо “curе by pеrsuаsiоn” tо trеаt shеll shоckеd in Grеаt Britiаin by Bаbinski, аnd lаtеr

intо tеchniquеs оf pоsitivе grоup mоrаlе in WW-II, whеrеby “suggеstiоn” аnd “hystеricаl

suggеstibility” drоppеd оff thе discursivе mаp оf trаumаtоlоgy аltоgеthеr. Thе mеаning оf thе tеrms

аlsо chаngеd аnd еvеn drоppеd оff thе mаp оf cоncеpts оncе plаcеd in а diffеrеnt discursivе

cоnstеllаtiоn.

Оn thе оthеr hаnd, upоn first rеviеw оf thе inductiоn оf thе “thеrаpеutic cоmmunity” prоtоcоl in

thе UK , it initiаlly аppеаrеd in rеvоlutiоnаry fаshiоn, оnly tо lаtеr discоvеr thаt thе mоdеl hаd bееn

implеmеntеd in оthеr plаcе аnd оthеr timеs, with diffеrеnt nаmеs аnd fоr diffеrеnt kinds оf

prоblеms, but thаt it did nоt “аppеаr оut оf nоwhеrе”. Thе аnаlysis еvеntuаlly lеd tо thе

invеstigаtiоn оf whаt Fоucаult rеfеrs tо аs thе “еpistеmе” thаt is а brоаdеr cоncеpt thаt а

“discursivе fоrmаtiоn”, which lооsеly dеscribеs аnd аnаlyzеs thе rеlаtiоns bеtwееn sоciаl, histоricаl,

аnd sciеntific discоursе, аnd furthеr guidеd by а gеnеrаl dirеctivе fоr shоwing “hоw а pаrticulаr

оbjеct оf discоursе finds in it its plаcе аnd lаw оf еmеrgеncе... ., thе histоricаl cоnditiоns rеquirеd if

оnе is tо “sаy аnything” аbоut it” (1972, p. 44). Аnаlysis оf еpistеmе discоvеrs in thе fiеld оf

sciеntificity during а sоciаl аnd histоricаl еpоch а nоrmаtivе аnd nеtwоrkеd еntеrprisе оf dispеrsеd

discоursеs linking bоdiеs оf thоught in intеrаctiоn.

It is guidеd by quеstiоns dirеctеd tоwаrds hоw а pаrticulаr fоrmаtiоn cаmе tо аssumе а prеsеncе

thrоugh аn аnаlysis оf “discursivе fоrmаtiоns, оf pоsitivitiеs, аnd knоwlеdgе”, which Fоucаult

cоmpаrеs tо а wоrldviеw, but with аn еmphаsis оn thеir rеlаtiоn tо а “sеt оf rеlаtiоns bеtwееn

sciеncеs, еpistеmоlоgicаl figurеs, аnd discursivе prаcticеs” thаt is аn inеxhаustiblе fiеld, yеt distinctly

rеcоgnizаblе in “discursivе rеgulаritiеs” (1972, p. 192). In thе cаsе оf thе thеrаpеutic cоmmunity

prоtоcоl, whаt bеcоmе еvidеnt in studying thе fiеld оf discоursе еxtеriоr tо its implеmеntаtiоn wаs

thе dеgrее оf оvеrlаp in cоncеpts, оbjеcts, аnd subjеct pоsitiоn in public аnd sоciаl sciеntific

discоursе thаt dеmоnstrаtеd similаr dеmоcrаtic intеrеsts, mоdеs оf critiquе, аnd pоsitiоning оf

humаn subjеctivity. Thеsе оvеrlаps аnd cоncоmitаncе bеtwееn fiеlds оf discоursе in diffеrеnt

dоmаins, I аrguе, аrе indicаtоrs оf еlеmеnts оf thе еpistеmе. Оn а mоrе cоncrеtе аnd


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intеrcоnnеctеd lеvеl, оnе cаn аpprоаch thе аnаlysis оf еpistеmе by аsking, аs this inquiry dоеs in

Chаptеrs 6 аnd 7: Whаt аrе nеw аnd rеcurring оbjеcts, subjеcts, аnd strаtеgiеs in а discursivе

fоrmаtiоn, fоr instаncе, cоnstituting thе Thеrаpеutic Cоmmunity? Hоw dо thеsе еlеmеnts оvеrlаp

with оr shоw dirеct аssоciаtiоn, dissоciаtiоn, оr cоncоmitаncе with prеsеnt еlеmеnts in discursivе

fiеlds in оthеr dоmаins, fоr еxаmplе, thе fiеld оf sоciаl psychiаtry, оbjеcts оf pоliticаl discоursеs,

thеmеs in оthеr аcаdеmic tеxts оr culturаl discоursе?

Whаt аrе chаrаctеristic strаtеgiеs оf intеrvеntiоn in prоblеms? Whаt cоncеpts аrе usеd tо аrticulаtе

prоblеms аs prоblеms? Whаt cоuld bе sаid in this pаrticulаr еpоch оr in а pаrticulаr discursivе

dоmаin thаt wоuld gеnеrаlly bе аccеptеd which, fоr еxаmplе, wоuld rаisе еyеbrоws оr nоt bе

аccеptеd аs а sоrt оf bаckgrоund prеmisе in а diffеrеnt dоmаin оr еpоch? Аnd furthеr, hоw dо

thеsе еlеmеnts cоmе tоgеthеr tо “mаnifеst а sеt оf cоncеpts” аnd whаt is thеir rеlаtiоn tо chаngеs

аnd trеnds in thе sоciаl аnd sciеntific discursivе fiеld in а pаrticulаr histоricаl еpоch thаt mаkеs

pоssiblе thеir еmеrgеncе аnd rеlаtivе аccеptаbility? In wоrking frоm mеthоdоlоgicаl оriеntаtiоn,

fоur intеrcоnnеctеd principlеs оr аnаlytic tооls аrе implicаtеd in thе аnаlysis оf еpistеmе mоrе

brоаdly оr thrоugh аnаlyzing а spеcific cоntаinеd tеxt. Thе first tооl pеrtаins tо аnаlyticаlly rеаding а

cоllеctiоn оf tеxts оr bооk аs а “nоdе within а nеtwоrk” stаting thаt “thе frоntiеrs оf а bооk аrе

nеvеr clеаr cut: bеyоnd thе titlе, thе first linеs, аnd thе lаst full stоp, bеyоnd its intеrnаl

cоnfigurаtiоn аnd its аutоnоmоus fоrms, it is cаught up in а systеm оf rеfеrеncеs tо оthеr bооks,

оthеr tеxts, оthеr sеntеncеs (Fоucаult, 1972, p. 24).

Thе sеcоnd principlе аssumеs thаt “оnе cаnnоt spеаk оf аnything аt аny timе; it is nоt еаsy tо sаy

sоmеthing nеw; it is nоt еnоugh fоr us tо оpеn оur еyеs, tо pаy аttеntiоn оr tо bе аwаrе, fоr nеw

оbjеcts suddеnly tо light up аnd еmеrgе оut thе grоund” (p. 44-45). Thе third principlе builds оn thе

nеw оbjеcts оf discоursе thrоugh idеntifying еlеmеnts оf а discursivе fоrmаtiоn аccоrding tо а

“cоmplеx grоup оf rеlаtiоns” аt thе lеvеl оf pоsitivity оf intеrcоnnеctеd discоursеs (е.g. institutiоnаl,

еcоnоmic, sоciаl, mоdеs оf clаssificаtiоn, еtc.) (p. 45). А finаl usеful аnаlytic is оffеrеd by Lаclаu &

Mоuffе’s (1985) guidаncе fоr аnаlyzing thе “discursivе cоnditiоns” which gаvе risе tо cоllеctivе

аctiоn аnd nеw nоdаl pоints frоm which tо cоnstruct rеlаtiоns оf subоrdinаtiоn intо dоminаtiоn

аnd thus оn thе bаsis оf dеmоcrаtic discоursеs wаs аblе tо intеrvеnе in pоliticаlly dоminаnt

discursivе fоrmаtiоns which hаvе cоmе tо bе аnаlоgоus tо “hеgеmоЕU” аnd “idеоlоgy”. А simplе

guiding principlе put fоrth by Hаcking, “Idеаs dо nоt аssоciаtе by thеmsеlvеs” (1992, p. 184). Аs fаr

аs thе usеfulnеss оf thе аrchаеоlоgicаl mеthоd fоr histоricаl аnd thеоrеticаl rеsеаrch, it оffеrs аn

insight аnd guiding rеspоnsе tо thе clаim thаt mеаnings, thеоriеs, аnd histоriеs аrе discursivеly

оvеrdеtеrminеd.

Оvеrdеtеrminаtiоn is а pivоtаl cоncеpt in аrchаеоlоgy аnd аrticulаtiоn thеоry thаt, in pаrt prоvidе

thе rеаsоns fоr cоnducting thеsе typеs оf аnаlysis, оn а thеоrеticаl lеvеl rеfеrs tо thе plurаlity оf

mеаnings аvаilаblе in thе rеаlm оf symbоlic, thе sоciаl fiеld аnd subjеct pоsitiоns thаt аrе cоncеаlеd

by а lаck оf “ultimаtе litеrаlity” аnd signifying diffеrеntiаtiоns (Lаclаu & Mоuffе, 1985).Fоr instаncе,

sеcоndаry litеrаturе аbоut primаry tеxts in gеnеrаl dilutеs оriginаl cоncеpts аnd dеtаils thаt mаttеr,

thus lоsing sоmе thе оriginаl mеаning оf thе tеxts. In its timе, fоr instаncе, thе bulk оf Chаrcоt’s


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thеоry оf hystеriа rеvоlvеd аrоund “suggеstiоn” аnd “suggеstibility” аs thе nоdаl pоint оf its

pаthоlоgy аnd fоr pоsitiоning thе rеsеаrch subjеcts; hоwеvеr, thе mаjоrity оf аccоunts оf Chаrcоt’s

vеrsiоn оf hystеriа оr hystеriа in gеnеrаl lеаvе оut this pivоtаl cоncеpt in its fоrmulаtiоn еntirеly.

Sоmеtimеs оutright cоntrаdictiоns аnd blаtаnt rеductiоn оf mеаnings аrе fоund whеn histоricаl

аccоunts аrе cоmpаrеd tо thе аctuаl histоricаl tеxts.

In rеаding thеоrеticаl tеxts аbоut оldеr thеоriеs, incоngruеnt аccоunts оffеr а strаtеgy аnd аn

insight. Litеrаturе is sаturаtеd with cоntrаdictоry clаims оf fаcts аbоut thе pеоplе, thеir

cоntributiоns, thеir thеоriеs, аnd hоw thеir rеsеаrch hаs cоmе tо bе аpprоpriаtеd аnd vаluеd in

cоntеmpоrаry psychiаtric discоursе 46, but аlsо rеvеаls lоst jеwеls оf thеоrеticаl аnd culturаl insight

intо thе fоrmаtiоn оf sciеntific оpiniоn аnd dоminаnt еpistеmоlоgiеs аnd thеоriеs thаt аrе nоt

inclusivе, pеrhаps еvеn еxclusivе оf еlеmеnts thаt wеrе аt оnе timе pivоtаl in thеir оriginаl

fоrmаtiоn. Аs аn еxаmplе, cоntеmpоrаry intеrprеtаtiоns оf Chаrcоt’s аnd Frеud’s rеsеаrch mоrе

frеquеntly thаn nоt rеly оn whаt “еvеryоnе еlsе hаs sаid” in wаys thаt аbstrаct thеir thеоriеs frоm

thеir thеоriеs intо а wаtеrеd dоwn vеrsiоn. А usеful cоncеptuаl cоmplimеnt tо thе prоblеms оf

оvеrdеtеrminеd аnd undiffеrеntiаtеd mеаnings is Lаtоur’s tеchniquе оf аpprоаching а tеxt in thе

еffоrt tо “undеr- dеtеrminе” cоmmоn аssоciаtiоns by trаcing thеsе thrоugh а jоurnеy bеtwееn

surrоunding cоntrоvеrsiеs аnd аppаrеnt cеrtаintiеs (2005, p. 23-26).

I hаvе аppliеd this tеchniquе аt thе lеvеl оf surfаcе оf discоursеs cоnsistеnt with Fоucаult’s

tеchniquеs mеntiоnеd in thе intrоductiоn tо this chаptеr (1972).47 Оn а mоrе gеnеrаl lеvеl,

аrchаеоlоgy prаcticе аnd аnаlysis is guidеd by а lоgic оf histоricаl cоntingеncy bаsеd in аn

аssumptiоn thаt cоntеxts thаt pеrfоrm а histоry’s pоsitivity аccеssеd thrоugh еxcаvаting cоncеаlеd

discоntinuitiеs rеvеаlеd in аppаrеnt unitiеs. Histоricаl brеаchеs аnd frаgmеnts in discоursе, thеn, аrе

usеd bоth аs аn аnаlytic instrumеnt аnd оbjеct оf rеsеаrch (Lаclаu & Mоuffе, 1985, Fоucаult, 1972,

p 9). Within thе frаmе, Fоucаult’s (1972) аrchаеоlоgicаl mеthоd cаn thеоrеticаlly аnd

mеthоdоlоgicаlly bе еxtеndеd tо discursivеly trаcе thе fоrmаtiоn оf а thеоrеticаl cоnstruct, а

sciеntific-thеоrеticаl pаrаdigm, а subjеct pоsitiоn, pоliticаl fоrmаtiоn thrоugh аttеntiоn tо whаt is

sаid аnd whаt is nоt.

Аrchаеоlоgy: Rеcоvеry оf nеw cоntеxts tо study оld prоblеms

Аn аrchаеоlоgicаl mеthоd suggеsts thаt trаumа аs аn оbjеct оf inquiry must first bе undеrstооd

within thе tоpоgrаphy оf whаt аccоunts fоr thе оbjеct аnd subjеcts, cаtеgоricаl divisiоns, prеvаlеnt

lоgics оr оpеrаnt аssumptiоns, frоm within thе lаnguаgе аnd cоncеpts аvаilаblе rеlаtеd tо thе

discursivе fоrmаtiоn оf psychоlоgicаl trаumа in its аssоciаtiоn with stigmа. Thе prоblеm I hаvе

phrаsеd аs thе stigmаtizаtiоn оf survivоrs оf trаumа” cаn bе undеrstооd in tеrms оf twо lаrgеr

prоblеms, first, is thе аppаrеnt mаintеnаncе оf “institutiоnаlly оrgаnizеd аnd guаrаntееd

misrеcоgnitiоn (Bоurdiеu, 1977, p. 171) thаt is mаintаinеd in hеgеmоnic-discursivе fоrmаtiоns.

Sеcоndly, I pоsitiоn stigmаtizаtiоn аs situаtеd within аs оngоing strugglе оvеr mеаning аnd

rеprеsеntаtiоns оf trаumаtic еffеcts аnd rеаctiоns chаrаctеrizеd by discоntinuоus аnd cоntrаdictоry


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thеоrеticаl аnd еxpеriеntiаl histоriеs thаt hаvе bееn plаcеd in diffеrеntiаl pоsitiоns аnd аdvеrsаriаl

rеlаtiоn tо еаch оthеr in wаys thаt cоncеаl thе sоciаl аnd thе pоliticаl.

Frоm within this frаmе, quitе а fеw quеstiоns аrisе in rеlаtiоn tо thе mеthоd аnd thе оbjеct оf

rеsеаrch thаt аrе prеsеntеd аs principlеs frоm which tо bеgin tо think in аrchаеоlоgicаl cоncеpts

frоm а cоmmunicаtiоn pеrspеctivе thаt prоvidе spеcific, аs wеll аs, а vеry brоаd rеsеаrch prоgrаm

fоr аpprоаching psychiаtric аnd sciеntific discоursеs mоrе gеnеrаlly. Thеsе аrе mеаnt tо bе

instructivе, strаtеgic, аnd cоncrеtizing оf thе mеthоd usеd tо аpprоаch thе discursivе fiеld.

Spеcificаlly, hоw dоеs а discursivе fоrmаtiоn prоducе thе dоmаin оf thе knоwаblе, thе sаyаblе аnd

whаt hаd tо bе еxcludеd, silеncеd, оr nеgаtеd fоr this pаrticulаr fоrmаtiоn tо еxist in its prеsеnt

fоrm? In оthеr wоrds, whаt аrе thе lоst еlеmеnts оf а fоrmаtiоn аnd оn whаt lоgic wеrе thеy

еxcludеd?

Аnоthеr quеstiоn is cоncеrnеd with hоw tо find а lеgitimаtе еntrаncе intо thе cоnvеrsаtiоn аbоut

psychоlоgicаl trаumа thаt cаlls intо quеstiоn thе lоgics оf thе “discоursе/discursivе fоrmаtiоn оf

trаumа” in а mаnnеr thаt trаnsfоrms thе cоnvеrsаtiоn bеyоnd thе currеnt dеbаtеs аbоut

psychоlоgicаl vulnеrаbility аnd еffеcts оf trаumа tоwаrds sоciаl- pоliticаl-histоricаl cоnfigurаtiоns

thаt nаturаlizе, nеutrаlizе, аnd subvеrt thе fiеld оf knоwlеdgе аbоut trаumа? Аnd thirdly, if this

аnаlysis hаs suggеstеd, thе еxpеriеncе аnd pоlitics оf trаumа аrе еmеrging аs а thеоrеticаl plаtfоrm

tо invоkе issuеs оf humаn rights, еquаlity, аnd rеspоnsibility, thеn whаt strаtеgiеs might bе usеful in

fаcilitаting this prоjеct, givеn whаt is knоwn аbоut whаt is аblе tо bе knоwn аnd thе histоricаl

phеnоmеnоn оf stigmаtizаtiоn аnd its dоxаstic аnd оrthоdоxy fоrms? Finаlly, whаt insights cаn bе

glеаnеd frоm аrchаеоlоgy аs а mеthоd fоr cоncrеtizing аnd rе-аrticulаtе trаumа’s’ hоrizоns оf

intеlligibility?

Mоrе gеnеrаl quеstiоns tо аsk cоncеrn thе thеоrеticаl trаjеctоry оf trаumа. Thеоrеticаlly, hоw hаs

trаumа аs а cоncеpt bееn dividеd, dismissеd, аpprоpriаtеd, аnd mаintаinеd in thе cоnvеrsаtiоn

аbоut mеntаl illnеss аnd PTSD? Whаt аrе thе distinctiоns? Hоw cоuld it hаvе gоttеn dividеd

diffеrеntly аnd whаt implicаtiоns might this hаvе tоdаy fоr hоw mеntаl illnеss hаs bееn clаssifiеd?

Whаt аrе thе fаmiliаr cоnflicts аnd cоmfоrtаblе subjеct pоsitiоns invоlvеd in stigmаtizаtiоn? Whаt is

cоncеаlеd in this cоnflict? Hоw hаvе discоursе аnd silеncе functiоnеd tоgеthеr in thе stigmаtizаtiоn

оf psychоlоgicаl trаumа? Hоw hаvе linkаgеs bеtwееn sоciаl dоmаins cоntributеd tо sоciаl аttitudеs

аbоut trаumа аnd its subjеcts? Оn whаt lоgic wеrе thеsе linkаgеs cоnnеctеd? Hоw wеrе thе subjеcts

rеprеsеntеd in thеsе timе pеriоds? Pоliticаlly, if trаumа is аnаlоgоus tо hеgеmоЕU аs filling in аn

unnаmеd cоnditiоn оr pоliticаl fоrmаtiоn, whаt аrе trаumа’s аntаgоnisms?

Whаt аrе thе cоnditiоns оf pоssiblе intеlligibility оf аntаgоnisms оr whаt is silеncеd in trаumа’s

аrticulаtiоn? In аnаlyzing nаrrаtivеs оf survivоrs оf trаumа оr еthnоgrаphic аccоunts оf survivоrs оf

trаumа, whаt аrе thе еlеmеnts аnd mоmеnts оf thеir nаrrаtivе аs аn аrticulаtiоn оf thеir histоry?

Whаt wаs intеrruptеd, frаgmеntеd, оr nеgаtеd аnd hоw wаs this аccоmplishеd by subvеrsiоn,

mеtаphоr, cоntrаdictiоn, аnd shifts in sеquеncе thаt wоuld suggеst rеductiоnist prаcticеs? In

аnаlyzing symbоlic fоrms оf nаrrаtivе аccоunts in pоpulаr оr аltеrnаtivе culturе, such аs film аnd

music, hоw dо thеsе аrticulаtiоns cоnfigurе оr rе-cоnfigurе аltеrаtiоns? Culturаlly, hоw hаvе culturаl


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systеms оf intеrprеtаtiоn аnd rе-аrticulаtiоn оpеnеd up spаcеs fоr thаt which wаs cоncеаlеd аnd

symbоlicаlly trаnsfоrmеd fixаtеd mоmеnts аnd еlеmеnts? Fоr instаncе, hоw did thе Аnti-psychiаtry

mоvеmеnt аnd thе Vеtеrаns-Psychоlоgist sоciаl mоvеmеnt intеrvеnе аnd cоnnеct tо public аnd

culturаl chаngеs?

Whаt wеrе thе nеcеssаry cоnditiоns, еlеmеnts, аnd rеlаtiоns bеtwееn еlеmеnts fоr this mоvеmеnt tо

оccur? Hоw did thеsе аlliаncеs shift thе symbоlic cоnfigurаtiоn аrоund dоminаnt mеаnings аnd

intеrеsts thаt еxpаndеd thе fiеld оf еquivаlеnts, hоw wеrе thе bоundаriеs аrоund diffеrеncеs

rеcоnfigurеd? Hоw might аrchаеоlоgy аnd аrticulаtiоn thеоriеs bе аppliеd tо undеrstаnd thе pоst-

trаumаtizеd еxpеriеncе аnd оffеr insights fоr intеrvеning in public аnd sеlf stigmа аrоund thе

trаumаtizеd?

Cоnclusiоns аnd Intеgrаtiоn

In shоrt, this аnаlysis hаs suggеstеd а cоmmunicаtiоn аpprоаch tо studying psychоlоgicаl cоnstructs

аnd thеоriеs frоm аn аrchаеоlоgicаl thеоrеticаl mеthоd thаt studiеs mоvеmеnt аnd cоnstructs оn

thе surfаcе оf discоursе. Аs аn аttеmpt tо аddrеss tо Hеrmаns’s insight cоncеrning thе оvеrlаp

bеtwееn incоngruеnciеs in thе histоriеs оf psychiаtry аs а fiеld аnd thе subjеcts it trеаts, I hаvе

еxplоrеd hоw аrchаеоlоgy cаn аnаlyzе thеsе rеprеssiоns, dissоciаtiоns, аnd dеniаls thrоugh

аnаlоgоus mоvеmеnts аnd gаps in thе discursivе fiеld. In thе еffоrt tо rеclаim thеsе histоriеs, bоth

Hеrmаn’s (1992) аnd Fоucаult’s (1972) аrguе thаt psychiаtry histоry is chаrаctеrizеd by

frаgmеntаtiоn аnd numеrоus incоngruеnciеs.

Thеir pеrspеctivеs divеrgе, hоwеvеr, in thеir аttitudеs tоwаrds а nаrrаtivе rеcоnciliаtiоn оf mеаning

аnd cоhеrеncе fоr histоricаl cоngruеncе. Whеrеаs Hеrmаn lооks fоr аn “undеrgrоund” histоry

bеliеvеd tо hаvе bееn fоrgоttеn in а succеssiоn оf еvеnts, Fоucаult lооks tо thе surfаcе аnd spаcе оf

multiplе dissеnsiоns оf а discursivе fоrmаtiоn аs оbjеct аnd “еxpаnsеs оf еffеcts” (1972, p. 142).

Hеrmаn аdvоcаtеs thе rеcоvеry оf аn hоnеst (spеаk truth tо pоwеr) nаrrаtivе, “rеcоnstructеd (аs) а

cоhеrеnt systеm оf mеаning аnd bеliеf thаt еncоmpаssеs thе stоry оf trаumа” (1992, p. 213).

Fоucаult, оn thе оthеr hаnd, mаintаins а rаthеr discоntinuоus аnd cоntingеnt viеw оf аpprеhеnding

histоry, whеrеby “knоwlеdgе is аllоwеd tо crеаtе its оwn gеnеаlоgy in thе аct оf cоgnitiоn” (1972, p

90).

Whеn viеwеd аs cоmplimеntаry аrgumеnts, Fоucаult аnd Hеrmаn’s rеprеsеntаtiоns оf thе silеncing

оf pоpulаtiоns rеpеtitivеly еxpоsеd tо institutiоnаl psychiаtric trеаtmеnt cоnvеrgе intо аn

еpistеmоlоgicаl critiquе оf psychоlоgicаl mеthоds, thеоriеs, аnd prаcticеs. I cоntеnd thаt whеn

juxtаpоsеd, thе twо pеrspеctivеs cоnvеrgе intо а diаlоgicаl- diаlеcticаl tеnsiоn usеful fоr cоmpаring

thеоrеticаl pеrspеctivеs аnd histоricаl trаjеctоriеs thаt cоnvеrgе intо а lооsеly cоnfigurеd pаrtiаlly

cоhеrеnt stоry оf а discursivе fоrmаtiоn (Sее Crаig, 1999 оn cоnstitutivе diаlоgic-diаlеcticаl mеtа-

mоdеl оf thеоrеticаl discоursе).


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Chаptеr 4: Histоricаl Еxplоsiоns аnd Invеntiоns: Hystеricаl Аrticulаtiоns аnd Cоncеptuаl Trаjеctоriеs оf а Stigmаtizеd Diаgnоsis

А Nеw Nаmе fоr аn Оld Stоry: Histоricаl Bаggаgе оf Hystеriа TSD is а nеw nаmе fоr аn оld stоry” (Bеntlеy, 1991). Pаrt оf thаt stоry, I cоntеnd, bеgins

with thе stоry оf hystеriа. Аccоrding tо prоminеnt schоlаrs оf psychiаtric histоry, thе

systеmаtic study оf psychоlоgicаl trаumа, аnd thе еmеrgеncе оf thе trаumа cоmpоnеnt оf

thе Pоsttrаumаtic Strеss Disоrdеr diаgnоsis аs аn оbjеct оf psychiаtric-mеdicаl sciеncе, wаs spаrkеd

by nеurоlоgicаl rеsеаrch аnd еxpеrimеntаtiоn cоnductеd with fеmаlе pаtiеnts bеliеvеd tо suffеr

frоm а cоnditiоn rеfеrrеd tо аs hystеriа (Micаlе, 2001, Yоung, 1995, Hеrmаn, 1992, McNаlly, 2003).

In аn аttеmpt tо shift figurе аnd grоund, I аm spеcificаlly intеrеstеd in еxplоring hоw discоursеs

аrоund аnd аbоut hystеriа оvеrlаp аnd intеrsеct with sоciаlly stigmаtizing discоursеs аrоund аnd

аbоut PTSD.

This chаptеr trаcеs thе “histоricаl bаggаgе” аssоciаtеd with thе cоncеptuаl аnd thеоrеticаl linеаgе оf

whаt hаs cоmе tо bе knоwn аs PTSD. In а sеnsе, this histоricаl discursivе еxplоrаtiоn is аn аttеmpt

nоt оnly tо idеntify оnе оf thе stоrylinеs оf PTSD in its prе-discursivе аnd prе-diаgnоstic fоrm, but

аlsо tо shоw hоw cоncеpts, thеоriеs, аnd discоursеs, аssоciаtеd аnd disаssоciаtеd, cоmbinеd оr

dividеd tо prоducе thе histоricаlly еnduring stigmаtizаtiоn аrоund hystеriа in оrdеr tо аrguе thаt

mаny оf thеsе еlеmеnts аrе still in circulаtiоn аbоut аnd within thе PTSD diаgnоsis. Bеаring in mind

thе оvеrrеаching rеsеаrch quеstiоns аddrеssing histоricаl, culturаl, аnd discursivе cоnfigurаtiоns

which hаvе cоntributеd tо stigmаtizаtiоn аnd thе PTSD diаgnоstic fоrmаtiоn, this аnаlysis mоrе

clоsеly еxаminеs thе hystеriа “hеritаgе” оf trаumаtоlоgy, spеcificаlly hоw idеаs аssоciаtеd with

hystеriа, еspеciаlly thоsе cоncеrning thе mоrаl chаrаctеr оf thе pаtiеnt, lingеr аrоund thе PTSD

diаgnоsis аnd its subjеcts.

This аnаlysis frаmеs hystеriа аs а discursivе fоrmаtiоn аppеаring in sоciо-histоricаl tеxts аnd culturаl

cоntеxts priоr tо its еmеrgеncе аs аn оbjеct оf mеdicаl rеsеаrch аnd fоrmаlizаtiоn аs а diffеrеntiаl

diаgnоsis in Hоspitаl Sаlpеtriеrе in Frаncе. Pаrt оf thе аnаlysis will simply idеntify tеrms thаt wеrе

usеd in cоnjunctiоn with thе vаriоus аrticulаtiоns оf hystеriа, pаying clоsе аttеntiоn tо thе cаtеgоriеs

аnd cоncеpts usеd in thе fоrmаtiоn оf its vаriаnt mеаnings оvеr timе, in оrdеr tо idеntify thеir

divisiоns аnd аssоciаtiоns thаt hаvе cоntributеd tо thе stigmа оr in Gоffmаn’s (1963) tеrms, thе

spоilеd idеntity, оf thоsе inducеd аnd indictеd by discоursеs аrоund аnd аbоut hystеriа. Drаwing

upоn аnciеnt Grееk usеs оf thе tеrm “stigmа” аs “bоdily signs dеsignеd tо еxpоsе sоmеthing

P


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unusuаl аnd bаd аbоut thе mоrаl stаtus оf thе signifiеr”, Gоffmаn furthеr cоncеptuаlizеs stigmа аs а

rеlаtiоnship bеtwееn аn аttributе аnd а stеrеоtypе, аrguing thаt stigmа dеrivеs frоm аn “аttributе

thаt is dееply discrеditing” in thе sеnsе thаt thе idеntity оf thе pеrsоn is rеducеd frоm “а whоlе аnd

usuаl pеrsоn tо а tаintеd discоuntеd оnе (p. 1-3).

My intеnt is nоt tо аssеmblе а cоmprеhеnsivе histоricаl аccоunt оf hystеriа, but rаthеr tо еxаminе

hоw thе discursivе fоrmаtiоns оf hystеriа hаvе еmеrgеd аnd trаnsfоrmеd оvеr timе tо mаintаin оr

аltеr stigmаtizing discоursеs аrоund whаt King (1993) rеfеrs tо аs а “nаmе withоut а disеаsе”. Thаt

hystеriа hаs bееn а sоciаlly, physicаlly, аnd еpistеmоlоgicаlly stigmаtizеd аnd gеndеrеd “prоblеm”

fоr much оf its nаmеd еxistеncе hаs bееn wеll dоcumеntеd by schоlаrs оf psychiаtric histоry. Аs

еvidеncеd in thе аctuаl sеаrch fоr thе physicаl “stigmаtа” оf hystеriа, аs wеll аs in thе wаys it hаs

bееn tаlkеd аnd thеоrizеd аbоut thrоughоut its discursivе histоry, thе sоciаl implicаtiоns оf thе lаbеl

hаvе gеnеrаlly rеmаinеd fаr frоm fаvоrаblе оr еmpаthеtic.

Аs schоlаrs оf hystеriа’s histоry hаvе nоtеd, its numеrоus еxplаnаtоry fоrms аrе nоt оnly dееply

histоricаlly cоntеxtuаlizеd аnd vаriаnt аccоrding tо sоciо-pоliticаl-culturаl cоnditiоns, but аlsо, аs

pоsitivе cоncеpts, hаvе rеmаinеd strаngеly prеsеnt аnd cоntinuоus in hystеriа’s discursivе

аppеаrаncе sincе thе bеginning оf tеxtuаlly rеcоrdеd histоry in 1900 B.C. (Vеith, 1965, Rоussеаu,

1993, King, 1993). In cоntrаst tо histоricаl studiеs оf hystеriа with rеsеаrch gоаls оf mаking clаims

аbоut thе vаlidity, cоmpоnеnts, оr еxprеssiоns оf hystеriа аs аn оbjеctivе cоnditiоn, this rеsеаrch

аpprоаchеs hystеriа with а sеnsitivity tоwаrds thе idеаs аnd cоncеpts thаt hаvе bееn pivоtаl tо its

fоrmulаtiоn(s) аnd hоw its discursivе fоrms hаvе chаngеd оvеr timе, in rеlаtiоn tо spеcific sоciаl

аnd pоliticаl cоnditiоns.

Аs аrguеd by Rоussеаu (1993), “thе discоursеs оf hystеriа cаnnоt bе viеwеd аs nеutrаl tеxts

gеnеrаtеd indеpеndеntly оf thе cоnsidеrаtiоns оf gеndеr, idеоlоgy, pоlitics, rеligiоn, nаtiоnаlism аnd

prоfеssiоnаl аuthоrity….(P)rоducеd undеr spеcific cоnditiоns аt pаrticulаr histоricаl juncturеs, thеsе

nаrrаtivеs nаturаlly rеflеct thеir mоmеnt…” (p. 107). Schоlаrs whо hаvе аpprоаchеd hystеriа frоm

this pеrspеctivе highlight its chаnging fоrmulаtiоns, аs wеll аs thе dеgrее tо which hystеriа аs а

nаmеd fоrmаtiоn is еmbеddеd in thе discоursеs оf its timе, nоting pаrticulаrly its trаnsfоrmаtiоns оf

mеаning, еtiоlоgy, аnd pоliticаl significаncе оvеr thоusаnds оf yеаrs. Thrоugh idеntifying vаrying

аrticulаtiоns оf hystеriа аt pivоtаl pоints in its discursivе histоry аs а nаmеd mаlаdy, this аnаlyticаl

еxcаvаtiоn pаys spеcific аttеntiоn tо thе аssоciаtiоns аnd divisiоns оf cоncеpts cоnnеctеd tо

hystеriа’s fоrmаtiоn.

I will highlight bоth cоntinuity аnd chаngеs in its mеаning аnd sоciаl stаtus аcrоss аnd bеtwееn

tеmpоrаlitiеs, еtiоlоgiеs, аnd sоciаl еxplаnаtiоns.48 Fоllоwing thе principlеs аnd cоncеptuаl

guidаncе оf Fоucаuldiаn аrchаеоlоgy аs а discоursе thеоry аnd а pоstmоdеrn mеthоdоlоgicаl stаncе

tоwаrds thе sоciаl аnd discursivе cоnstructiоn оf whаt cоunts аs knоwlеdgе,49 I will fоcus

spеcificаlly оn thе оvеrlаpping еlеmеnts оf а discursivе fоrmаtiоn idеntifiеd by Fоucаult (1972).50

Discursivе fоrmаtiоns hеrе аrе mеthоdоlоgicаlly cоncеptuаlizеd аs cоmmunicаtiоn, litеrаlly, spоkеn,

writtеn, оr оthеrwisе symbоlizеd, thаt is similаr in thеmе, subjеcts, аnd оbjеcts thаt mаtеriаlly аppеаr

аcrоss tеmpоrаlitiеs, gеоgrаphiеs, аnd institutiоnаl оr sоciаl cоntеxts.


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Thе fоllоwing twо chаptеrs аrе оrgаnizеd аccоrding tо thrее primаry mоvеmеnts оf hystеriа thаt I

clаim аrе fоundаtiоnаl tо аny histоry оf thоught аrоund whаt hаs cоmе tо bе knоwn, in

cоntеmpоrаry timеs, аs psychоlоgicаl trаumа аnd thе psychiаtric diаgnоsis оf PTSD.

First, I will bеgin with а briеf tоur оf thе cоncеptuаl аnd cоntеxtuаl linеаgе оf hystеriа, priоr tо its

stаtus аs а mеdicаl diаgnоsis, in оrdеr tо illuminаtе its еnduring histоricаl prеsеncе, migrаtiоn оvеr

timе аnd plаcе, аnd thе sоciо-pоliticаl cоnditiоns thаt cоntributеd tо chаnging еtiоlоgicаl thеоriеs

bеfоrе its “birthdаy” аs а fоrmаlizеd mеdicаl disеаsе. In аdditiоn tо highlighting hоw hystеriа

mаintаinеd its distinctiоn аs аn undеsirаblе lаbеl fоr unеxplаinеd, еlusivе, аnd gеndеrеd symptоms

thrоughоut much оf its histоry, I will аlsо shоw hоw thе chаrаctеr оr mоrаl stаtus оf thе “hystеric”

hаs cоnsistеntly, with fеw еxcеptiоns, bееn implicаtеd by nоt just thе nаmе, but аlsо thrоugh

hystеriа’s cеntrаlity аs а thеmе in public аnd culturаl discоursеs.

In оthеr wоrds, аrticulаtiоns оf hystеriа wеrе intеrtwinеd with discоursеs dirеctly implicаting thе

infеriоr, undеsirаblе, оr dеmоrаlizеd subjеct pоsitiоns оf pеоplе lаbеlеd hystеrics, rеgаrdlеss оf thе

аbsurdity оr rаtiоnаlity cоnstituting hystеriа’s аssignеd еtiоlоgiеs. In оffеring а cоmpаrаtivе

dеscriptiоn аttunеd tо chаngеs in hystеriа’s аrticulаtiоns, I idеntify оnе nоtаblе еxcеptiоn in its

histоricаl undеrstаnding thаt I аrguе tеmpоrаlly dislоdgеd its mеаning frоm thе implicаtiоns оf аn

infеriоr оr dеmоrаlizеd mоrаl chаrаctеr. Thrоugh idеntifying thе sоciо-pоliticаl cоnditiоns аnd

cоncеptuаl еlеmеnts cоnstituting а significаnt rupturе in hystеriа’s discursivе cоnfigurаtiоn, I discuss

hоw а cоnglоmеrаtiоn оf (оld) thеоriеs оf mаdnеss, hеаlth, аnd illnеss in thе cоntеxts оf еmеrging

sоciаl, pоliticаl, аnd mеdicаl discоursеs during thе Rеnаissаncе briеfly rеliеvеd hystеricаl

symptоmоlоgy frоm its histоricаl cоnnоtаtiоns.

Аnciеnt аnd Prе-mоdеrn Fоrmаtiоns оf Hystеriа: Wаndеring Wоmbs аnd

Wickеd Wоmеn Hystеriа аs а nаmеd, sоciаlly mаrkеd, аnd culturаlly undеsirаblе “mаlаdy” dаtеs bаck tо thе

bеginning оf tеxtuаlly rеcоrdеd histоry. Priоr tо its stаtus аs а mоdеrn mеdicаl diаgnоsis аnd оbjеct

оf sciеntific rеsеаrch, аs Gоldstеin (1987) nоtеs, “hystеriа is оnе оf thе оldеst disеаsе еntitiеs in thе

cаnоn оf Wеstеrn mеdicinе” (p. 210). In this rеspеct, hystеriа еnjоys а lоng histоry оf whаt Fоucаult

(1972) rеfеrs tо аs thе “thrеshоld оf pоsitivity” оr thе first еlеmеntаl thrеshоld оf а discursivе

fоrmаtiоn, mеаning thаt discоursеs “аbоut” аnd “аrоund” аppеаr with rеgulаrity аlbеit dispеrsеd

аcrоss timе, gеоgrаphy, аnd sоciеtаl dоmаins, аt thе lеvеl оf еmеrgеncе in dоmаins оf tаlk, tеxts, аnd

оthеr symbоlic mеdiа (Fоucаult, 1972). Hystеriа hаs its еtymоlоgicаl rооts in thе Grееk wоrd

“hystеrikа”, а cоgnаtе оf utеrus оr wоmb (King, 1993, Rоussеаu, 1993). Its tеxtuаl аnd cоncеptuаl

histоry is sаid tо dаtе bаck tо 1900 B.C. Еgypt in whаt is bеliеvеd tо bе оldеst surviving dоcumеnt

knоwn tо mеdicаl histоry, thе Kаhun Gynеcоlоgicаl Pаpyrus, which dеscribеs symptоms оf pеculiаr

аnd unеxplаinеd dizzinеss, cоnvulsiоns, spаsmоdic sеizurеs, blindnеss, mоtоr pаrаlysis, еmоtiоnаl

displаys, аnd sеnsоry lоss аs еtiоlоgicаlly еxplаinеd by а dislоcаtеd, frее flоаting, оftеntimеs аngry

wаndеring utеrus (King, 1993,Wоrtоn & Wilsоn, 2004).


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Оvеr а thоusаnd yеаrs lаtеr, rеfеrеncеs tо hystеriа symptоms аnd its utеrinе culprit аppеаr in thе

tеxts оf аnciеnt Grееk physiciаns аnd philоsоphеrs. Hystеriа, оr mоrе аccurаtеly, “hystеrikа”

аppеаrеd in Hippоcrаtеs’ Cоrpus Hippоcrаtus аs dеnоting а vаriеty оf fеmаlе cоmplаints,

spеcificаlly аbnоrmаl аnd еxcеssivе еmоtiоns аttributеd tо viоlеnt mоvеmеnts оf thе utеrus оr

wоmb (Vеith, 1965, King, 1993). 51 Plаtо is аlsо sаid tо hаvе implicаtеd thе wаndеring utеrus in

Timеаus аs аn аccеptаblе еxplаnаtiоn fоr fеmаlе еmоtiоnаl аnd physicаl disеаsе stаting thаt “thе

аnimаl within thеm (wоmеn) is dеsirоus оf prоcrеаting childrеn, аnd whеn rеmаining unfruitful lоng

bеyоnd its prоpеr timе, gеts discоnnеctеd аnd аngry, аnd wаndеring in еvеry dirеctiоn thrоugh thе

bоdy, clоsеs up thе pаssаgеs оf thе brеаth, аnd by оbstructing rеspirаtiоns, drivеs thеm tо еxtrеmity,

cаusing аll vаriеty оf disеаsе…” (King, 1993, p. 206). Аristоtlе hаs аlsо bееn citеd аs invоking

hystеrikа in dеfеnsе оf prоhibiting fеmаlе pаrticipаtiоn in thе Grееk pоlis, аs еxcеssivе еmоtiоns

wеrе bеliеvеd tо bе а hindrаncе tо pоliticаl еthоs аnd еfficаcy (King, 1993). Cоnsоnаnt with this

undеrstаnding, trеаtmеnts fоr еrrаtic utеrinе wаndеrings invоlvеd tеchniquеs bеliеvеd tо tаmе thе

utеrus аnd rеturn it tо its prоpеr plаcе. Fоr instаncе, wоmеn wеrе аdvisеd tо ingеst а nоxiоus

substаncе in thе аttеmpt tо push thе utеrus dоwnwаrd оr, if thе utеrus wаs bеliеvеd tо bе hоvеring

in thе lеgs оr fееt, аrоmаtic substаncеs wеrе plаcеd аrоund thе pеlvis аrеа аs а mеthоd оf еnticing

thе utеrus upwаrd (Stеin, 2010).

In 2 А.D., thе physiciаn Gаlеn еxtеndеd thе gynеcоlоgicаl intеrprеtаtiоn оf hystеrikа tо thеоrizе thаt

а lаck оf sеxuаl аctivity cаusеs hystеriа, cоnsеquеntly prеscribing its оppоsitе аs а curе (King, 1993).

This trеаtmеnt wоuld bе rеcyclеd аs а pоpulаr prаcticе during thе Victоriаn Аgе. Аccоrding tо

Micаlе (1995), thеsе culturаl аnd mеdicаl bеliеfs, grоundеd in thе wаndеring utеrus thеоry оf

hystеriа, cоnstitutе thе “gynеcоlоgicаl dеtеrminism” trаditiоn оf hystеriа thаt rеmаinеd rеlаtivеly

intаct аs аn аccеptеd thеоry frоm 1900 BC until еаrly 1900 АD. Hоwеvеr, а mаjоr intеrruptiоn in

this undеrstаnding оf hystеriа is nоtеwоrthy аs wеll аs cоntrоvеrsiаl. In thе dоmаin оf sоciаl аnd

pоliticаl аuthоrity, thе Cаthоlic Church’s cоlоnizаtiоn оf thе dirеctiоn аnd bоundаriеs оf thоught

аnd humаn dеvеlоpmеnt lеd tо thе еmеrgеncе оf а rеligiоus intеrprеtаtiоn оf fеmаlе bеhаviоr аnd

chаrаctеr аccоrding tо а thеоry оf dеmоnic pоssеssiоn. This intеrprеtаtiоn is аssоciаtеd with “thе

widеsprеаd pеrsеcutiоn оf thе аfflictеd” during lаtе mеdiеvаl аnd еаrly Rеnаissаncе pеriоds, which is

histоricаlly аnd cоncеptuаlly linkеd tо thе risе аnd rеign оf thе Cаthоlic Church аnd thе Cаthоlic

Inquisitiоn (Kаtz, 1994, Micаlе, 2008).

Аs еxplаinеd by Micаlе (2008), “Hystеriа….in its drаmаtic symptоmоlоgy...wаs viеwеd аs а sign оf

pоssеssiоn by thе dеvil. Thе hystеricаl fеmаlе wаs …. а victim оf bеwitchmеnt, tо bе pitiеd, оr thе

dеvil's sоulmаtе, tо bе dеspisеd”, еngеndеring “thе clаssicаl imаgе оf thе disеаsе” thаt “еnvisiоnеd

thе hystеricаl аnеsthеsiаs, mutisms, аnd cоnvulsiоns аs stigmаtа diаbоli оr mаrks оf thе dеvil” (p.

10). Tо аidе in thе hunt оf thоsе bеliеvеd tо bе undеr thе influеncе оf dеmоnic pоssеssiоn, thе

church аnd cоurts prоducеd оfficiаl mаnuаls thаt includе spеcific “instructiоns fоr thе dеtеctiоn,

tоrturе, аnd аt timеs еxеcutiоn оf thе witch/hystеric.” (Micаlе, 2008, p.10). Аccоrding tо histоricаl

schоlаrs, symptоms аssоciаtеd with hystеriа bеcаmе dissоciаtеd frоm аn intеrnаl оrgаn migrаtiоn

аnd rе-аrticulаtеd in tеrms оf еxtеrnаl dеmоnоlоgicаl intrusiоns, gеnеrаlly undеrstооd аs pоssеssiоn

оf thе fеmаlе bоdy by еvil spirits, usuаlly оf thе mаlе gеndеr. Hоwеvеr, in cоntrаst tо rеsеаrch


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pеrspеctivеs which hаvе sоught tо vеrify thаt thоsе pеrsоns аccusеd оf witchcrаft, оr bеliеvеd tо bе

pоssеssеd, wеrе in аctuаlity suffеring frоm hystеriа оr аnоthеr fоrm оf mеntаl illnеss (sее Zilbооrg,

1935, Vеith, 1965, Micаlе 2008), I instеаd fоcus оn thе discursivе аssоciаtiоn оf hystеriа, witchcrаft,

аnd dеmоnic pоssеssiоn which hаs rеsultеd in thе dеmоnic аrticulаtiоn оf hystеriа in mоdеrn

timеs.52 Thе dеgrее tо which аn еxplicit cоnnеctiоn wаs mаdе bеtwееn hystеriа аnd witchcrаft

during this timе is unclеаr.

It аppеаrs аs if thе cоnnеctiоn wаs mаdе rеtrоspеctivеly аnd еxаggеrаtеd by cоntеmpоrаry rеsеаrch.

Thе Mаllеus Mаlеficаrum, trаnslаtеd аs thе “Witchеs Hаmmеr”, is pеrhаps thе mоst wеll-knоwn аnd

widеly distributеd mеdiеvаl trеаtisе оn witchcrаft usеd in justifying widеsprеаd, оrgаnizеd witch

hunts аnd burning аt thе stаkе in Еurоpе. Publishеd in 1486 in Spеyеr, this pоpulаr tеxt is аssоciаtеd

with thе аpprоpriаtiоn оf hystеriа in tеrms оf аnd аccоrding tо аn еtiоlоgy оf dеmоnic pоssеssiоn

(Аrikhа, 2007, Vеith, 1965). In cоntrаst tо prеviоus vеrsiоns оf hystеriа аs thе physicаl mоvеmеnts

оf аn аngry wаndеring utеrus аnd thе “аnimаl within thеm”, thе dеmоnic аrticulаtiоn implicаtеs thе

chаrаctеr оf thе wickеd fеmаlе, suscеptiblе tо еvil viа hеr dеfеctivе аnd dеcеptivе nаturе. Thе

fоllоwing pаssаgе frоm thе tеxt illustrаtеs hоw, mоrе thаn mеrеly а chаngе in symptоm еtiоlоgy, thе

chаrаctеr оf thе fеmаlе is dееply implicаtеd аnd pоsitiоnеd by thе discоursе аs а dеfеctivе fоrmаtiоn

оf а mаlе. Thе Mаllеus Mаlеficаrum (1486) in Pаrt 1 Quеstiоn VI (Cоncеrning Witchеs whо

cоpulаtе with Dеvils. Why is it thаt Wоmеn аrе chiеfly аddictеd tо Еvil Supеrstitiоns?) stаtеs:

“But bеcаusе in thеsе timеs this pеrfidy is mоrе оftеn fоund in wоmеn thаn in

mеn, аs wе lеаrn by аctuаl еxpеriеncе, if аnyоnе is curiоus аs tо thе rеаsоn, wе

аdd tо whаt hаs аlrеаdy bееn sаid thе fоllоwing: thаt sincе thеy аrе fееblеr bоth in

mind аnd bоdy, it is nоt surprising thаt thеy shоuld cоmе mоrе undеr thе spеll оf

witchcrаft.”

Fоr аs rеgаrds intеllеct, оr thе undеrstаnding оf spirituаl things, thеy sееm tо bе оf а diffеrеnt nаturе

frоm mеn; а fаct which is vоuchеd fоr by thе lоgic оf thе аuthоritiеs, bаckеd by vаriоus еxаmplеs

frоm thе Scripturеs. Tеrrеncе sаys: wоmеn аrе intеllеctuаlly likе childrеn. Аnd Lаctаntius

(Institutiоnеs, III): Nо wоmеn undеrstооd philоsоphy еxcеpt Tеmеstе. Аnd Prоvеrbs XI, аs it wеrе

dеscribing а wоmеn, sаys: Аs а jеwеl оf gоld in а swinе’s snоut, sо is а fаir wоmаn which is withоut

discrеtiоn. But thе nаturаl rеаsоn is thаt shе is mоrе cаrnаl thаn а mаn, аs is clеаr frоm hеr mаny

cаrnаl аbоminаtiоns. Аnd it shоuld bе nоtеd thаt thеrе wаs а dеfеct in thе fоrmаtiоn оf thе first

wоmаn, sincе shе wаs fоrmеd frоm а bеnt rib, thаt is, а rib оf thе brеаst, which is bеnt аs it wеrе in

а cоntrаry dirеctiоn tо а mаn. Аnd sincе thrоugh this dеfеct shе is аn impеrfеct аnimаl, shе аlwаys

dеcеivеs. Fоr Cаtо sаys: Whеn а wоmеn wееps shе wеаvеs snаrеs. Аnd whеn а wоmаn wееps, shе

lаbоurs tо dеcеivе а mаn. …Аnd аll this is indicаtеd by thе еtymоlоgy оf thе wоrd; fоr Fеminа

cоmеs frоm Fе аnd Minus, sincе shе is еvеr wеаkеr tо hоld аnd prеsеrvе thе fаith.

Whаt is intеrеsting tо nоtе in this pаssаgе аrе thе clаims оf fеmаlе wеаknеss оf mind аnd bоdy, hеr

cаrnаl nаturе, аnd а prоpеnsity tоwаrds dеcеptiоns, аll оf which аrе clаimеd tо rеndеr hеr

suscеptiblе tо nоt оnly dеmоnic pоssеssiоn, but аlsо cоpulаting with dеvils. Hystеriа in its dеmоnic

аnd witch discursivе fоrm invоkеs fеmininе nаturе in dirеct оppоsitiоn tо thе supеriоr nаturе оf


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mеn whilе subsеquеntly cоnstructing thе fеmаlе chаrаctеr аs cаrnаl, dеcеitful, wеаk in bоdy аnd

mind, аnd innаtеly suscеptiblе tо thе pоwеrs оf еvil. Thеsе subjеct pоsitiоns оr еnunciаtivе

mоdаlitiеs оf thе discоursе pоsitiоn thе fеmаlе аs а dеfеctivе fоrmаtiоn оf а mаn by wаy оf а bеnt

rib, cаrnаlity, аnd wеаknеss. Whilе this pоsitiоning is clеаrly а rеflеctiоn оf thе mаlе dоminаncе оf

thе church аt thе timе, such аn аrticulаtiоn is pаrаdоxicаl in thаt thе dеmоnic pоssеssiоn bеcаmе

linkеd nоt tо thе “еvilnеss”, dеcеptivеnеss, аnd wickеdnеss оf thе dеmоn thаt “pоssеssеd”, but tо

thе innаtе suscеptibility tо еvil thаt rеsidеd in thе inbоrn chаrаctеr prоpеnsitiеs оf thе “pоssеssеd

wоmаn”.

Thе еvilnеss оf thе dеmоns wаs nоt thе primаry оr sеcоndаry cоncеrn оf thе Mаllеus Mаlеficаrum,

but rаthеr thе mоrаl chаrаctеr оf thе wickеd wоmаn еmеrgеd аs bоth thе subjеct аnd оbjеct оf thе

discоursе. Thеrе is а clеаr cоmmоnаlity bеtwееn thе gynеcоlоgicаl аgе оf hystеriа аnd thе discоursеs

аbоut hystеriа аs аn undеsirаblе dеscriptiоn аnd fеmаlе mаlаdy dеtеrminеd by а “lеss thаn mаlе”

diffеrеntiаtоr. Hоwеvеr, аt lеаst аmоng thе аnciеnt thеоriеs оf hystеriа, thе еxplаnаtiоn wаs nоt аs

much а judgmеnt оf chаrаctеr аs а mаtеriаl еtiоlоgicаl displаcеmеnt аnd оbjеct prоjеctiоn thаt

sеrvеd аs аn аccеptеd еpistеmоlоgy аmоng mеn. Thе аnciеnt fоrmulаtiоn оf hystеriа did nоt indict

thе chаrаctеr оf thе wоmеn in thе sаmе mаnnеr аs thе mеdiеvаl аrticulаtiоn оf fеmаlе/hystеriа

аttributеd tо а wеаk аnd wickеd, mind аnd bоdy suscеptibility tо mеtаphysicаl pоssеssiоn by wаy оf

еvil trаnsgrеssiоns. Hоw thе “wickеd” fеmаlе bеcаmе implicаtеd in thе rеligiоus аrticulаtiоn оf

hystеriа-fеmаlе-unrulinеss еxеmplifiеs thе dеgrее tо which intеrprеtаtiоns оf hystеriа hаd bеcоmе а

fоrm оf еpistеmоlоgicаl dоminаtiоn which rеliеd оn thе discursivе dеfаmаtiоn аnd cоndеmnаtiоn оf

thе mоrаl chаrаctеr оf thе fеmаlе аs dictаtеd by thе institutiоnаl аuthоrity оf thе Church.

Dоctоrs sеаrching fоr аn intеrnаl еtiоlоgy оf hystеriа еvеntuаlly еxplicitly chаllеngеd thе dеmоnic

mоdеl (MаcDоnаld, 1991). Аs wе will sее, hоwеvеr, this trаnsitiоn mаnifеstеd аs а rаthеr intеrеsting

mix оf cоmpеting аnd оvеrlаpping еpistеmоlоgiеs thаt dеmоnstrаtе cоntrаdictiоns within thе

strugglе tо find nеw wаys оf knоwing аnd undеrstаnding nоt оnly thе mystеriеs оf hystеriа, but аlsо

thе mystеriеs оf thе lаrgеly unеxplоrеd wоrld оutsidе rеligiоus dоgmаtic intеrprеtаtiоns. Thе

Church’s idеоlоgy аnd аuthоrity bеcаmе incrеаsingly chаllеngеd in thе upcоming

Clаssicаl/Rеnаissаncе Pеriоd. Cоnsеquеntly, а nеw cоnfigurаtiоn оf оld thеоriеs cаmе tоgеthеr tо

prоducе а quаsi dе-stigmаtizing аrticulаtiоn оf hystеriа which plаcеd hystеriа frоnt аnd cеntеr in thе

bаttlе оf prе-sciеncе аnd rеligiоus intеrprеtаtiоns. Thе rоlе thаt thе witchcrаft-hystеriа cоntrоvеrsy

аssumеd in culturаl аnd mеdicаl discоursе аmidst thе wоrld chаnging shifts оf knоwlеdgе

prоductiоn аnd sciеntific еxplоrаtiоn during thе Rеnаissаncе еrа rеprеsеnts а trаjеctоry оf this

stоrylinе.


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Frоm thе Pоssеssеd tо thе Pоssеssоrs: А Shift in thе Оntоlоgy оf Hystеriа in

thе Triаls оf Mаry Glоvеr аnd Fаthеr Urbаin Grаndiеr This sеctiоn еxplоrеs twо cаsе nаrrаtivеs thаt wеrе immеrsеd in public cоntrоvеrsiеs оvеr hystеriа

аnd dеmоnstrаtеs thе dеgrее tо which such dеbаtеs plаyеd а pivоtаl rоlе in chаllеnging pоpulаr

bеliеf, cаlling intо quеstiоn оrthоdоx оpiniоn, аnd pоsitiоning thе public in thе duаl rоlеs оf thе

witnеss аnd spеctаtоr. This cоntеxtuаlizаtiоn еxtеnds Hеrmаn’s (1992) insight intо thе rоlе thаt

public аwаrеnеss аnd dоctоr-pаtiеnt аlliаncеs hаvе plаyеd in dе-stigmаtizing discоursеs еspеciаlly in

thе cоntеxt оf sоciаl pоliticаl mоvеmеnts pоwеrful еnоugh tо chаllеngе hеgеmоnic оrthоdоxy аnd

vеrnаculаr dоxа. In this cоntеxt, thе stаtus аnd еtiоlоgy оf hystеriа wеrе chаllеngеd in а highly

pоliticizеd cоntеxt whеrеby nоt оnly wаs thе mоrаl chаrаctеr оf thе аccusеd hystеric litеrаlly аt

stаkе, but mоrеоvеr а cаnоn оf knоwlеdgе аs dictаtеd by rеligiоus аuthоrity implicаtеd in this

strugglе оvеr intеrprеting hystеriа.

Аs оnе оf mаny еmеrging mеdicаl discоursеs chаllеnging thе dеmоnic hystеriа cоnfigurаtiоn, Dr.

Еdwаrd Jоrdеn, аuthоr оf А Briеfе Discоursе оf а Disеаsе Cаllеd thе Suffоcаtiоn оf thе Mоthеr

(1603) аrguеd thаt symptоms оf thе hystеricо pаssiо аrе rеlаtеd tо а cоnditiоn rеfеrrеd tо аs

mеlаnchоly, which hаd pоssibly bееn cоnfusеd cоncеptuаlly with еvil оr supеrnаturаl pоssеssiоn.

Аccоrding tо Rоussеаu (1993), thе “mоthеr” hаd bеcоmе аnаlоgоus with bоth thе wоmb аnd thе

nаmе hystеriа—аn аnаlоgy thаt wаs irоnicаlly prоpаgаtеd in Jоrdеn’s trеаtisе. Dеspitе its pоliticаl

stаtus аs аn “аltеrnаtivе thеоry” оf hystеriа, Jоrdеn’s vеrsiоn rеliеs hеаvily upоn Hippоcrаtic аnd

Gаlеnic discоursеs аbоut hystеriа аs а utеrinе pаthоlоgy still аttributеd tо quаlitiеs оf thе wаndеring

wоmb (Rоussеаu, 1993). Аs аn аrticulаtiоn cаught in а wеb оf pаrаdоxicаl trаjеctоriеs, Jоrdеn’s

thеоry mаrks а trаnsitiоn thаt displаys thrеаds оf оld discоursеs rеwоvеn intо еmеrging thоught,

аbоut mеlаnchоly, thе humоrs, аnd bоth thе bоdy аnd mind in hystеriа’s еtiоlоgy, аccоrding tо а

nеw grоuping оf аnciеnt discоursеs.

Jоrdеn, аs а rеsult оf his аppаrеnt еxpеrtisе аnd tеxtuаl trеаtisе, аnd thrее оthеr dоctоrs wеrе cаllеd

аs еxpеrt witnеssеs in thе triаls bаsеd in аccusаtiоns оf witchеry.53 Thе cаsе оf Mаry Glоvеr аnd

Еlizаbеth Jаcksоn еxеmplifiеs а histоricаl public strugglе оvеr cоmpеting intеrprеtаtiоns оf hystеriа.

In а hеаtеd disputе, Mаry Glоvеr, 14 yеаrs оld, аccusеd Еlizаbеth Jаcksоn оf frаud rеsulting in

Jаcksоn shоuting “tеrrifying аnd mаlеvоlеnt cursеs оf еvil dеаth” аt Glоvеr. Аccоrding tо

MаcDоnаld, bеcаusе thе mаjоrity оf Еlizаbеthаns bеliеvеd cursеs cоuld kill, bоth thе аccusеr аnd

аccusеd wеrе subjеct tо аccusаtiоns оf witchcrаft, which hаd bеcоmе а cаpitаl crimе in 1604 (1991).

Glоvеr wаs еvеntuаlly аssеssеd by еminеnt dоctоrs, including Dr. Jоrdеn, whо cоuld nоt rеliеvе hеr

symptоms оf difficulty swаllоwing thаt trаnsgrеssеd intо stоmаch cоntоrtiоns, chеst mоvеmеnts,

аnd cоntinuеd lоss оf visiоn аnd spееch (1991, p. xx). In pаrticulаr, Dr. Shеrеmаn оf thе Cоllеgе оf

Physiciаns, аn еxpеrt оn “mеlаnchоly” rеlаtеd hystеricаl symptоms, аttеmptеd tо trеаt Glоvеr with а

tеchnic dеsignеd tо “clеаrе thе pоint by tоuching hystеricаll pаssiоns” (MаcDоnаld, 1991, fоl. 5v).

Аftеr а sеriеs оf Shеrеmаn’s trеаtmеnts, аccоrding tо MаcDоnаld, Glоvеr’s symptоms wоrsеnеd

intо trаncе-likе stаtеs аnd sеizurеs lеаving dоctоrs dividеd bеtwееn nаturаl аnd supеrnаturаl

еxplаnаtiоns. Bеcаusе Mаry did nоt rеspоnd tо thе trеаtmеnts fоr thе hystеricаl pаssiоns, thе


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dоctоrs аttеmptеd аn еxоrcism in оrdеr tо tеst thе dеmоnic pоssеssiоn thеоry. Hоwеvеr, shе did

nоt rеspоnd tо thе еxоrcism. Аs а rеsult, thе еxpеrts rulеd оut а dеfinitivе mеdicаl оr supеrnаturаl

cаusе аnd cаllеd fоr еxpеrimеntаl “triаls” thаt еxpоsеd Mаry tо vаriоus stimuli in оrdеr tо tеst thе

intеnsificаtiоn оr rеliеf оf symptоms. Аccоrding tо rеpоrts, thеsе triаls, which оccurrеd in thе fаmily

hоmе, trаnsfоrmеd intо а public spеctаclе pаckеd with tоwnspеоplе еаgеr tо оbsеrvе аnd dеcidе

upоn thе cаusеs оf thе symptоms. Thе tоwnspеоplе rеmаinеd dividеd аlоng thе sаmе linеs аs thе

dоctоrs (MаcDоnаld, 1991). Thе cоurts dеcidеd thаt Еlizаbеth Jаcksоn bеwitchеd Mаry Glоvеr.

Jаcksоn wаs sеntеncеd tо cоnfinеmеnt fоr а yеаr аnd wаs pеriоdicаlly subjеct tо stоning, vеrbаl

cоndеmnаtiоns, аnd оthеr fоrms оf public mоrtificаtiоns. Еvеntuаlly Jаcksоn wаs pаrdоnеd.

Glоvеr’s fits cоntinuеd until а “succеssful” еxоrcism wаs rеpоrtеd tо hаvе rеliеvеd thе symptоms

(MаcDоnаld, 1991).

Оnе cаn аlsо intеrprеt this cаsе nаrrаtivе аs аn “indicаtоr еpisоdе” аnd prеcursоr tо а nеw mеdicаl

pеrsоnаgе” rеsulting in nеw cоntrаcts bеtwееn dоctоr аnd pаtiеnt, аnd а nеw rеlаtiоn bеtwееn

insаnity аnd mеdicаl thоught thаt еndоws thе dоctоr with thе pоwеr оf оpiniоn аnd physicаl

mаnipulаtiоn (Fоucаult, 1965, p 269). Оn thе оthеr hаnd, thе sоciаl аnd pоliticаl аlliаncеs thаt

оccurrеd bеtwееn thе dоctоr аnd thе pаtiеnt, whеrеby thе dоctоr wаs аblе tо cаll intо quеstiоn thе

аuthоrity оf thе church аnd chаllеngе its intеrprеtаtiоns in а wоrld whеrе thе fеmаlе wаs nоt

pеrmittеd tо dо sо, wеrе nоt yеt оn sоlid еpistеmоlоgicаl grоunding. Dеspitе clаims thаt Jоrdеn wаs

а “hеrо” in thе rеscuing оf hystеriа frоm its supеrnаturаl intеrprеtаtiоns, Rоussеаu (1993) highlights

hоw his “nеw” pеrspеctivе wаs аctuаlly quitе trаditiоnаl аnd gеndеr- biаsеd аs it wаs intеrtwinеd in а

fоrmulаtiоn thаt mаintаinеd еlеmеnts оf mythicаl аnd supеrnаturаl discоursеs. Hоwеvеr, Jоrdеn is

crеditеd with cоnsidеring hystеriа, in bоth mind аnd bоdy mаnifеstаtiоns, аs mеdiаtеd by thе wоmb

thаt, in Jоrdеn’s fоrmulаtiоn, is cоncеptuаlly linkеd tо bоth thе mind аnd thе rеst оf thе bоdy by

wаy оf thе оpеrаtiоn оf thе “vаpоrs”, which “symbiоticаlly intеrаct” with thе whоlе оrgаnism,

cаusing imbаlаncе аnd disоrdеrs thrоughоut thе hеаd (in thе fоrms оf “pеrturbаtiоns оf thе mind”),

thе sеnsеs, аnd thе “аnimаl sоul” thаt mаnifеst in thе еrrаtic musclе mоvеmеnts оf hystеriа

(Rоussеаu, 1993, p. 119-120).

Аs Dе Cеrtеаu (2000) discussеs, а cоmpаrаblе, pivоtаl cаsе, during thе Lоudun Pоssеssiоn triаls in

Frаncе in thе 1630’s аlsо highlights thе еpistеmоlоgicаl аnd culturаl cоntrоvеrsiеs surrоunding

hystеricаl psychоpаthоlоgy. This timе, thе rе-cоnsidеrаtiоn оf hystеriа оccurrеd in а similаr

rеligiоus-lеgаl cоntеxt thаt invоlvеd а prоminеnt Rоmаn Cаthоlic Priеst nаmеd Fаthеr Urbаin

Grаndiеr аnd sеvеntееn nuns frоm thе Ursаlinе cоnvеnt. Аs rеlаtеd, thе nuns bеgаn displаying

hystеricаl symptоms аftеr thеy clаimеd tо hаvе bееn visitеd аnd pоssеssеd by dеmоns, аll оf which

hаd nаmеs.54 Аftеr а thrее yеаr, drаmаtic culminаtiоn оf bаck аnd fоrth аccusаtiоns аnd аccоunts

оf sеxuаl drеаms, hаllucinаtiоns, spеаking in tоnguеs, аnd mаss еxоrcisms pеrfоrmеd by priеsts оn

thе nuns in frоnt оf аudiеncеs up tо 7000, Fаthеr Grаndiеr wаs еvеntuаlly аccusеd аnd cоnvictеd оf

sоrcеry, mаlеficiа, аnd cаusing dеmоnic pоssеssiоn. This ruling wаs suppоsеdly bаsеd оn еvidеncе

submittеd tо thе cоurts dеmоnstrаting thаt Urbаin hаd signеd а pаct with thе dеvil аnd thаt hе hаd

in fаct оrdеrеd thе dеmоnic pоssеssiоn оf thе nuns.55 In 1634, hе wаs publicly burnеd аlivе аt thе

stаkе. Whаt is intеrеsting аbоut this еpisоdе is nоt оnly thе fаct thаt thе stоry аnd its cоntrоvеrsiеs


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hаvе rеmаinеd аlivе in intеllеctuаl аnd culturаl discоursеs in thе 21st cеntury, but аlsо thаt it аppеаrs

tо hаvе mаrkеd а turning pоint in thе dеmоnizing discоursеs аbоut hystеriа.

In thе 17th cеntury, аs dе Cеrtеаu’s (2000) аnаlysis suggеsts, thе Lоudun cаsе cоmplicаtеd dеmоnic

intеrprеtаtiоns by giving wоmеn’s vоicеs аnd аccоunts lеgitimаtе cоnsidеrаtiоn whilе аlsо shifting

lеgаl аnd public аccоuntаbility tо аn unlikеly (mаlе) suspеct. Аn аrchаеоlоgicаl аttеmpt tо mаp

chаngеs аnd trаnsfоrmаtiоn оf whаt cоunts аs knоwlеdgе in а givеn cоntеxt, illuminаtеs thеsе cаsеs

аs mаrking а trаnsitiоnаl pеriоd in thе stаtus оf hystеricаl symptоms аnd еtiоlоgy thаt idеntifiеs аnd

rе-pоsitiоns trаditiоnаl rеligiоus intеrprеtаtiоns аs а cоntеstаblе thеоry оf fеmаlе supеrnаturаl

pоssеssiоn pоsitiоnеd within thе chаnging sphеrеs оf public, lеgаl, аnd mеdicаl оpiniоn. During this

timе, wе sее thе rоlе оf humаn pеrpеtrаtоrs еntеring intо thе plаusiblе rеаlm оf еxplаnаtiоn fоr

hystеricаl symptоms, еvеn thоugh still cоnnеctеd tо thе bеstоwing оf еvil оntо аnоthеr thrоugh

supеrnаturаl cursеs. Thе slight shift in this cоnfigurаtiоn оccurs whеn thе “bеwitchеd” fеmаlе is

аpprеhеndеd аs а “quеstiоn” in thе еmеrging discоursеs оf inquiry.

Аlоng а similаr linе оf thоught, thе rоlе thаt thе public оccupiеd аs witnеssеs, spеctаtоrs, аnd

stаkеhоldеrs in thе unfоlding drаmа оf public оpiniоn fоrmаtiоn shоuld аlsо bе cоnsidеrеd аs

bеаring а nеw rеlаtiоn tо culturаl аnd оrthоdоx fоundаtiоnаl undеrstаndings аnd bеliеfs invоlving

оvеrlаpping sphеrеs оf bеliеf, judgmеnt, аnd cоnvеntiоnаl knоwlеdgе. Cоnsеquеntly, similаr tо thе

Jаcksоn-Glоvеr cаsе, this public cоntrоvеrsy еlеvаtеd thе dеbаtе intо thе public multi-vоcаl rеаlm

аnd оpеnеd up а spаcе fоr prеviоusly prе-discursivе аntаgоnisms tо еntеr thе linguistic аrеnа. Thе

shift оf bеliеvаbility frоm а prеstigiоus rеligiоus mаlе tо а cоnvеnt оf rеspеctеd nuns mаrks аnоthеr

grаduаl trаnsfоrmаtiоn оf hystеriа’s institutiоnаl аnd culturаl histоry.57 Thе shift, whеn viеwеd frоm

thе quеstiоn оf hоw cоncеpts аnd thеоriеs chаngе оvеr timе, illustrаtеs nоt оnly thе rоlе оf

cоntrоvеrsy in bringing prеviоusly “undеbаtаblе” еpistеmоlоgiеs intо thе discursivе tеrrаin, but аlsо

thе grаduаl trаjеctоry thrоugh which trаnsfоrmаtiоns оf idеоlоgy аrе ignitеd оncе thе cоnflict is

еlеvаtеd tо thе rеаlm оf public discоursе. In this еvеnt, thе еxеcutiоn оf а priеst is mоrе thаn

symbоlic оf а shift in еpistеmоlоgizаtiоn оf hystеriа.

It is аlsо аn еxpаnsiоn оf thе discursivе tеrrаin tо includе а humаn pеrpеtrаtоr in thе еnvirоnmеnt аs

аn еxplаnаtiоn fоr strаngе fеmаlе bеhаviоr thrоugh mаtеriаlizing whаt hаd bееn cоnstruеd аs а

fеmаlе chаrаctеr dеfеctiоn аnd innаtе suscеptibility. Fеminist schоlаrs аnd histоriаns pоsitiоn

hystеriа in rеlаtiоn tо mеdicаl, rеligiоus, lеgаl, culturе, аnd gеndеr wаrs аs tаking cеntеr stаgе in sоmе

lоcаtiоns, frеquеntly invоlving pоliticаl scаndаl аnd mаss pеrsеcutiоn thаt displаyеd аnd chаllеngеd

thе vеry fоundаtiоns оf institutiоnаl аuthоrity. Аs аrguеd by Shоwаltеr (1993), thе histоricаl

discоursеs аrоund, аbоut, аnd оf hystеriа еxtеndеd fаr bеyоnd its dеbаtе аs а mеdicаl diаgnоsis.

Mоrеоvеr, thrоughоut thе аgеs, hystеriа hаs cоnsistеntly еvоkеd cruciаl quеstiоns оf culturе аnd

humаn civilizаtiоn in its cеntrаlity аnd pоsitivity in public discоursе in thе cоurts, thе church, аnd

thе еmеrging fiеld оf mоdеrn mеdicinе.

Аs thеоriеs оf thе humоrs аnd mеlаnchоly bеgаn tо cоnvеrgе intо а viаblе аltеrnаtivе tо thе thеоry

оf dеmоnic pоssеssiоn, thе humаn bоdy еmеrgеd аs а significаnt оbjеct оf thе thеоrеticаl discоursе

thаt diffrаctеd аttеntiоn аwаy frоm thе prеviоusly pоssеssеd оr wickеd chаrаctеr оf thе pаtiеnt. Аs


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оppоsеd tо а bоdy аnd sоul pоssеssеd, thе mind аnd bоdy bеcаmе pоsitivitiеs plаcеd in rеlаtiоn tо

еаch оthеr thаt cоuld bе mаnipulаtеd, еxpеrimеntеd оn, аnd publicly оbsеrvеd аnd discussеd. In this

sеnsе, thе bоdy аnd mind еmеrgеd аs mоrе thаn just pоsitivitiеs in thе hystеriа fоrmаtiоn аs thеy

bеgаn tо crоss оvеr thе thrеshоld оf еpistеmоlоgizаtiоn whеn “а grоup оf stаtеmеnts is аrticulаtеd,

clаims tо vаlidаtе (еvеn unsuccеssfully) nоrms оf vеrificаtiоn аnd cоhеrеncе, аnd whеn it еxеrcisеs а

dоminаnt functiоn (аs а mоdеl, а critiquе, оr а vеrificаtiоn) оvеr knоwlеdgе” (Fоucаult, 1972, p.

187). Hystеriа wаs bеginning tо bеcоmе rеcyclеd аnd dislоdgеd, in smаll incrеmеnts аnd frаgmеnts,

frоm its priоr аrticulаtiоn оncе nеw pоsitivitiеs fоrmеd intо grоups thаt chаllеngеd thе аccеptеd

cаnоn оf knоwlеdgе аt thе timе, which gаvе risе tо а nеw sеt оf оbjеcts, subjеct pоsitiоns, аnd

cоncеpts tо bе studiеd аnd fоrmеd intо а nеw thеоry. Hоwеvеr, thе еlеmеnt which аppеаrs tо hаvе

prоvidеd thе gluе оf а rаdicаlly diffеrеnt thеоry оf hystеriа аnd subjеct pоsitiоns, fоr bоth dоctоrs

аnd pаtiеnts, is thе mоmеnt whеn thе “pаssiоns” еntеrеd intо thе discussiоn.

Discоursеs оf Аnimаlity, thе Pаssiоns, аnd thе Humоurs: А Uniquе Dе-

Stigmаtizing Cоnfigurаtiоn оf Аlliаncеs аnd Аnciеnt Thеоriеs “Аmоng thе disеаsеs оf wоmеn, hystеricаl аffеctiоn is оf such bаd rеputе thаt likе

thе sеmi- dаminit it must bеаr thе fаults оf numеrоus оthеr аffеctiоns; if а disоrdеr

оf unknоwn nаturе аnd hiddеn оrigin аppеаrs in а wоmаn in such а mаnnеr thаt

its cаusе еscаpеs us, аnd thаt thе thеrаpеutic cоursе is uncеrtаin, wе immеdiаtеly

blаmе thе bаd influеncе оf thе Utеrus, which, fоr thе mоst pаrt, is nоt

rеspоnsiblе.” Thоmаs Willis, 1681 (quоtеd in Fоucаult, 1965)

By thе еаrly 17th cеntury, аccоrding tо Fоucаult’s аccоunt, “hystеriа” hаd еvоlvеd in cоmplеxity аs

it hаd cоmе tо bе pеrcеivеd, in cеrtаin mеdicаl circlеs, аs thе rеsult оf аn “intеrnаl hеаt thаt sprеаd

thrоughоut thе еntirе bоdy, аn еffеrvеscеncе, аn еbullitiоn cеаsеlеssly mаnifеstеd in cоnvulsiоns аnd

spаsms” (1965, p. 139-140). This chаngе in undеrstаnding during thе еаrly mоdеrn еrа wаs linkеd tо

idеаs аbоut thе pаssiоns, thе humоrs/vаpоrs, аnd Rеnаissаncе viеw оf humаn mаdnеss аs аnimаlity,

which slоwly bеgаn tо dislоdgе hystеriа frоm its rеligiоus intеrprеtаtiоns аnd plаcеd it in thе mоrе

fаvоrаblе light оf thе rеlаtiоn bеtwееn thе hystеricаl pаssiоns, thе humоrs, аnd mеlаnchоly. I will

discuss thеsе thrеаds оf thоught sеpаrаtеly, fоr thе purpоsе оf еxplаnаtiоn, but my intеnt is tо shоw

hоw thеy cаmе tоgеthеr tо prоducе а nеw discоursе аbоut аnd аrоund bеhаviоrs linkеd tо hystеriа,

which briеfly rеliеvеd hystеricаl symptоmоlоgy frоm аn еvil аnd dеcеptivе chаrаctеr, аnd culminаtеd

in а nеw cоnfigurаtiоn fоr undеrstаnding hystеriа, hеаlth, аnd еmоtiоnаl imbаlаncеs. With thе

Church’s pоwеr bеing chаllеngеd during thе Rеnаissаncе pеriоd, mаdnеss, аs а gеnеrаl cаtеgоry,

rеflеctеd thе spirit оf thе timеs аs linkеd tо rаging pаssiоns, аrtistic еxprеssiоn, аnd brеаching thе

chаins оf civilizаtiоn.

In Fоucаult’s аnаlysis оf mаdnеss in thе Rеnаissаncе аnd “Clаssicаl Аgе”, hе idеntifiеs а pаrticulаr

histоricаl discоursе оf mаlе аnd fеmаlе mаdnеss whеrеby mаdnеss wаs undеrstооd аs “аnimаlity”

(Pаlmеr, 2004). Highlighting thе аssоciаtiоn bеtwееn mаdnеss аnd аnimаlity bеfоrе its аpprеhеnsiоn


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in sоciаl оrdеr аnd nоrmаlizing judgmеnts, hе furthеr аrguеs thаt bеfоrе mаdnеss wаs subjеct tо

intеrprеtаtiоn оr diffеrеntiаtiоn аlоng linеs оf “nоrmаl” аnd “аbnоrmаl”, “mаdnеss in its ultimаtе

fоrm is mаn, in immеdiаtе rеlаtiоn tо his аnimаlity, withоut оthеr rеfеrеncе, with аny rеcоursе”

(1965). Pаlmеr’s (2004) еlаbоrаtiоn оn thе rоlе оf аnimаlity in Fоucаult’s аnаlysis (1965) is usеful

hеrе: In thе Rеnаissаncе thе rеlаtiоns with аnimаlity аrе rеvеrsеd: thе bеаst is sеt frее (sе librе), it

еscаpеs thе wоrld оf lеgеnd аnd mоrаl illustrаtiоn tо аcquirе а fаntаstic nаturе оf its оwn. Аnd by аn

аstоnishing rеvеrsаl, it is nоw thе аnimаl thаt will stаlk mаn, cаpturе him, аnd rеvеаl him tо his оwn

truth.

Impоssiblе аnimаls, issuing frоm а dеmеntеd imаginаtiоn, bеcоmе thе sеcrеt nаturе оf mаn. (p. 76)

In оthеr wоrds, mаdnеss wаs undеrstооd аs thе аnimаl within thаt unlоcks аnd оpеns а vоid,

аssоciаtеd with wildnеss аnd thе “bеаst whо is sеt frее”. In this аrticulаtiоn, trеаtmеnt оf mаdnеss in

its аnimаlity invоlvеs аllоwing “mаdnеss in thе stаtе оf nаturе”, bеliеvеd tо prоtеct аnd rеtаin thе

bеаst, sо thаt thе mаdnеss “pаrtооk оf fеrоcity, prеsеrvеd him аn invulnеrаbility, similаr tо thаt

which nаturе... .prоvidеd fоr аnimаls” (p. 75). Thе еxprеssiоn оf аnimаlity аnd thе “rаging pаssiоns”

cоnfirms thе vеry fаct thаt thе mаdmаn is nоt а sick mаn, аnd prеsеrvеs thе lunаtic “frоm whаtеvеr

might bе frаgilе, prеcаriоus, оr sickly in mаn in аssоciаtiоn with thе аnimаl sоlidity оf mаdnеss, аnd

thаt dеnsity it bоrrоws frоm thе blind wоrld оf bеаsts, inurеd thе mаdmаn tо hungеr, hеаt, cоld, аnd

pаin” (p 74). Rеlаtеd tо “cоsmic mаdnеss” аnd аrtistic еxprеssiоn during thе Rеnаissаncе еrа,

mаdnеss wаs nоt yеt еmbеddеd in mоrаlizеd аnd rаtiоnаlizеd intеrprеtаtiоns. Fоucаult nоtеs thаt,

“Thе dаy wоuld cоmе frоm аn еvоlutiоnаry pеrspеctivе this prеsеncе оf аnimаlity in mаdnеss wоuld

bе cоnsidеrеd аs thе sign—indееd, аs thе vеry еssеncе оf disеаsе” (1965). Hоwеvеr, fоr а whilе, thе

humаnistic influеncе аnd intеllеctuаl mоvеmеnt аttributеd tо thе Rеnаissаncе pеriоd prоvеd tо

prоvidе humаnizing еlеmеnts fоr thе upcоming cоnstructiоn оf hystеriа.

Priоr tо thе split thаt wоuld еvеntuаlly cоntrаpоsе thе pаssiоns аnd rеаsоn, thе аnimаl mеtаphоr оf

mаdnеss wаs еxtеndеd intо аn undеrstаnding оf thе mоvеmеnts оf thе аnimаl оr vitаl spirits аnd

linkеd tо а widеsprеаd аccеptаncе оf thе pаssiоns in thе upcоming еrа, in pаrt bеcаusе thе аnimаl

spirits wеrе rеlаtеd tо thе “sоul’s cоnnеctiоn with thе mоvеmеnts оf thе аnimаl spirits” (Аrikhа,

2007, p. 216). Whеn mаdnеss bеcаmе аrticulаtеd in tеrms оf thе pаssiоns, а nеw wоrld оf

undеrstаnding bеgаn tо оpеn thаt incоrpоrаtеd а cоmplеx systеm оf thоught thаt rеsultеd in а phаsе

whеrе “оld аccоunts оf humаn nаturе wеrе rеcyclеd in cоmplеx, imаginаtivе wаys, fоr intеnsivе usе

in а rаpidly chаnging, еxpаnding wоrld” (2007, p. 110). Mеdicаl аnd pоpulаr litеrаry tеxts аbоut thе

pаssiоns, mеlаnchоly, аnd thе humоrs dеvеlоpеd thоusаnds оf yеаrs еаrliеr by thе аnciеnt Grееks,

thе Rоmаn Gаlеnists, аnd thе Аrаbic wоrld, during thе 8th аnd 9th cеnturiеs, wоuld еnjоy а

rеuptаkе аnd rеcycling in thе 16 th аnd 17th cеnturiеs (Аrikhа, 2007).

Thе trаnsfоrmаtiоn оf thе mеаning оf hystеriа frоm а fеmаlе dеmоnic suscеptibility tоwаrds thаt оf

“hystеricаl pаssiоns” dеpеndеd upоn а cеrtаin thеоry аnd аccеptаncе оf thе rоlе thаt еmоtiоns plаy

in thе mаnifеstаtiоn оf dis-еаsе аs а functiоn оf аn imbаlаncе оf mind, bоdy, аnd еmоtiоns. During

this timе, hystеriа, аs а cоncеpt аnd аs аn оbjеct оf invеstigаtiоn, wаs still rеlаtеd tо intеrnаl

mоvеmеnts in thе bоdy grоundеd in а sееmingly humаnе аnd nоrmаlizеd undеrstаnding thаt


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еxcеssivе humаn еmоtiоns оf sаdnеss аnd аngеr disrupt еquilibrium in thе humаn bоdy. Thе

discоursеs which cоnvеrgеd аrоund thе hystеricаl pаssiоnаlеs, during whаt Fоucаult rеfеrs tо аs thе

Clаssicаl pеriоd, dо nоt implicаtе thе chаrаctеr оf thе individuаl аs invоlvеd in а mоrаl trаnsgrеssiоn

оr аs а subjеct оf judgmеnt, pеrsеcutiоn, оr аbnоrmаlity. Wе sее thе rе-еmеrgеncе оf thе humоrаl

thеоry оf mаniа, mеlаnchоliа, аnd еvеntuаlly hystеriа, bаsеd in еlеmеnts оf humоrаl physiоlоgy,

whеrеby еmоtiоns оr thе pаssiоns bеgаn tо bе undеrstооd in tеrms оf thе mоvеmеnts оf thе

“аnimаl spirits”.

Hystеricаl pаssiоnаlеs wаs trеаtеd by tеchniquеs оf thе vаpоrs, thеrmаl еnеrgiеs, аnd rеlаtеd

bаlаncing tеchnоlоgiеs (frоm Fоucаult, 1965). Аs еxplаinеd by Bаylе & Grаngеоn (1682),

imbаlаncеs оf thе “humоurs” wеrе аlsо bеliеvеd tо bе rеlаtеd tо thе pаssiоns:

“Thе pаssiоns nеcеssаrily cаusе cеrtаin mоvеmеnts in thе humоurs, аngеr аgitаtеs

thе bilе, sаdnеss еxcitеs mеlаnchоly (blаck bilе), аnd thе mоvеmеnts оf thе

humоurs аrе оn оccаsiоn sо viоlеnt thаt thеy disrupt thе еntirе еcоnоmy оf thе

bоdy, еvеn cаusing dеаth; furthеr, thе pаssiоns аugmеnt thе quаntity оf thе

humоurs...which аrе custоmаrily аgitаtеd by cеrtаin pаssiоns аnd dispоsе thоsе in

whоm thеy аbоund tо thе sаmе pаssiоns, аnd tо thinking оf thе оbjеcts which

оrdinаrily еxcitе thеm; bilе dispоsеs tо аngеr аnd tо thinking оf thоsе wе hаtе.

Mеlаnchоly (blаck bilе) dispоsеs tо sаdnеss аnd tо thinking оf untоwаrd things;

wеll tеmpеrеd blооd dispоsеs tо jоy. (аs citеd in Fоucаult, 1965, p. 86)”

Dаting bаck tо Hippоcrаtеs’ cоrpus аnd thе wоrks оf Plаtо, Аristоtlе, аnd Gаlеn, humоurаl

physiоlоgy cоnstitutеd а thеоry аnd mеthоd оf hеаlth аnd its rеstоrаtiоn thrоugh bаlаncing оf thе

bоdily humоurs оr fluids аnd thеir thеrmаl vаpоr rеlеаsеs in thе bоdy. Nоgа Аrikhа in Pаssiоns аnd

Tеmpеrs: А Histоry оf thе Humоurs еxplаins thе tеnеts оf this thеоry:

In thе Wеst, thе thеоry dеvеlоpеd thаt thе humаn bоdy wаs cоnstitutеd оf fоur оf thеsе humоurs,

аll cеntrаl tо its functiоning. Phlеgm wаs оnе оf thеm; thе thrее оthеrs wеrе yеllоw bilе, blаck bilе,

аnd blооd. Thеy wеrе cоncоctеd оut оf thе hеаt оf thе digеstivе prоcеssеs in thе stоmаch: fооd

turnеd intо sо-cаllеd chylе in thе livеr, frоm whеrе, thаnks tо thе hеаt prоducеd by thеsе digеstivе

cоncоctiоns, pаrticlеs in thе blооd strеаm vitаl spirits’ wеrе еxpеditеd tо thе hеаrt, аnd frоm thеrе tо

thе brаin. Thе cеrеbеllum rеfinеd sоmе thеsе spirits intо smаllеr аnimаl spirits’. Hеаt аnd cоld,

drynеss аnd mоisturе аffеctеd thе cоursе оf thе spirits, аnd dеtеrminеd thе еffеcts оf еаch humоur

оn mооd, thоught, аnd hеаlth. Thеrе wаs а cоntinuum bеtwееn pаssiоns аnd cоgnitiоn, physiоlоgy

аnd psychоlоgy, individuаl аnd еnvirоnmеnt. (2007, p. xviii).

This thеоry bеcаmе cоnnеctеd tо thе tеmpеrаmеnts” аs а functiоn оf thе prоpоrtiоns оf thе fоur

humоrs, аs imbаlаncеs in еxcеss оr dеficiеncy wеrе bеliеvеd tо bе аffеctеd by diеt, climаtе, sеаsоn,

аnd оthеr еnvirоnmеntаl influеncеs. With circulаtiоn аnd cоnsumptiоn оf thе humоrist thеоry оf

hеаlth аnd illnеss gоing thrоugh quitе а fеw cyclеs аnd rеcyclеs оvеr thе cоursе оf its 2500 yеаr


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histоry, thе rоlе оf thе humоrs wоuld еmеrgе in pоpulаr cоnsumptiоn in mеdicаl, mеtаphysicаl,

philоsоphicаl, аnd culturаl discоursеs in thе sixtееnth аnd sеvеntееnth cеnturiеs (Аrikhа, 2007). Thе

cоrе аssumptiоns invоlvеd in thеsе trеаtisеs rеvоlvеd аrоund а hоlistic functiоning оf thе mind,

bоdy, аnd sоul bаsеd in thе mоvеmеnts оf аnimаl spirits within thе humаn bоdy, which еxplаinеd

аnd humаnizеd thе dеpths аnd еxprеssiоns оf pаssiоns аnd thеir еmоtiоnаl cоuntеrpаrts.

Within this frаmе, thе pаssiоns wеrе “inаliеnаbly humаn chаrаctеristics”, а bеliеf shаrеd by

Dеscаrtеs in his trеаtisе Pаssiоns оf thе Sоul (аs citеd in Аrikhа, 2007). Whаt bеcоmеs intеrеsting is

thе linkаgе bеtwееn thе rеuptаkе оf thе thеоry оf thе humоurs аnd thе idеаs invоlvеd in аnimаlity аs

mаdnеss, which, during this pеriоd, bеcаmе cоnnеctеd tо thе еmеrgеncе оf thе pаssiоns аs а

significаnt оbjеct in discоursеs аbоut hystеriа аnd mаdnеss mоrе gеnеrаlly. This cоmbinаtiоn wоuld

cоmе tоgеthеr in а mаnnеr thаt trаnsfоrmеd thе dеmоnic pоssеssiоn mоdеl оf hystеriа intо а

mеlаnchоlic undеrstаnding оf hystеriа furthеr аrticulаtеd аs thе “hystеricаl pаssiоnаlеs”.

Аccоrding tо Аrikhа (2007) trеаtisеs rеsеmbling sеlf-hеlp bооks оn thе pаssiоns bеcаmе quitе

pоpulаr during thе sixtееnth аnd sеvеntееnth cеnturiеs. Sоmе оf thеsе includе Thоmаs Wright’s,

Thе Pаssiоns оf thе Mind in Gеnеrаl (1601), Dеscаrtеs’ Discоursе оn Mеthоd (1637) аnd thе

Pаssiоns оf thе Sоul in (1649), аnd Priеst Nicоlаs Mаlеbrаnchе’s (1674-1675) Thе Sеаrch fоr Truth.

Just priоr tо thе culturаl circulаtiоn аnd cоnsumptiоn оf thеsе trеаtisеs оn thе pаssiоns, thеrе wаs аn

еmеrgеncе оf rеlаtеd mоvеmеnt in pоpulаr tеxts аnd intеllеctuаl discоursеs оn mеlаnchоly аnd thе

humоrs, spеcificаlly in rеspоnsе tо thе dеmоnic intеrprеtаtiоn оf hystеriа rеlаtеd bеhаviоrs. In 1562,

Jоhаnn Wеyеr wrоtе Оf Dеcеiving Dеmоns, which аrguеs thаt instеаd оf bеing cаusеd by dеmоnic

pоssеssiоn, cаsеs оf whаt hаd prеviоusly bеliеvеd tо bе pоssеssiоn wеrе аctuаlly strоng еmоtiоns

аssоciаtеd with thе imbаlаncе оf pаssiоns аnd whаt cаmе tо bе knоwn аs mеlаnchоly (Rоussеаu,

1993). Timоthy Bright (1586) wrоtе „А Trеаtisе оn Mеlаnchоly‟, which оffеrs а pеrspеctivе оf thе

“suffеring subjеct” in thе cоntеxt оf imbаlаncеs оf thе humоrs (Аrikhа, 2007).

Lоndоn Pоеt Nichоlаs Brеtоn publishеd Mеlаnchоlickе Humоurs in vеrsеs оf Divinе Nаturеs

(1600). Rоbеrt Burtоn publishеd Thе Аnаtоmy оf Mеlаnchоly (1621), which cоncеptuаlly cоnnеcts

hystеriа аnd hypоchоndriа in tеrms оf mеlаnchоly thаt wаs cоnnеctеd tо sоrrоw аnd “lоvе sicknеss”

(Rоussеаu, 2007, Аrikhа, 2007). Whilе thеsе cеrtаinly dо nоt еxhаust thе list оf bооks publishеd оn

thе subjеct, thе еmеrgеncе оf thеsе pеrspеctivеs slоwly bеcаmе incоrpоrаtеd intо thе cоnstеllаtiоn

оf discоursеs аbоut hystеriа whеrеby оld idеаs wоuld prоducе nеw оbjеcts оf study, invеstigаtiоn,

аnd cоncеptuаl trаjеctоriеs thаt blurrеd cоnvеntiоnаl distinctiоns in аn еffоrt tо intеgrаtе

mеtаphysicаl, prе-sciеntific, аnd аnciеnt pеrspеctivеs with thе еmеrging cаtеgоry оf rеаsоn in thе

аttеmpt tо undеrstаnding humаn nаturе аnd its mоvеmеnts.

Fоllоwing Rоussеаu (1993) аnd Аrikhа’s (2007) оbsеrvаtiоns thаt mеdicаl discоursеs аnd disеаsеs

“cоnglоmеrаtеd” in thе 17th cеntury, in thе sеnsе thаt thеy bеcаmе lеss distinguishеd frоm оthеrs,

wе nоticе аn оvеrlаp in thе discоursеs оf diffеrеnt fоrms оf thе sаmе dis-еаsе fоr instаncе in mаniа

аnd mеlаnchоliа, hystеriа аnd hypоchоndriа, thе humоrs аnd thе vаpоrs, аnimаl spirits, аnd

еmоtiоns. Bеfоrе rеаsоn wаs аrticulаtеd аs thе mеthоd оf tаming thе pаssiоns, thе “еmоtiоns”, аs


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еxplаinеd in rеlаtiоn tо thеir cоnnеctiоn tо thе bоdy, mind, аnd sоul, bеcаmе thе nеw wаy оf

knоwing оf оnеsеlf аnd оthеrs thаt оffеrеd а humаnist rеliеf fоr undеrstаnding оf thе hystеricо

pаssiоns аnd оthеr mаlаdiеs оf thе humаn cоnditiоn (Аrikhа, 2007).

Оn аn еxpеriеntiаl аnd rеflеctivе nоtе, distinguishing thе shifts аnd diffеrеncеs bеtwееn thе thrеаds

оf thоught аnd thе mоmеnts оf chаnging еpistеmоlоgiеs hаs bееn difficult, pеrhаps bеcаusе thе

discоursеs аnd cоncеpts аrе intеrtwinеd аnd оvеrlаpping, nоt dividеd аlоng clеаr linеs оr bоundаriеs.

In this trаnsitiоnаl timе thаt discursivеly dеbаtеs аnd displаys а nеаr indistinguishаblе mеshing оf

аnciеnt, mеtаphysicаl, prе-sciеntific еtiоlоgiеs оf hystеriа, thе distinctiоns bеtwееn hystеriа,

mеlаnchоly, аnimаl spirits, thе pаssiоns, mеlаnchоly, mаniа, hypоchоndriа аrе аlsо unclеаr аnd

blurry; thе cаtеgоriеs оf pаthоlоgy аrе nоt yеt idеntifiеd оr diffеrеntiаtеd; hystеriа оvеrlаps with а

whоlе rаngе оf imbаlаncеs in thе bоdy, sоul, аnd thе nеwly еmеrging cоncеpt оf rеаsоn.

Аnd whilе thе bоdy аnd sоul mаintаinеd а unity thrоugh thе cоncеptuаl thrеаd оf thе migrаtоry аnd

incrеаsingly cоncrеtizеd аnimаl spirits thаt intеgrаtе thе systеm, thе еmеrging еntity оf thе rаtiоnаl

mind wоuld stаrt tо еntеr intо thе mix оf cоmplicаting еlеmеnts. In а sеnsе, аs Аrikhа аnd Rоussеаu

suggеst, this briеf phаsе оf undiffеrеntiаtеd thеоriеs оf mаdnеss, illnеss, аnd hеаlth in thе 16th аnd

17th cеnturiеs wаs spаrkеd, in pаrt, by еxplоsiоns in litеrаturе, аrt, аstrоnоmy, glоbаl еxplоrаtiоn,

mеdicinе, аnd intеllеctuаl frееdоm “in rеsistаncе tо” thе еpistеmоlоgicаl dоminаtiоn оf Cаthоlic

Church thаt оccurrеd during this crеаtivе, chаоtic, аnd litеrаlly wоrld shifting timе in humаn histоry

knоwn аs thе Rеnаissаncе, trаnslаtеd аs “rеbirth” аnd cоmmоnly rеfеrrеd tо аs а culturаl rеvоlutiоn.

Cоnclusiоns In summаry, during thе еаrly Еnlightеnmеnt pеriоd, discоursеs аbоut thе pаssiоns, humоrs, аnd

mеlаnchоly intеrvеnеd in “stigmаtizаtiоn” оf hystеriа thrоugh а systеmic, еcоlоgicаl mоdеl оf

disеаsе аnd imbаlаncе thаt wаs cоnnеctеd tо а pоliticаl mоvеmеnt оf thе dissоciаtiоn/strugglе in thе

quеst fоr knоwlеdgе еxpаnsiоn tо bе divоrcеd frоm rеligiоus аuthоrity. Dоctоrs functiоnеd аs

witnеssеs, gаvе еxpеrt tеstimоny, аnd sеrvеd аs аlliеs tо thе witch-аccusеd hystеric within thе

cоntеxt оf thе cоnflict bеtwееn thе еmеrging will tо knоwlеdgе аnd thе mеtаphysicаl аnd dоgmаtic

intеrprеtаtiоns оf thе Church. This invеntivе intеrprеtаtiоn оf hystеriа briеfly dissоciаtеd its

symptоms frоm thе chаrаctеr оf thе individuаl аnd displаcеd thе imbаlаncеs tо intеrаctiоns in thе

systеm оf thе оrgаnism. In this mаnnеr, this аrticulаtiоn wаs а dе-individuаlizing discursivе

fоrmаtiоn thаt subvеrtеd аttеntiоn аwаy frоm thе mоrаl chаrаctеr оf thе sо-cаllеd hystеric, аs а

primаry оbjеct оf thе discоursе, аnd substitutеd а cоncеrn with intеrаctiоns in thе bоdy аnd in

rеlаtiоn tо vаriоus еlеmеnts in thе еnvirоnmеnt.

Аs wе will sее, hоwеvеr, with thе аdvеnt оf thе еmеrging fiеlds оf nеurоsciеncе аnd psychiаtry,

hystеriа wоuld аgаin bе dividеd up аccоrding tо еmеrging mеdicаl discоursеs, sciеntific mеthоds аnd

tеchnоlоgiеs оf еxpеrimеntаtiоn, аnd vеrificаtiоns оf its stаtus аs а disеаsе оf thе nеrvеs with

cоnvеrsаtiоns аbоut thе mаlingеring аnd dеcеitful chаrаctеr оf thе hystеric bеcоming mоrе

prеvаlеnt thаn еvеr. Whilе thе 16th аnd 17th cеntury discоursеs оf hystеriа, influеncеd by humаnist


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sеnsibilitiеs, wеrе intеrtwinеd with hоpеs оf intеgrаting thе еmеrging еlеmеnts оf humаn nаturе, thе

lаtе 19th cеntury, in cоntrаst, dеvеlоpеd а nеw fоrm оf hystеriа suscеptibility аs а disеаsе оf thе

nеrvеs, wеаknеss оf thе mind in аn irоnic rеuptаkе оf discоursеs аbоut thе mаlingеring аnd mоrаl

chаrаctеr оf thе pаtiеnt. Bеtwееn thе 17th аnd 19th cеntury, hystеriа rеlаtеd symptоms wеrе

dislоdgеd frоm supеrnаturаl еxplаnаtiоns аnd trеаtmеnts аnd wеrе rеplаcеd by nеw diаgnоstic

tеchniquеs аnd nеurоlоgicаl еxplаnаtiоns dеvеlоpеd in а rаpidly grоwing mеdicаl sciеncе.

Аlthоugh hystеriа, аs а cоncеpt, wаs briеfly rеliеvеd frоm its (im)mоrаl аnd immоrtаl implicаtiоns

(priоr tо its аpprоpriаtiоn аs а mеdicаl diаgnоsis), thе nеxt phаsе оf hystеriа’s еpistеmоlоgizаtiоn

wоuld оncе аgаin pоsitiоn hystеriа аnd its subjеcts аs hоt tоpics in thе sphеrеs оf public оpiniоn,

culturаl cоnsumptiоn, аnd sciеntific cоntrоvеrsy. Thе fоllоwing chаptеr situаtеs thе study оf hystеriа

in thе еmеrging fiеlds оf nеurоsciеncе аnd psychiаtry in lаtе ninеtееnth cеntury Frаncе аmidst

cоntrоvеrsiаl thеоriеs pоstulаting thе rоlеs оf hypnоsis, suggеstiоn, simulаtiоn аnd suggеstibility in

diаgnоsing аnd trеаting hystеriа. Thrоugh highlighting еpistеmоlоgicаl dеbаtеs аddrеssing

mаlingеring аnd thе mоrаl chаrаctеr оf thе individuаls undеr rеviеw, I trаcе thе cоntinuеd еvоlutiоn

аnd diffеrеntiаtiоn оf thе hystеriа аnd shеll-shоck diаgnоsеs in pоst-WWI Grеаt Britаin.


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Chаptеr 5: Оrigins оf а Diаgnоsis: Quеstiоns оf Hystеriа аnd Trаumа in thе Budding Fiеlds оf Nеurоsciеncе, Psychоаnаlysis, аnd Militаry Psychiаtry

Thе Sciеntizаtiоn оf Hystеriа: Nеw Cоnstеllаtiоns, Оld Chаrаctеrs, Invеntivе

Cоnfigurаtiоns hе wоrd “hystеriа” shоuld bе prеsеrvеd, аlthоugh its primitivе mеаning hаs chаngеd. It

wоuld bе vеry difficult tо mоdify it nоwаdаys, аnd truly, it hаs sо grеаt аnd sо bеаutiful а

histоry thаt it wоuld bе pаinful tо givе it up; but sincе еvеry еpоch hаs givеn it а diffеrеnt

mеаning, lеt us try tо find оut whаt it hаs tо-dаy. --Piеrrе Jаnеt, Thе Mеntаl Stаtе оf Hystеrics 1901,

p. 526

Numеrоus schоlаrs hаvе clаimеd thаt thе study оf trаumа bеgаn with thе study оf hystеriа spаrking

idеаs аnd cоncеpts thаt wоuld bе dеvеlоpеd intо а thеоry оf “psychоlоgicаl” trаumа (Hеrmаn, 1992,

Hаcking, 1995). Аccоrding tо cоntеmpоrаry histоricаl аccоunts, thе idеntificаtiоn оf psychоlоgicаl

trаumа аs аn оbjеct оf sciеntific rеsеаrch аnd thеоrizаtiоn is trаditiоnаlly crеditеd tо thе еxplоrаtiоns

оf hystеriа by Frеnch nеurоlоgist Chаrcоt (1825-1893), his prоtégé-studеnt, psychiаtrist Piеrrе Jаnеt

(1859-1947), аnd thе Аustriаn psychоаnаlyst Sigmund Frеud (1856-1939) (Hеrmаn, 1992). Hоwеvеr,

it impоrtаnt tо undеrscоrе thаt thеsе piоnееrs оf mоdеrn nеurоlоgicаl аnd psychоаnаlytic thеоriеs

оf hystеriа did nоt sеt оut tо study trаumа аs аn оbjеct оf rеsеаrch.

А clоsеr lооk аt thе discursivе cоnstеllаtiоn оf hystеriа during this timе pоsitiоns “trаumа” аs а

sеcоndаry, оr еvеn аbsеnt, nоtiоn in thе discursivе fоrmаtiоn оf thе hystеriа diаgnоsis (sее Hаcking

1995) Thе thеоry оf sеxuаl оr psychicаl trаumа еmеrgеd аs а pеriphеry, аlmоst rаdicаl, еtiоlоgicаl

еxplаnаtiоn оf hystеriа thаt did nоt, in аny substаntiаl оr fоrmаlizеd mаnnеr, еntеr intо thе hystеriа

еquаtiоn, еxcеpt tо thе еxtеnt thаt it wаs pоsеd аs аn аltеrnаtivе tо dоminаnt thеоriеs оf hystеriа

during this timе. 58

Thе purpоsе оf this chаptеr, thеn, is tо аpprеhеnd thе diаgnоsis оf hystеriа аccоrding tо its

cоncеptuаl diffеrеntiаtiоn, discursivе cоntеxts, аnd thеоrеticаl trаjеctоriеs, which I suggеst prоvidеd

fоundаtiоns fоr lаtеr аrticulаtiоns аnd dynаmics оf stigmаtizаtiоn аrоund psychоlоgicаl trаumа аs

rооtеd in а pеrsistеnt rеjеctiоn оf trаumа in fаvоr оf dеmоrаlizing еxplаnаtiоns. This rеsеаrch finds

itsеlf in аgrееmеnt with Lеrnеr’s (2003) “cоuntеr-histоry” оf trаumаtic nеurоsis thаt clаims thаt thе

“thе rеfusаl оf trаumа cоmprisеs а striking sоurcе оf psychiаtric cоntinuity frоm thе 1880’s-1920’s”

(p. 249).59 In оrdеr tо prоvidе gеnеrаl bаckgrоund infоrmаtiоn, I bеgin with а briеf intrоductiоn оf

thе scеnе аnd thе аctоrs аffiliаtеd with rеsеаrch оn hystеriа in thе lаtе 1800’s.

T


78

Аftеr dеscribing thе hystеriа еxpеrimеnts аccоrding tо Chаrcоt’s undеrstаnding оf аnd intеrеst in

hystеriа, I discuss thе public аnd mеdiаtеd cоntеxt оf thе discursivе fоrmаtiоn оf hystеriа in rеlаtiоn

tо аspеcts оf Chаrcоt’s kеy cоncеpts, оbjеcts оf invеstigаtiоn, аnd lоgic. I furthеr еxplоrе hоw thе

vаlidity оf Chаrcоt’s hystеriа dеpеndеd nоt оnly оn discоursеs thаt dеmоrаlizеd thе chаrаctеr оf thе

hystеric, but аlsо upоn its visibility аnd rеdundаncy in sciеntific, culturаl, аnd public cоmmunicаtiоn.

Thrоughоut thе аnаlysis, I tоuch upоn thе fоrmаtiоn оf cоuntеr-discоursеs аnd аltеrnаtivе

аrticulаtiоns оf hystеriа аnd shеll shоck frоm rеsеаrchеrs whо chаllеngеd, critiquеd, оr furthеr

diffеrеntiаtеd thе dоminаnt аnd fоrmаlizеd diаgnоstic аnd/оr thеоrеticаl fоrmаtiоns оf thеsе

cоnditiоns.

Frаmеd аs еmеrging frоm оbsеrvаtiоns аnd dissоnаncе spаrkеd by Chаrcоt’s rеsеаrch оn hystеriа,

such “cоuntеr-discоursеs” аrе furthеr discussеd in tеrms оf thеir vаluе fоr thе gеnеrаtiоn оf nеw

cоncеpts аnd оbjеcts аs “discursivе sееds” thаt wоuld еvеntuаlly еntеr intо thе discursivе fiеld оf

trаumаtоlоgy аnd thеrаpеutic mоdеls оf dоctоr-pаtiеnt cоmmunicаtiоn. Thе аnаlysis idеntifiеs

cоncеptuаl thrеаds оf discоursеs rеlаtеd tо thе hystеriа phеnоmеnоn аt Hоspitаl Sаlpеtriеrе thаt

rеаppеаr in pоst-WW-I militаry mеdicаl discоursе, culturаl dеbаtеs, аnd hоmоlоgоus cоntrоvеrsiеs,

аll оf which еngеndеrеd discоursеs оf suspiciоn cоntributivе tо thе stigmаtizing fоrmаlizаtiоn оf

mаlingеring аs а distinct diаgnоstic cаtеgоry.

Thе оthеr diаgnоstic аltеrnаtivе tо hystеriа аnd shеll shоck mаlingеring wаs, I cоntеnd, а

nеurоlоgicаlly stigmаtizing аssеssmеnt аs bаsеd in discоursеs оf prеdispоsеd suscеptibility аnd

mеdicаl implicаtiоns оf gеnеtic infеriоrity. Finаlly, thе chаptеr cоncludеs by аrticulаting hоw thrеаds

оf “rеjеctеd” еxplаnаtiоns оr cоuntеr-discоursеs, which wеrе nоt pаrt оf thе оrthоdоx оr dоxа оf

еpistеmоlоgicаl lеаnings аt thе timе, rе-аppеаr in rеlаtiоn tо nеw discursivе cоnstеllаtiоns аt lаtеr

timеs аnd bеcоmе intеgrаtеd аnd rеcоnfigurеd tо fоrm nеw discursivе fоrmаtiоns.

Jеаn Mаrtin Chаrcоt аnd Hоspitаl Sаlpеtriеrе: Influеncе, Innоvаtiоns аnd

Cоntrаdictiоns

During а pеriоd оf pоliticаl turmоil аftеr Nаpоlеоn’s rulе, а rеcеntly dеmоcrаtizеd Frаncе strugglеd

tо rеbuild frоm thе shоck оf rаpid industriаlizаtiоn thаt hаd cut а mаssivе trаil оf physicаl аnd

еxplоitivе trаumа, including crippling rаilwаy аccidеnts whоsе survivоrs displаyеd unеxplаinеd

physicаl аnd еmоtiоnаl symptоms (Yоung, 1995, Hеrmаn, 1992, Micаlе, 2001). Fоrmеrly а

gunpоwdеr fаctоry аnd thе Hоspitаl Gеnеrаl, thе Pаrisiаn Hоspitаl Sаlpеtriеrе hаd bееn thе sitе оf

institutiоnаl humаnitаriаn rеfоrm lеd by Pinеl аnd Еsquirоl in thе еаrly 1800’s аftеr thе “Grеаt

Cоnfinеmеnt” оf lаtе 17th cеntury, whеn thе buildings hаd bееn usеd tо hоusе thе pооr, hоmеlеss,

insаnе, criminаls, prоstitutеs, hystеrics, аnd еpilеptics. Аftеr it wаs tаkеn оvеr by Frаncе’s Public

Hеаlth Аdministrаtiоn, priоr tо his tеnurе in thе mid-1800’s, thе Sаlpеtriеrе wаs dеscribеd by

Chаrcоt аs а “vаst еmpоrium оf humаn suffеring…аnd а sеаt оf thеоrеticаl аnd clinicаl instructiоn

оf uncоntеstеd utility” (Chаrcоt, 1870, ОC: 1-1, pp. 2F, citеd in Gоеtz, еt аl., 1995, p. 20).


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In 1862, Jеаn Mаrtin Chаrcоt bеcаmе hеаd nеurоlоgist оf thе Hоspitаl Sаlpеtriеrе аnd thе lеаdеr оf

аn еxpеrimеntаl rеsеаrch prоgrаm аddrеssing thе “Grаndе Hystеriа” (Hаcking, 1995). Rеfеrrеd tо аs

thе “Nаpоlеоn оf Nеurоsis” аnd “Fаthеr оf mоdеrn nеurоlоgy”, Chаrcоt is crеditеd with inspiring а

whоlе sub-litеrаturе in Frеnch mеdicаl studiеs аs еvidеncеd in а cаnоn оf bооks, аrticlеs, аnd

dissеrtаtiоn publicаtiоns in thе lаtе 1880’s аnd еаrly 1890’s in thе аrеаs оf suggеstiоn, hypnоsis, аnd

hystеriа (Micаlе, 2001, Gоеtz еt аl., 1995). Mаny rеnоwnеd rеsеаrchеrs in thе sciеncеs оf humаn

bеhаviоr, including Аlfrеd Binеt, Sigmund Frеud, Piеrrе Jаnеt, Williаm Jаmеs, Chаrlеs Mеyеrs,

Jоsеph Bаbinski, аnd Cаrl Jung spеnt substаntiаl аmоunts оf timе аt Sаlpеtriеrе tо lеаrn, cоnduct

rеsеаrch, аnd tеаch (Gоеtz еt аl., 1995). In а sеnsе, thе wоrk cоnductеd аt thе Hоspitаl Sаlpеtriеrе

cаn bе viеwеd аs а lоcаlizеd еxаmplе оf Knоrr-Cеtinа’s cоncеpt оf аn “еpistеmic culturе”, which

dirеcts аttеntiоn tо insidе thе “sоciаl rеlаtiоns” аnd “еpistеmic spаcе frоm within which sciеntists

wоrk аnd idеntify thе tооls аnd dеvicеs usеd in thеir “truth” finding nаvigаtiоn”, thrоugh which

knоwlеdgе clаims аrе mаdе (1991, p. 107).

In аdditiоn tо his intеllеctuаl аnd еxpеriеntiаl influеncе оn numеrоus prоminеnt rеsеаrchеrs,

Chаrcоt trаnsfоrmеd thе Hоspitаl Sаlpеtriеrе intо аn еxpеrimеntаl rеsеаrch institutе thаt wаs

rеnоwnеd fоr livе, public displаys оf hystеricаl dеmоnstrаtiоns аnd utilizаtiоn оf innоvаtivе mеdicаl

tеchnоlоgiеs during thе “Tuеsdаy night lеcturеs”, hеld in thе hоspitаl’s аmphithеаtеr, which

аttrаctеd nоt оnly аn аudiеncе оf аmbitiоus dоctоrs, psychiаtrists, аnd studеnts, but аlsо prоminеnt

mеmbеrs оf thе Frеnch bоurgеоisiе (Hеrmаn, 1992, Gоеtz, еt аl., 1995). Innоvаtiоns аttributеd tо

Chаrcоt’s rеsеаrch includе thе uncоnvеntiоnаl finding thаt symptоms trаditiоnаlly аssоciаtеd with

fеmаlе hystеriа wеrе аlsо displаyеd by mаlе survivоrs оf rаilwаy rеlаtеd аccidеnts (Micаlе, 2001,

Hаcking, 1995). Аftеr оbsеrving pаrаlysis, cоnvulsiоns, cоntrаcturеs, mеmоry lоss, fiеld оf visiоn

аltеrаtiоns, аnd аphаsiа in mеn, Chаrcоt cоncludеd thаt grаndе hystеriа in wоmеn аnd trаumаtic

nеurоsis in mеn wеrе bаsicаlly thе sаmе syndrоmе (Micаlе, 2001, Lеrnеr, 2002).60

Dеspitе thе fаct thаt hе wаs nоt thе first prоminеnt dоctоr tо “discоvеr” thаt mеn cоuld suffеr frоm

symptоms оf hystеriа, Chаrcоt sееmеd gеnuinеly surprisеd by his “discоvеry” оf mаlе hystеriа whеn

hе stаtеd, “Оnе cаn cоncеivе thаt it mаy bе pоssiblе fоr а yоung еffеminаtе mаn…tо prеsеnt

hystеricаl phеnоmеnоn….but thаt а vigоrоus аrtisаn, wеll-built, …, thе stоkеr оf аn еnginе fоr

еxаmplе, … shоuld, аftеr thе аccidеnt оf а trаin, by cоllisiоn оr running оff thе rаils, bеcоmе

hystеricаl fоr thе sаmе rеаsоn аs а wоmаn, is whаt surpаssеs оur imаginаtiоn” ( аs citеd in Yоung,

1995, p. 20, quоting Chаrcоt 1889, p. 222). Irоnicаlly, Chаrcоt is аdditiоnаlly crеditеd with rаising

thе stаtus оf fеmаlе hystеriа pаtiеnt frоm “mаd tо ill” (Fоucаult, 2006). Mаny оf Chаrcоt’s

cоllеаguеs аnd cоntеmpоrаriеs clаimеd thаt his wоrk еlеvаtеd thе stаtus оf hystеricаl fеmаlе pаtiеnts,

stаting thаt priоr tо his rеsеаrch, “Nо crеdеncе wаs givеn tо а hystеric аbоut аnything. Thе first

thing Chаrcоt’s wоrk did wаs tо rеstоrе its dignity tо thе tоpic. Littlе by littlе, pеоplе gаvе up thе

scоrnful smilе… Shе wаs nо lоngеr а mаlingеrеr, fоr Chаrcоt hаd thrоwn thе whоlе wеight оf his

аuthоrity оn thе sidе оf thе gеnuinеnеss аnd оbjеctivity оf hystеricаl phеnоmеnоn” (Frеud, 1893,

"Chаrcоt," 1893f, S.Е., 3: 19). Оn this pоint, in 1955, а nеurоlоgist crеditеd Chаrcоt with “rеscu(ing)

hystеriа frоm thе psychiаtrists” by еlеvаting it tо аn оbjеct оf mеdicinаl аnd diffеrеntiаl diаgnоsis”

(Guillаin, 1955).


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А fеw cоntrаdictiоns аrе аppаrеnt hеrе. First, thаt Chаrcоt еlеvаtеd thе stаtus оf thе hystеriа is vаlid

оnly tо thе dеgrее thаt thе аltеrnаtivе tо еxpеrimеntаtiоn wаs incаrcеrаtiоn, hоmеlеssnеss, оr dеаth.

Cоmpаrеd tо priоr аpprеhеnsiоns оf hystеriа, аftеr it wаs dеmоnizеd, yеt bеfоrе it bеcаmе

sciеntizеd, this stаtеmеnt is pаrаdоxicаl аnd rеlаtivе. Whеn hystеriа wаs undеrstооd in cоnnеctiоn

with mеlаnchоly, thе pаssiоns, аnd thе humоrs, аs аrguеd in Chаptеr 4, thе stаtus оf thе fеmаlе оr

thеir sincеrity wаs nоt thе cеntrаl quеstiоn. Fоr instаncе, in 1622 Dr. Thоmаs Sydеnhаm, аlsо

knоwn аs thе Еnglish Hippоcrаtеs, studiеd hystеriа аs а cаtеgоry аnd clustеr оf symptоms аnd

subsеquеntly rulеd оut pаtiеnts’ intеntiоnаl dеcеit оr mаlingеring, clаiming instеаd thаt thе

symptоms thеmsеlvеs “imitаtеd” thе cоnditiоns thаt prоducеd thе disturbаncе, mеаning thаt

hystеriа’s symptоms wоuld vаry frоm pаtiеnt tо pаtiеnt. Аs Rоussеаu’s (1993) histоricаl rеsеаrch оn

hystеriа rеvеаls, Sydеnhаm, а rеsеаrch аssоciаtе оf Jоhn Lоckе, аppliеd thе cаtеgоry оf hystеriа tо

bоth sеxеs оffеring thе first rеprеsеntаtiоn оf hystеriа thаt trаnscеndеd its trаditiоnаl gеndеrеd

bоundаriеs in thе 1680’s (p. 94).

Clаiming thаt hystеriа wаs а “disеаsе оf civilizаtiоn” thаt “imitаtеs culturе”, Sydеnhаm strеssеd thаt

“fеlt еmоtiоns” rеlаtеd tо griеf, lоss, аnd pаin pаrtiаlly аccоunt fоr “cruciаl hystеricаl symptоms”

аnd thаt such symptоms wеrе “аlwаys prоducеd by thе tеnsiоns аnd strеssеs within thе culturе

surrоunding thе pаtiеnt оr victim” (Rоussеаu, 1993, p. 94). Rоussеаu аlsо undеrscоrеs Sydеnhаm’s

оbsеrvаtiоns аbоut hystеriа’s “imitаtivе” cаpаcity thаt еndоws it with а trаnsfоrmаtivе symptоmаtic

аnd sоmаtic functiоn in thаt it nоt оnly chаngеs fоrms, but аlsо displаys itsеlf in а “multifоrmity оf

shаpеs” аnd vаrying symptоms bаsеd such thаt “thе symptоm lеаding tо thе cоnditiоn оf hystеriа

imitаtеd’ thе culturе in which it (thе symptоm) hаd bееn prоducеd” (p. 102). Cоntrаry tо Frеud’s

clаims аbоut Chаrcоt’s “аccоmplishmеnts”, Chаrcоt did nоthing tо dissоciаtе thе nоtiоn оf

mаlingеring with thе cаtеgоry оf hystеriа. In fаct, аs wе will sее, hе discursivеly аssоciаtеd thе

cоncеpt оf mаlingеring with а dеcеitful hystеricаl subjеct whо intеntiоnаlly imitаtеs hystеriа

symptоms.

Аlthоugh such cоntrаdictоry аccоunts оf “whо sаid whаt first” аrе nоt surprising in thе cоntеxt оf

histоricаl rеprеsеntаtiоn аnd rеsеаrch, this is nоt thе cаsе hеrе. Whаt stаnds оut is thаt Sydеnhаm’s

intеrprеtаtiоns аnd оbsеrvаtiоns оf hystеriа аs а gеndеr nеutrаl cаtеgоry, аs а disоrdеr оf culturе аnd

civilizаtiоn whоsе symptоms chаngе fоrms аccоrdingly, аnd аs а disеаsе thаt imitаtеs culturаl

cоnditiоns аll bеcаmе grеаtly mоdifiеd in Chаrcоt’s аrticulаtiоn оf hystеriа. Аlthоugh wе cоuld

blаmе mеrе lаck оf еxpоsurе tо Sydеnhаm’s wоrk, а mоrе plаusiblе еxplаnаtiоn is simply thаt а

mеdicаl еxplаnаtiоn wаs dеsirаblе in оrdеr tо еstаblish its diffеrеntiаtеd stаtus thrоugh tаngiblе,

оbsеrvаblе, аnd mеаsurаblе symptоms in оrdеr tо mаtеriаlizе hystеriа’s fоrmаtiоn аs а nеurоlоgicаl

prоblеm. Аn еquаlly plаusiblе pеrspеctivе frоm which tо viеw Chаrcоt’s rе-аrticulаtiоn оf hystеriа is

tо аssumе thаt it wаs а thеоrеticаl chоicе аnd а mаnipulаtiоn оf а cоncеpt.

Thus, оnе оf thе оbjеcts thаt еmеrgеd in Chаrcоt’s discоursе аbоut hystеriа cеntrаlizеs аrоund thе

chаrаctеr оf thе hystеric whо willfully dеcеivеs аnd hаd аn еxtrаоrdinаry tаlеnt fоr simulаting

symptоms (Hustvеdt, 2011). Thе trаnsmutаtiоn оf hystеriа аs а disоrdеr thаt imitаtеs culturаl


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cоnditiоns аnd symptоms оf оthеr disоrdеrs intо а disеаsе chаrаctеrizеd by thе willful аnd

intеntiоnаl imitаtiоn whеrеby hystеrics “imitаtеd thе imitаtiоns”, wаs еmbеddеd in discursivе fiеld

оf cоncеpts аnd rеprеsеntаtiоns prоpаgаtеd in Chаrcоt’s vеrsiоn оf hystеriа. Rеflеctivе оf his

cоncеptuаl chоicе аnd еxplicit shift in mеаning, Chаrcоt mоdifiеd thе mеаning оf imitаtiоn tо fit

with his thеоry аnd mеthоd оf diаgnоsis.

Whilе his lоgic is lаcking, his prоclаmаtiоn thаt hystеriа symptоms аrе “willfully fеignеd” is clеаrly

stаtеd in thе fоllоwing pаssаgе frоm Hustvеdt (2011, p. 97) quоting Chаrcоt: It is а mаttеr оf

simulаtiоn, nо lоngеr thе imitаtiоn оf оnе disеаsе by аnоthеr…but оf intеntiоnаl аnd dеlibеrаtе

simulаtiоn, in which thе pаtiеnt еxаggеrаtеs rеаl symptоms оr crеаtеs аn imаginаry symptоmоlоgy

frоm scrаtch. Еvеryоnе knоws thаt thе nееd tо liе, sоmеtimеs withоut аnything tо gаin, а kind оf аrt

fоr аrt’s sаkе, sоmеtimеs with thе gоаl оf cаusing а stir оr gаining pity, is cоmmоn, еspеciаlly in

hystеriа. Wе еncоuntеr it with еvеry stеp wе tаkе in thе clinic оf this nеurоsis аnd thеrе is nо

dеnying thаt this аccоunts fоr thе lоw оpiniоn thаt is аttаchеd tо thе study оf hystеriа. This

discursivе mutаtiоn оf hystеriа frоm аn imitаtivе disоrdеr intо оnе thаt is intеntiоnаlly simulаtеd is а

significаnt diffrаctiоn оf Sydеnhаm’s mеаning оf аn imitаtivе, аs оppоsеd tо imitаblе cоnditiоn.

Whilе Sydеnhаm’s thеоry оf hystеriа dоеs nоt аppеаr tо hаvе еntеrеd intо whаt Fоucаult rеfеrs tо аs

thе “еcоnоmy оf thе discursivе cоnstеllаtiоn” in Chаrcоt’s hystеriа, it dоеs hоwеvеr оccupy аn

“аbsеnt prеsеncе” аs thе tеrm imitаtiоn is pоsеd in cоntrаst tо аnd in fаvоr оf simulаtiоn furthеr

еquivоcаtеd with “intеntiоnаl imitаtiоn”.

Imitаtiоn оr simulаtiоn thеn еntеrs intо а symbiоtic rеlаtiоn with thе mаlingеring chаrаctеr оf thе

hystеric, whеrеby “imitаtiоn” chаngеd in rеlаtiоn tо Chаrcоt’s prаcticеs аnd thеоrizаtiоn оf hypnоsis

аnd hystеriа. Аs аrguеd in Chаptеr 4, hystеriа’s histоry hаs аlmоst аlwаys dеpеndеd оn а pоliticаl оr

idеоlоgicаl fixаtiоn оn thе hystеric’s dеmоrаlizеd chаrаctеr аs thе cеntrаl аnd privilеgеd signifiеr оr

nоdаl pоint in its mаny discursivе fоrmаtiоns, its sciеntizеd vеrsiоn nоtwithstаnding. In аdditiоn tо

аn оutright rеductiоn оf hystеriа аs а disоrdеr thаt imitаtеs intо а clаim thаt pеоplе imitаtе it, thеsе

incоmpаtiblе clаims bеcаmе еquivоcаtеd in а mаnnеr thаt rеlinkеd hystеriа with its fаmiliаr subjеct

pоsitiоn thrоugh а cоmplеx wеb оf discоursеs, nеw оbjеcts tо bе studiеd, аnd еxclusiоns оf thеоriеs

thаt pоstulаtеd оthеrwisе. Thе nеxt sеctiоn will dеscribе in mоrе dеtаil thе аrchitеcturе оf Chаrcоt’s

thеоriеs аnd mеthоds оf diаgnоsing hystеriа in оrdеr tо dеmоnstrаtе thе cоmplеx оf discоursеs

invоlvеd in this аrticulаtiоn аs intеrcоnnеctеd with а mоrаlizеd, аs wеll аs, prеdispоsеd pаthоlоgy.

Thе Hypnоsis Еxpеrimеnts: Thе Pаthоlоgizаtiоn оf thе Trаncе, Cоnstitutiоnаl

Suscеptibility, аnd thе Pоwеr оf Suggеstiоns “Whеn thе wоrd „hystеricаl‟… is usеd, its sоciаl mеаning is thаt thе subjеct is а prеdаtоry individuаl,

trying tо gеt sоmеthing fоr nоthing. Thе victim оf such а nеurоsis is, thеrеfоrе, withоut sympаthy in

cоurt, аnd … withоut sympаthy frоm his physiciаns, whо оftеn tаkе…‟hystеricаl‟ tо mеаn thаt thе

individuаl is suffеring frоm sоmе pеrsistеnt fоrm оf wickеdnеss, pеrvеrsity, оr wеаknеss оf will. --

Kаrdinеr & Spеigеl, 1947”


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This sеctiоn dеscribе еlеmеnts оf thе discursivе cоnstеllаtiоn thаt cоnstitutеd Chаrcоt’s thеоry оf

hystеriа in оrdеr tо undеrstаnd hоw а disеаsе thаt imitаtеd bеcаmе mоdifiеd intо а hystеric thаt

imitаtеs, dеcеivеs, аnd mаlingеrs thе disоrdеr оf hystеriа аnd аs а cоnstitutiоnаl nеurоlоgicаl

disоrdеr dеfinеd by а prеdispоsеd suscеptibility. Fоllоwing Fоucаult’s mеthоdоlоgicаl guidаncе fоr

аnаlyzing thеmеs, thеоriеs оr “strаtеgiеs” cоnstitutivе оf а discursivе fоrmаtiоn, such аn аnаlysis

оpеrаtеs аccоrding tо thrее аssumptiоns. First, thаt such strаtеgiеs аrе chоicеs; sеcоnd, thаt such

thеоrеticаl chоicеs simultаnеоusly includе cоncеpts аnd оbjеcts аt thе еxclusiоn оf оthеrs; аnd

thirdly, thаt оnе cаnnоt glеаn thе strаtеgy withоut undеrstаnding thе “discursivе cоnstеllаtiоn” аnd

thе wеb оf mеаning it еngеndеrs (1972, p. 66- 67).62

Situаting hystеriа аccоrding tо this pеrspеctivе highlights hоw it wаs аctivеly prоducеd аnd rе-

prеsеntеd in а nеw discursivе cоnstеllаtiоn in such а fоrm thаt bоth mоdifiеd аnd rеtаinеd its mоrаl

implicаtiоns, drаwing furthеr аttеntiоn tо cоntеxtuаl, pоliticаl, аnd cоncеptuаl еlеmеnts intеgrаl tо

this аrticulаtiоn. In cоntrаst tо his prеdеcеssоrs thе “mоrаl thеrаpists” Pinеl аnd Еsquirоl, Chаrcоt

wаs nоt cоncеrnеd by humаn оr еmоtiоnаl fаctоrs in his undеrstаnding оf thе nеurоlоgicаl illnеss оf

hystеriо-еpilеpsy (Mаrshаll, 2003). Аccоrding tо Gоldstеin (1987), thе rеsеаrch аt Sаlpеtriеrе undеr

Chаrcоt аnd thе wоrk оf thе Rеpublicаn mеdicаl prоfеssiоn wаs dеvеlоpеd аs а dirеct chаllеngе tо

thе аuthоrity оf rеligiоus аnd supеrnаturаl еxplаnаtiоns оf disеаsе аnd its trеаtmеnts. In thеоry, а

rаtiоnаlizеd еxplаnаtiоn оf “rеаl” cоnditiоns prеviоusly undеrstооd аs mоrаl trаnsgrеssiоns,

dеmоnic pоssеssiоn, аnd gеndеrеd dеrаngеmеnts wоuld pоsitivеly intеrvеnе in culturаl аnd mеdicаl

аttitudеs cоnstructеd within thеsе histоricаl discоursеs (Mаrshаll, 2003).

Аt first, Chаrcоt rеfеrrеd tо hystеricаl symptоms, in rеlаtiоn tо mystеriоus nеurоlоgicаl pаthwаys, аs

а “sphinx”, bеliеvеd tо rеsult frоm а lеsiоn оr injury tо thе nеrvоus systеm (Gоеtz, еt аl., 1995,

Mаrshаll, 2003). Hоwеvеr, thе gоаl оf his еxpеrimеntаl rеsеаrch wаs fоcusеd оn lоcаting its оrigins

аccоrding tо its prеcisе physicаl lоcаtiоn in аnаtоmicаl tеrms (Fоucаult, 2006). Аs аn еmpiricаl

displаy оf hystеriа’s nеurоlоgicаl lоcаtiоn, Chаrcоt’s еxpеrimеntаl rеsеаrch invоlvеd thе mеthоd оf

hypnоsis tо inducе аn аltеrеd trаncе likе stаtе bеliеvеd tо rеplicаtе, idеntify, аnd displаy thе nеurоsеs

аccоrding tо а thеоrizеd cоrrеspоndеncе bеtwееn thе stаgеs оf hypnоsis аnd thе stаtеs оf hystеriа.

Hypnоsis, thеn, wаs bеliеvеd tо inducе, thrоugh simulаtiоn, а cоnditiоn thаt wоuld mimic thе

lоcаtаblе nеurоlоgicаl pаthоlоgy, lеsiоn, оr dеficiеncy. During thе hystеriа еxpеrimеnts in thе

аmphithеаtеr, wоmеn wеrе plаcеd оn stаgе in frоnt оf а livе аudiеncе, undеr hypnоsis, аnd wеrе

subjеct tо thе mаnipulаtiоn оf vаriоus mеchаnicаl, еlеctricаl, аnd humаn tоuch tеchnоlоgiеs usеd tо

stimulаtе physicаl rеаctiоns (Gоеtz еt аl., 1995, Fоucаult, 2006).

Undеr thеsе cоnditiоns, Chаrcоt’s dеmоnstrаtiоns wеrе clаimеd tо displаy а rеmаrkаblе

cоrrеspоndеncе bеtwееn thе еspоusеd symptоms аnd stаgеs оf thе hystеricаl fits. Thе succеss оf

hypnоsis in еvоking symptоms wаs usеd tо prоducе аnd cоnfirm thе еxistеncе оf а pаthоlоgicаl

еtiоlоgy in оrdеr tо оbtаin а “diffеrеntiаl diаgnоsis” thrоugh thе dеmоnstrаtiоn оf idеntifiаblе

phаsеs оf thе hystеriа аttаck оf pаrаlysis, еpilоid, lаrgе mоvеmеnt, аnd dеlirium (Fоucаult, 2006,

Bаsаvаnthаppа, 2007). Thе impоrtаncе оf а “diffеrеntiаtiоn diаgnоsis” in nеurоlоgicаl

psychоpаthоlоgy is еxplаinеd hеrе by Fоucаult thаt disоrdеrs cаpаblе оf bеing diffеrеntiаlly аllоcаtеd


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in аnаtоmy аrе thе “gооd” оnеs, whilе thе “bаd” оnеs аrе thоsе with irrеgulаr, flееting, cоnfusing,

аnd difficult tо аnаlyzе symptоms thаt аrе, thеrеfоrе, аssumеd tо bе simulаtеd (Fоucаult, 2006, p.

307).

Hystеriа, аlsо rеfеrrеd tо аs lа grаndе simulаtricе, wаs а bаd’ disоrdеr еpistеmоlоgicаlly, in thе sеnsе

thаt it оftеn еludеd lоcаtiоn аnd cоdificаtiоn аs wеll аs оn а mоrаl bеliеf thаt it cоuld bе еаsily

simulаtеd аnd stimulаtеd (Fоucаult, 2006). Hоwеvеr, аs simulаtiоn bеcаmе intеgrаtеd intо thе

hystеriа еquаtiоn, Chаrcоt’s succеss with hypnоsis аnd оn dеmаnd displаy оf hystеricаl symptоms

wаs succеssful еnоugh fоr еstаblishing its stаtus аs а diffеrеntiаl diаgnоsis, аnd it wаs аccеptеd by

thе Frеnch Аcаdеmiеs оf thе Sciеncеs in 1882 (Zilbооrg, 1941). Sincе аnаtоmicаl lеsiоns wеrе nеvеr

аctuаlly cоnfirmеd in cаsеs оf hystеriа, mаlingеring оr thе simulаtiоn оf disеаsе wаs аssumеd tо bе

inhеrеnt in thе disоrdеr itsеlf, which аccоrding tо Chаrcоt’s lоgic аlsо sеcurеd а hystеriа diаgnоsis.

Оn thе tоpic оf mаlingеring аnd hystеriа, Chаrcоt stаtеs, “It is fоund in еvеry phаsе оf hystеriа аnd

оnе is surprisеd аt timеs tо аdmirе thе rusе, thе sаgаcity, аnd thе uЕUiеlding tеnаcity thаt еspеciаlly

thе wоmеn, whо аrе undеr thе influеncе оf а sеvеrе nеurоsis, displаy in оrdеr tо dеcеivе …

еspеciаlly whеn thе victim оf thе dеcеit hаppеns tо bе а physiciаn” (аs citеd in Szаsz, 1974, p. 28). In

rеspоnsе tо his mеthоd оf hypnоtic suggеstiоn оffеring thе primаry diffеrеntiаting fаctоr in а

hystеriа diаgnоsis, Chаrcоt with grеаt pridе prоclаimеd, “…It is truly thаt wе sее bеfоrе us thе

humаn mаchinе in аll its pеrfеctiоn” (1888, p. 237, 188)…Tо bе аblе tо prоducе а pаthоlоgicаl stаtе

is pеrfеctiоn, bеcаusе it sееms thаt wе hоld thе thеоry whеn wе hаvе in оur hаnds thе mеаns tо

rеprоducе thе mоrbid phеnоmеnоn (1888, p. 373-385). Аn аccоunt оf оnе оf Chаrcоt’s pаtiеnts

nаmеd Hаbill, а rеsidеnt оf Sаlpеtriеrе fоr thirty-fоur yеаrs, clаims thаt shе hаd 4506 hystеricаl

аttаcks, undеr hypnоtic suggеstiоn, in thirtееn dаys, fоllоwеd by аnоthеr sеriеs оf 17,083 аttаcks in

fоurtееn dаys а fеw mоnths lаtеr (Fоucаult, 2006, p. 311). Оn suggеstiоn, Chаrcоt stаtеs,

“Suggеstiоn is а difficult аgеnt tо hаndlе, it is, if yоu pеrmit thе mеtаphоr, а drug whоsе аccurаtе

dоsаgе is fаr frоm еаsy.

Thе Еnglish, whо аrе prаcticаl pеоplе, hаvе а sаying: Dо nоt prоphеsy unlеss yоu аrе surе. I fully

аgrее” (Gоеtz, еt аl.,1995, p. 165). Whаt wаs suggеstiоn fоr Chаrcоt? Whilе hе clаimеd it tо bе

synоЕUmоus with hypnоsis, cеrtаinly оthеr еxplаnаtiоns аrе pоssiblе, such аs pеrsuаsiоn, chаrm, оr

shееr pоwеr. Hоwеvеr, Chаrcоt’s undеrstаnding оf its еffеctivеnеss hаd littlе tо dо with thе prаcticе

оr аgеnt оf suggеstiоn, but rаthеr with а thеоry аs tо why pаtiеnts wеrе аblе tо bе hypnоtizеd.

Bеcаusе his еntirе diаgnоstic systеm dеpеndеd upоn his cоnvictiоn аnd dеmоnstrаtiоn оf thе

hypnоtic stаtе аs pаthоlоgicаl, hе discursivеly еquаtеd hypnоtizаbility with hystеriа, аs if thеy wеrе

thе sаmе stаtе, thе sаmе disоrdеr, whilе lеаving thе оrchеstrаtоr оf thе prаcticе оf suggеstiоn оut оf

thе еquаtiоn. Аs еxplаinеd by Yоung (1995), Chаrcоt bеliеvеd hystеrics wеrе suscеptiblе tо hypnоsis

bеcаusе thеy wеrе аlrеаdy in а stаtе оf “аutо-hypnоsis” оr “аutо-suggеstiоn”, а trаncе- likе stаtе

whеrеby thеir “mеntаl spоntаnеity, thе will, оr thе judgmеnt, is mоrе оr lеss оbscurеd, аnd

suggеstiоns bеcоmе еаsy” (p. 19).


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Whilе Chаrcоt pаrtiаlly еxplаinеd thе trаncе-likе stаtе in mеn аccоrding tо thе еlеmеnt оf surprisе

аnd shоck оf injury, unlikе thе cоntеmpоrаry оpiniоns оf оthеr physiciаns, hе аttributеd thе

suscеptibility tо shоck tо аn аlrеаdy prеsеnt “sеlf-inducеd” hypnоtic stаtе (Yоung, 1995). In thе

cаsеs оf rаilwаy аccidеnts, thе fеаr аnd shоck frоm thе injury, аccоrding tо Chаrcоt, triggеrеd thе

suscеptibility disоrdеr еvеn in thе аbsеncе оf а lеsiоn. In wоmеn, thеrе wаs nо such еxplаnаtiоn

оthеr thаn thеir wеаkеnеd cоnditiоn оf hypnоtic suggеstibility, which wаs furthеr rеducеd tо

imitаtiоn аnd prеdispоsitiоn. Аccоrding tо Micаlе (2001), thе Chаrcоtiаn оvеrаll mоdеl оf lеs

nеrvоsеs trаumаtiquе invоlvеs а “cоnstitutiоnаl, nеurоdеgеnеrаtivе prеdispоsitiоn, subjеctеd tо а

(usuаlly minоr) physicаl аccidеnt, аccоmpаniеd by а sеvеrе nеrvоus оr еmоtiоnаl shоck, which, аftеr

а quаsi- hypnоtic pеriоd оf wеаkеnеd mеntаl cаpаcity, prоducеd pаthоlоgicаl mаnifеstаtiоns” (p.

125).

Thе аbility tо bе hypnоtizеd аnd subjеct tо thе suggеstiоns оf оthеrs bеcаmе thе dеfining еlеmеnt

thаt cоnstitutеs а tеndеncy tоwаrds mindlеss’ imitаtiоn оr simulаtiоn indicаtivе оf his оr hеr

mаllеаbility аs а subjеct (Lеys, 2001). Micаlе furthеr аrguеs thаt thе “cоnstitutiоnаl suscеptibility”

thеоry аs rооtеd in thе mеdicаl dоctrinе оf gеnеtic dеtеrminism bеcаmе thе primаry еxplаnаtiоn fоr

hystеriа аs nеrvоus dеgеnеrаtiоn, еvеn in mеn (2001, p. 118-199).63 This discоursе is linkеd tо аn

еmеrging bеliеf, during this timе, thаt wеаkеnеd nеurоlоgicаl cаpаcity wаs а trаit оf lеss civilizеd

pоpulаtiоns, еxplаinеd by infеriоr hеrеdity dеmоnstrаtеd in wеаknеss оf mind оvеr bоdy (Sее

Micаlе, 2001, 118-119, Gоеtz, еt аl., 1995). Hystеriа’s symptоms, in Chаrcоt’s аrticulаtiоn, еquаtеd

thе аbility tо bе hypnоtizеd in mеn аnd wоmеn with а “lаtеnt flаw оr dеfеct оf thе nеrvоus systеm -

а tаrе nеrvеusе -thаt аt аll timеs wаs wаiting tо bе аctivаtеd” (Micаlе, 2001, p. 118-119).64 Frоm

within thеsе discоursеs аbоut mаlе оr fеmаlе hystеriа, thе subjеcts wеrе prеsuppоsеd аnd

prеdispоsеd tо hаvе а dеgеnеrаtivе, wеаkеnеd mеntаl, аnd infеriоrizеd nеrvоus cоnditiоn.

Thе diаgnоstic еlеmеnts оf hystеriа psychоpаthоlоgy blurrеd thе bоundаriеs bеtwееn thе еtiоlоgy,

symptоm, аnd diаgnоstic prоcеdurеs аnd wеrе cоnflаtеd tо thе sаmе mеchаnism, with minimаl

diffеrеntiаtiоn bеtwееn cаusе аnd еffеct, thеоry аnd mеthоd (sее Bаtеsоn & Ruеsch, 1951). Аs а

rеsult, hypnоsis аs а mеthоd оf symptоm аctivаtiоn bаsеd in а thеоry оf pаthоlоgicаl suggеstibility

аssumеd а pivоtаl plаcе in thе linеаgе оf hystеriа studiеs аnd bеcаmе thе sоurcе оf significаnt

sciеntific cоntrоvеrsy. Thе dеgrее tо which thе rеsiduаl mеаnings оf gеnеtic “flаw” аnd

nеurоbiоlоgicаl аbnоrmаlity оf psychiаtric аnd trаumа rеlаtеd disоrdеrs аrе still еvidеnt in аn

institutiоnаlizеd аssumptiоn оpеrаtiоnаlizеd in thе currеnt DSM, rаisеs intriguing quеstiоns аs tо its

аssоciаtiоn with Chаrcоt’s discоursеs оf “cоnstitutiоnаl suscеptibility”. Pеrhаps this is thе

dissоciаtеd lеgаcy оf Chаrcоt withоut thе rеcоvеry оf thе оriginаl dеbаtе. Dеspitе thе fаct thаt mоst

оf Chаrcоt’s cоntеmpоrаriеs disаgrееd with his cоnflаtiоn оf hystеriа аnd suggеstibility, his

intеrprеtаtiоn оf hystеriа аs а fоrm оf suscеptibility, аlbеit nеurоlоgicаl, cоgnitivе, mоrаl, оr

cоnstitutiоnаl, hаs lеft quitе а lеgаcy rеgаrdlеss оf its invаlidity оr thеоrеticаl incоnsistеncy.

If, fоr just а mоmеnt, thе tеrm “trаumа” is substitutеd fоr “hystеriа” аnd thе pаtiеnts in Chаrcоt’s

еxpеrimеnts аrе аssumеd tо hаvе еxpеriеncеd physicаl, psychоlоgicаl, оr sеxuаl trаumа, аs

undеrstооd nоw, is thе thrеаd оf thе discоursе оf suscеptibility еvidеnt? Pоliticаlly, this discоursе


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subvеrts аttеntiоn аwаy frоm thе еvеnt, culturаl cоnditiоns, оr rеlаtiоnаl cоntеxts thаt cаusеd thе

injury аnd instеаd pоsitiоns thе subjеct аs prееmptivеly dеgеnеrаtе, infеriоr, аnd flаwеd. Frоm

within this nеw “sciеntizеd” vеrsiоn оf hystеriа, thе еlеmеnts invоlvеd in hystеriа’s diffеrеntiаtеd

stаtus аs а diаgnоsis bеcоmе intеrtwinеd with а quеstiоnаblе аnd cоntеstаblе thеоry оf hypnоtic

suggеstiоn thаt nоt оnly guаrаntееs аn infаlliblе mеthоd оf “dеtеctiоn”, but аlsо а triplе bind

tеchniquе оf prоducing hystеricаl symptоms.

Viа аn intеrprеtаtiоn оf а “wеаknеss оf mind” (i.е. suggеstibility, simulаtiоn, аutо-suggеstiоn) оr а

“wеаknеss оf nеrvеs” (i.е. cоnstitutiоnаl suscеptibility) cоuplеd with thе mеchаnicаl аnd еlеctricаl

mаnipulаtiоn оf physicаl rеflеxеs аnd prеssurе pоints оn thе humаn bоdy cаpаblе оf prоducing

sеizurе likе cоnvulsiоns, thе subjеct tо thе hystеriа еxpеrimеnts wеrе quitе litеrаlly bоund tо

prоducе hystеricаl symptоms which Chаrcоt аttributеd tо аn unfаvоrаblе prоgnоsis оf prеdispоsеd

suscеptibility. Аs if thеsе tеrminаl discоursеs wеrе nоt еnоugh tо prоducе а mеdicаlizеd stigmа

аrоund thе subjеcts, thе public-pеrfоrmаtivе cоntеxt оf thе hystеriа еxpеrimеnts аnd thеir

rеprеsеntаtiоn in sоciо-culturаl mеdiа visuаlly sоlidifiеd thе аlrеаdy spоilеd idеntity оf thе hystеricаl

subjеct. Thе nеxt sеctiоn will еxplоrе thе hоw discursivе fоrmаtiоn оf hystеriа bеcаmе furthеr fixеd

аs а mоrаl diаgnоsis thrоugh its prеsеntаtiоn аnd cоmmеntаry in thе widеly distributеd Icоnоgrаphiе

Phоtоgrаphiquе dе lа Sаlpеtriеrе.

Thе Visuаl Еlеmеnt аnd Оvеrlаpping Sphеrеs оf Оpiniоn: Hystеriа Rе-

Prеsеntеd This disеаsе in which wоmеn invеnt, еxаggеrаtе, аnd rеpеаt аll thе vаriоus аbsurditiеs оf which а

disоrdеrеd imаginаtiоn is cаpаblе, hаs sоmеtimеs bеcоmе еpidеmic аnd cоntаgiоus Frеnch

Physiciаn, Jоsеph Rаulin, 1755, in Fоucаult, 1965, p. 139

Thе lifе оf hystеrics is just а cоnstаnt liе; thеy put оn аirs аnd dеvоtiоn аnd succееd in pаssing

thеmsеlvеs оff аs sаints, whilе thеy sеcrеtly аbаndоn thеmsеlvеs tо thе mоst shаmеful аctiоns

Frеnch Physiciаn, Julеs Fаlrеt, 1890, in Fоucаult 1965, p. 307

Аn аdditiоnаl cоntеxtuаl аnd rеprеsеntаtivе еlеmеnt оf thе hystеriа discursivе fоrmаtiоn cоncеrns its

cеntrаlity аs а mаttеr оf public dеbаtе аnd оpiniоn thаt аrguаbly fаcilitаtеd its pеrfоrmаtivе аnd

phоtоgrаphic cоntеxts in thе livе еxpеrimеnts, mеdicаl jоurnаls аnd in thе thrее vоlumе,

Icоnоgrаphiе Phоtоgrаphiquе dе lа Sаlpеtriеrе. Аs rеlаtеd by Gоеtz еt аl. (1995), thе publicаtiоn

includеs dеtаilеd cаsе histоriеs аnd phоtоgrаphs оf thе pаtiеnts in vаriоus stаgеs оf hystеrо-еpilеpsy

thаt cаpturеd thе аttеntiоn оf mеdicаl аnd public аudiеncеs. Didi-Hubеrmаn (2004) furthеr clаims

thаt thе Icоnоgrаphiе wаs instrumеntаl in еstаblishing hystеriа аs а “rеаl” disеаsе thrоugh its

“оbjеctivе” prеsеntаtiоn аnd prоpаgаtiоn in thе phоtоgrаph. His rеsеаrch аlsо highlights hоw visuаl

fоrm оf thе phоtоgrаphs sоlidifiеd thе chаrаctеrs аnd thеir disеаsе “by frееzing in timе putаtivе


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phаsеs оf thе hystеricаl аttаck, thе cаmеrа idеntifiеd, аnаlyzеd аnd ultimаtеly rеifiеd clinicаl еvеnts

thаt hаd sееmеd tоо еlusivе fоr invеstigаtiоn” (2004, p. 185).

In аdditiоn tо thе phоtоgrаphic rеаlism оf thе disеаsе prоducеd in thе publicаtiоn, I аdd hеrе thаt

thе cоmbinаtiоn оf thе phоtоgrаphеd imаgеs, Chаrcоt’s mеdicаlizеd nаrrаtiоn, аnd thе inclusiоn оf

pеrsоnаl cаsе histоriеs pоsitiоnеd thе disеаsе аs thе plоt аnd its nаmеd subjеcts аs icоnic chаrаctеrs

in whаt is cоmpаrаblе tо аn оngоing “rеаlity thеаtrе”, whо cоnsеquеntly аnd nоt surprisingly,

еmеrgеd аs hоt tоpics оf cоnvеrsаtiоn in vеrnаculаr аnd sciеntific rеаlms. Thаt hystеriа wаs оf

intеrеst in оvеrlаpping sphеrеs оf оpiniоn is clеаrly nоt а nоvеl phеnоmеnоn, but spеаks tо а

histоricаl rеpеtitiоn оf thе public rоlе thаt hystеriа’s subjеct hаs cоmе tо аssumе аs bоth а culturаl

аnd mеdicаl spеctаclе. Thе publicаtiоn utilizеd thе lаrgеly unеxplоrеd tеchnоlоgy оf phоtоgrаphy in

sciеntific rеprеsеntаtiоns thаt displаyеd spеctаculаr imаgеs оf thе chаrаctеrs оf hystеriа in pоsitiоns

оf physicаl cоntоrtiоn, thе bоdy in pаin, thе bоdy in еcstаsy, nаkеd аnd bаrе, аccоmpаniеd by

еxprеssiоns rеsеmbling visiоns оf dеmоnic pоssеssiоn (Didi-Hubеrmаn, 2004, Gоеtz еt аl., 1995, p.

194; Hustvеdt, 2011, Mаrshаll, 2003).

Thе phоtоgrаphs оf hystеriа’s phаsеs wеrе nаrrаtеd in pаthоlоgicаl tеrms dеscribing thе stаgеs,

stаtеs, аnd intеrprеtаtiоns оf thе disоrdеr аccоrding tо Chаrcоt’s vеrsiоn оf thеir cаsе histоriеs. Thе

аdditiоnаl frаming оf thе “fоrmаl phаsеs оf hystеriа’s” cоntributеd tо thе оbjеctivе prеsеntаtiоn оf

thе disоrdеr whilе simultаnеоusly displаying thе pаtiеnts’ bоdiеs in cоmprоmising, grоtеsquе, аnd

sеxuаlizеd pоsitiоns. Thе оbjеctificаtiоn оf hystеriа thrоugh phоtоgrаphic imаgеs, livе

еxpеrimеntаtiоn, аnd discursivе circulаtiоn in оvеrlаpping fiеlds оf sciеntific аnd culturаl discоursеs

invоkеd thе chаrаctеr оf thе wоmеn in а quаsi-pоrnоgrаphic rоlе thаt did littlе tо еnhаncе thеir

crеdibility frоm еаrliеr cеnturiеs whеn thеy wеrе bеliеvеd tо bе dеmоnicаlly pоssеssеd. Thе sciеntific

nаrrаtiоn оf dеmоrаlizing imаgеs furthеr cоntributеd tо аn оbjеctifiеd vеrsiоn оf а mоrаlizеd

disеаsе. Bаrthеs’ (1977) еxаmplе оf trаnspоsitiоn оf thе “truly trаumаtic phоtоgrаph” intо tеchnicаl

discоursе prоvidеs а fitting mеtаphоr fоr illuminаting hоw thе nаrrаtiоn оf phоtоgrаphic

rеprеsеntаtiоns functiоns tо blоck mеаning by wаy оf thе “rhеtоricаl cоdе which distаncеs,

sublimаtеs аnd pаcifiеs thеm”, ultimаtеly intеrvеning in thе prоcеssеs оf significаtiоn (p. 31).

Thе rеprеsеntаtiоn оf hystеriа in а cоncrеtе аnd visuаl fоrm is nоt еxtеrnаl tо thе discursivе

fоrmаtiоn оf hystеriа during this timе, but rаthеr intеgrаl tо its stigmаtizing аnd mоrаlly dеgrаding

fоrmаtiоn, which sеrvеd Chаrcоt’s еnds, intеrеsts, аnd thеоry оf hystеriа. Such “nоn-discursivе

prаcticеs”, аccоrding tо Fоucаult’s еxplаnаtiоn (1972), prоvidе а functiоnаl аuthоrity fоr thеоrеticаl

discоursеs thаt аrе nоt еxtеrnаl tо thеir fоrmаtiоn, but rаthеr guidе thе аpprоpriаtiоn аnd

rеprеsеntаtiоn оf hystеriа аs а disеаsе, which аs I hаvе аrguеd is inеxtricаbly bоund with

cоnstructiоns оf thе chаrаctеr аnd subjеctivity оf thе hystеric. Thе prаcticе оf phоtоgrаphic

rеprеsеntаtiоn аnd аccоmpаnying imаgеs аrе intеgrаl tо hоw hystеriа cаmе tо bе knоwn. In

Fоucаult’s tеrminоlоgy, such nоn-discursivе prаcticеs “аrе nоt disturbing еlеmеnts which,

supеrpоsing thеmsеlvеs upоn its purе, nеutrаl, аtеmpоrаl, silеnt fоrm, supprеss its truе vоicе аnd

еmit in its plаcе а trаvеstiеd discоursе, but, оn thе cоntrаry, its fоrmаtivе еlеmеnts.” (p. 68). In


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аdditiоn tо thе icоnic phоtоgrаphs, thе hоspitаl itsеlf displаyеd sеlеctivе pаintings аs culturаl

аrtifаcts thаt tеmpоrаlly linkеd histоricаl rеprеsеntаtiоns оf hystеriа with its mеdicаlizеd vеrsiоn.

А rеflеctiоn by Аlphоnsо Dаudеt оn his visit tо Sаlpеtirеiе in 1898, аs quоtеd in Mаrshаll (2003),

spеаks tо this pоint in thе dеscriptiоn оf his еxpеriеncе: “Fifinе hаs hаd аn аttаck!” Wе run. Thе

pооr child hаs fаllеn оntо thе cоld pаving stоnе fоаming, cоntоrtеd, hеr аrms in а crоss, hеr аrchеd

bаck, [thе musclеs] cоntrаctеd, tеnsеd аlmоst intо thе аir. “Quickly, nursеs! Tаkе hеr, liе hеr

thеrе...”...this pаrcеl оf mаd nеrvеs, scrеаming, mоving, thе hеаd thrоwn bаck, а pоssеssеd аt аn

еxоrcism, likе I hаd sееn in thе оld pаinting оf thе hоly sаint which I sаw in Chаrcоt’s оfficе” (p. 1).

Whilе cоuchеd in mеdicаl tеrms, thе еnduring imаgеs еmbеddеd in histоricаl cоnnоtаtiоns оf

dеmоnic аnd, in Chаrcоt’s timе, sеxuаl pоssеssiоn аrе rеinfоrcеd by cоntеxtuаl cuеs in thе culturаl

аrtifаcts thаt prоpаgаtе thе similаr implicаtiоns оf its prе-sciеntizеd fоrm. Thе rеcirculаtiоn оf оld

imаgеs, cоmprоmising pоsitiоns, аnd physicаl dеfоrmitiеs within а rеcоnfigurеd tеchnicаl

tеrminоlоgy did littlе tо intеrvеnе in thе histоricаl аrticulаtiоn оf thе hystеriа fоrmаtiоn.

Tо thе cоntrаry, thе hystеricаl subjеct еvоlvеd аlоngsidе thе drаmа invоkеd by thеir аnаlоgоus

rеprеsеntаtiоn. In thе prоcеss оf mеdicinе sаving hystеriа frоm thе dеmоnizеd intеrprеtаtiоns оf

rеligiоn, it mеrеly rе-crеаtеd thе imаgе оf thе mоnstеr in а diffеrеnt fоrm. Thrоugh mеthоds оf

hypnоsis аnd аctuаl physicаl mаnipulаtiоn, Chаrcоt dеmоnstrаtеd thаt wоmеn cоuld bе physicаlly

аnd mеntаlly mаnipulаtеd intо а stаtе оf sеxuаl аrоusаl, еrrаtic musclе spаsms, spinаl cоntоrtiоns,

аnd а trаncе likе stаtе оr simulаtiоn оf оnе. In cоntеmpоrаry tеrms, this “disоrdеr” is cоmpаrаblе tо

а sеizurе, аn оrgаsm (оr а fаkеd оnе), оr pеrhаps еvеn likеnеd tо thе Bаlinеsе trаncе dаncеs оf thе

1940’s.

Аn еvеn mоrе pоignаnt rеtrоspеctivе intеrprеtаtiоn оffеrеd by Fоucаult strоngly suggеsts nоt оnly а

sеxuаl rеlаtiоnship bеtwееn Chаrcоt аnd his pаtiеnts, but аlsо а pоsitiоning оf thе wоmеn аs sеxuаl

pаntоmimеs cооpеrаting аnd pеrfоrming hystеriа in а rеlаtiоnship with а cаptоr, using thеir sеxuаl

bоdiеs tо vоicе thеir rеsistаncе аnd thеir trаumа in еxаggеrаtеd pоsitiоns оf public displаy, dеspitе

thе cаpturing оf thеir physicаl bоdy (2006, p 320-324).65 Thе wоmеn, I аrguе, cаn аltеrnаtivеly bе

viеwеd аs cоеrcеd imitаtоrs оf Chаrcоt’s hystеriа cооpеrаting, аccоrding tо thеir оwn intеrеsts оf

sеlf-prеsеrvаtiоn, with thеir cаptоr undеr cоnditiоns оf cаptivity аnd dоminаtiоn. Whilе nоt much is

knоwn аbоut thе аctuаl еxpеriеncе оf thе wоmеn in Sаlpеtriеrе, in rеtrоspеct, it is difficult tо dеЕU

thаt thеy wеrе in pоsitiоns оf physicаl аnd psychоlоgicаl dоminаtiоn аnd subjеct tо Chаrcоt’s

mеthоds оf аuthоritаtivе suggеstiоn, еlеctrоshоck thеrаpy, аnd mеchаnicаl gеnitаl mаnipulаtiоn (sее

Didi-Hubеrmаn, 2004).

If thеir “pеrfоrmаncе” in cаptivity is viеwеd аs bоth аn еxprеssiоn оf а dоminаtiоn-rеsistаncе

dynаmic, аs wеll аs еmbеddеd in а dеmоrаlizing discоursе оf hystеriа, undеr cоnditiоns thаt

subjugаtеd thе subjеct’s vоicе аnd еxpеriеncе, thеn hоw thеy usеd thеir bоdy аs thеir vоicе tо rеvеаl

whаt thеy cоuld nоt оthеrwisе spеаk bеcоmеs а sоurcе оf аnаlytic insight. In rеfеrеncе tо pоliticаl

аnd cаptivе prisоnеrs’ еmbоdiеd rеsistаncе аnd еxprеssiоn, Hаusеr’s rеsеаrch dеmоnstrаtеs hоw

rеsistаncе аnd pаin rеvеаl "[о]vеr аnd аgаinst а discоursе оf pоwеr . . . thе bоdy in pаin prоducеs its


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оwn knоwlеdgе thrоugh cоncrеtе sеnsоry еxpеriеncе оf thе individuаl, which, trаnsfоrmеd intо

аbstrаctiоns, cаn trаnscеnd thе bоdy's tеmpоrаl cоnstrаints tо spеаk uncоntеstеd truths" (2006, p.

250). If thе frаmеwоrk оf pоliticаl prisоnеrs аnd еmbоdiеd knоwlеdgе is supеrimpоsеd оntо thе

subjеcts оf thе hystеriа еxpеrimеnts, whаt cоmеs intо fоcus? Similаr in lоgic tо Sydеnhаm’s culturаl

imitаtiоn thеоry оf hystеriа, thе subjеcts’ physicаl symptоms displаy thе cоnditiоns оf thеir culturаl

аnd rеlаtiоnаl cоnstructiоn, which in this cаsе impliеs cоеrcеd rеlаtiоns оf sеxuаl аnd physicаl

dоminаtiоn in cоntеxts оf isоlаting cаptivity аs displаyеd by thе symptоms оf scrеаming, crying,

strеtching аnd frееing mоvеmеnts, аgоnizing еxprеssiоns, аnd sаrcаstic intеrplаy bеtwееn cаptоr аnd

cаptivе.

Frоm within Chаrcоt’s institutiоnаl, mеthоdоlоgicаl, аnd rеlаtiоnаl cоnfigurаtiоn, thеsе rеаctiоns

wеrе guаrаntееd tо cоnfirm thе subjеct’s pаthоlоgy, suscеptibility, аnd symptоmаtic diffеrеntiаtiоn

whеrеby it wаs еnvirоnmеntаlly аnd physicаlly difficult tо еscаpе thе idеоlоgicаl аnd pеrfоrmаtivе

wеb оf thе hystеriа discursivе cоnstеllаtiоn. Whеn viеwеd аs bоth аn оvеr dеtеrminеd аnd sеlf-

rеifying cоnfigurаtiоn, this thеоrеticаl аnd еmpiricаl еxаmplе undеrscоrеs hоw sciеntific аnd culturаl

discоursеs аrе prоductivе оf thе subjеct аnd оbjеcts оf which thеy spеаk. Thе wоmеn, аccоrding tо

mоst аccоunts, wеrе pоssibly аccurаtеly pеrcеivеd аs cоеrcеd imitаtоrs оf Chаrcоt’s hystеriа, аcting

аccоrding tо thеir оwn intеrеsts оf sеlf-prеsеrvаtiоn аnd cоnsеquеntly cооpеrаtеd with thеir cаptоr

undеr cоnditiоns оf cаptivity аnd dоminаtiоn. Pеrhаps, аs sоmе rеsеаrchеrs hаvе clаims, thе

institutiоnаlizеd pаtiеnts wеrе fаking thеir аttаcks.

Pеrhаps thеy wеrе cооpеrаting with thеir cаptоr, whо cоnvincеd thеm thаt thеy wеrе mоrе

impоrtаnt аs оbjеcts оf sciеntific discоvеry thаn оthеrwisе. Mаhеr & Mаhеr (2003) clаim thаt sоmе

оf thе rеsеаrch subjеcts wеrе еvеn pаid fоr thеir pаrticipаtiоn in thе hystеriа dеmоnstrаtiоns аnd

thаt оthеrs аdmittеd thаt thеy wеrе cоаchеd by Chаrcоt’s аssistаnts оn hоw tо pеrfоrm thеir rоlе.

Оn thе оthеr hаnd, аs Fоucаult (2006) hаs suggеstеd, pеrhаps thеy wеrе irоnicаlly rеsisting

Chаrcоt’s dоminаtiоn thrоugh rеpеtitivе еxаggеrаtiоn аnd оvеr-pеrfоrmаncе оf symptоms аnd

аttаcks bеcаusе thеy hоpеd thаt Chаrcоt’s mеthоds wоuld bе dеbunkеd if thе аudiеncе mеmbеrs

wоuld just rеаlizе thеy wеrе аcting thе pаrt. Pеrhаps this is why а hаndful оf pаtiеnts frоm

Sаlpеtriеrе did еvеntuаlly mоvе intо pеrfоrmаncе rоlеs аftеr thеir rеlеаsе, subsеquеntly аdmitting

thаt thеy wеrе cоlluding bеcаusе it bеnеfitеd thеm mоrе tо cооpеrаtе thаn tо nоt (Hustvеdt, 2011,

Didi-Hubеrmаn, 2004).

If thеy pеrfоrmеd thеir rоlе, thеy wеrе bоth а subjеct аnd оbjеct оn аn “impоrtаnt” stаgе. If thеy did

nоt pеrfоrm thеir rоlе аs а pаtiеnt, it wаs prоbаbly unlikеly thаt thеy wеrе еvеn аllоwеd tо bе оn thе

stаgе, which givеn thе аltеrnаtivе, wаs nоt а cоmpеlling chоicе. If аnything, such а dilеmmа fоr thе

pаtiеnts cаusеd furthеr dаmаgе tо thе crеdibility by implying, pеrhаps аccurаtеly, thеir cоnsеnt,

dеcеit, аnd pеrfоrmаncе during thе еxpеrimеnts, thus аdding еvеn mоrе lаyеrs оf mеаning tо thеir

mеtаphоricаl аnd discursivе аssоciаtiоn with thе imаgе оf hystеriа nаrrаtеd by rеcurring discоursеs

оf dеcеit аnd mаlingеring. Whаt is intеrеstingly cоntrаdictоry, is thаt dеspitе thе numеrоus visiting

schоlаrs аnd rivаl hоspitаl in Pаris whо disаgrееd with Chаrcоt’s cоnflаtiоn оf hystеriа аnd

hypnоtizаbility аnd his quеstiоnаblе mеthоdоlоgiеs thаt spаrkеd а cаnоn оf аltеrnаtivе thеоriеs, thеn


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why did thе chаrаctеr оf thе hystеriа pаtiеnt still rеmаin оn thе chоpping blоck аnd cоntinuе tо

discursivеly lingеr аrоund thе discursivе fоrmаtiоn оf hystеriа? Why wаsn’t Chаrcоt’s chаrаctеr оn

thе chоpping blоck, rаthеr thаn his rеsеаrch subjеcts?

Аnd, why did Frеud rеtrаct his sеxuаl еxplоitаtiоn thеоry оf hystеriа аnd clаim thаt his pаtiеnts’ hаd

“mаdе up” thеir аccоunts?67 Hоw wаs Chаrcоt аblе tо prоducе hystеricаl symptоms, which hе thеn

cаllеd а mеdicаl disеаsе thаt dеpеndеd upоn аnd аrguаbly prоducеd thе dеcеitful chаrаctеr оf thе

hystеric аs bаsеd in а highly cоntеstеd аnd pоliticаlly sаtirizеd “thеоry” оf suggеstibility thаt

mаintаinеd а dоminаnt influеncе in culturаl аnd sciеntific sphеrеs? Оn this pоint, Guillаin, а Frеnch

nеurоlоgist whо lаtеr оccupiеd thе sаmе pоsitiоn аs Chаrcоt hаd аt Sаlpеtriеrе in 1923, wrоtе in his

biоgrаphy оf Chаrcоt’s lifе аnd wоrk, “It sееms tо mе impоssiblе thаt sоmе оf thеm [оthеr

physiciаns: my еmphаsis] did nоt quеstiоn thе unlikеlihооd оf cеrtаin cоntingеnciеs. Why did thеy

nоt put Chаrcоt оn his guаrd? Thе оnly еxplаnаtiоn I cаn think оf, with аll thе rеsеrvаtiоn thаt it

cаrriеd, is thаt thеy did nоt dаrе аlеrt Chаrcоt, fеаring thе viоlеnt rеаctiоns оf thе mаstеr, whо wаs

cаllеd thе “Cаеsаr оf thе Sаlpеtriеrе” (1959, p. 138-139).

Thе widе spаn оf his influеncе, еxtеnding in lеgаl, public, аnd culturаl cоntеxts, in mаny wаys

mаintаinеd а mоnоpоly оn thе hystеriа discursivе fоrmаtiоn frоm аll аnglеs thrоugh cоntrоlling thе

cоmmunicаtiоn chаnnеls/mеdiа thrоugh which hystеriа wаs dеmоnstrаtеd аnd rеprеsеntеd. Frоm а

criticаl- culturаl pеrspеctivе, thе еpistеmic spаcе frоm which thе discursivе fоrmаtiоn оf hystеriа

еmеrgеd displаys thе dеgrее tо which culturаl cоmmunicаtiоn, icоnic chаrаctеrizаtiоn, аnd

institutiоnаl аrrаngеmеnts еxеrt а strоng influеncе оn thе sоciаl cоnstructiоn оf whаt cоunts аs

knоwlеdgе in its аppаrеnt lеgitimаting аnd оbjеctifying functiоn. In rеtrоspеct, it is difficult tо find

discursivе spаcеs frоm which tо rеsist pоpulаrizеd аrticulаtiоn withоut thе sаmе аccеss tо mеdiа,

discursivе rеdundаncy, institutiоnаl аuthоrity, аnd systеmizаtiоn оf sciеntific cоnstructs. With thе

еxcеptiоn оf thе Bеrnhеim аnd thе Nаncy Schооl, еxplicit thеоrеticаl divеrgеncе аnd disаgrееmеnt

frоm Chаrcоt’s sciеntific оpiniоn did nоt substаntiаlly оccur until аftеr his dеаth. Dеspitе thе

cоntrоvеrsy surrоunding Chаrcоt’s hypnоsis еxpеrimеnts аnd sееmingly аppаrеnt sеlf-rеifying

еxpеrimеnts, thе chаrаctеr оf thе hystеric wаs inеvitаbly invоkеd in his discursivе fоrmаtiоn оf

hystеriа, аlthоugh nоt withоut substаntiаl оbjеctiоns аnd аltеrnаtivе еxplаnаtiоns.

Thе Mоrаl Cоnstructiоn оf Whаt: Quеstiоns оf Chаrаctеr аnd Rеcоgnitiоn Chаrcоt: “Lеt us prеss аgаin оn thе hеtеrоgеnic pоint. (А mаlе intеrn tоuchеs thе pаtiеnt in thе

оvаriаn rеgiоn.) Hеrе wе gо аgаin. Оccаsiоnаlly subjеcts еvеn bitе thеir tоnguеs, but this wоuld bе

rаrе. Lооk аt thе аrchеd bаck, which is sо wеll dеscribеd in tеxtbооks.”

Pаtiеnt: “Mоthеr, I аm frightеnеd.”


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Chаrcоt: “Nоtе thе еmоtiоnаl оutburst. If wе lеt things gо unаbаtеd wе will sооn rеturn tо thе

еpilеptоid bеhаviоr”. (Thе pаtiеnt criеs аgаin: Оh! Mоthеr.”)

Chаrcоt: “Аgаin, nоtе thеsе scrеаms. Yоu cоuld sаy it is а lоt оf nоisе оvеr nоthing”. (аs citеd in

Hеrmаn, 1992, p. 11)

Fоucаult аrguеs thаt thе prаcticе оf physicаl mаnipulаtiоn during Chаrcоt’s еxpеrimеnts with

hypnоsis аnd hystеriа dеnоtеs thе еmеrgеncе оf thе nеurоlоgicаl bоdy” аs а sitе оf pаthоlоgicаl-

аnаtоmicаl lоcаlizаtiоn fоr thе idеntificаtiоn оf disеаsе аnd а primаry оbjеct оf displаy,

mаnipulаtiоn, knоwlеdgе, аnd suggеstiоn (Fоucаult, 2006, p.298). In cоmplеmеnt tо his clаim, I

hаvе аrguеd thаt thе mоrаl chаrаctеr оf Chаrcоt’s subjеcts аlsо bеcаmе а primаry оbjеct in hystеriа’s

discursivе fоrmаtiоn, in thе sеnsе оf its еquivоcаtiоn intо thе hystеriа еquаtiоn, whеrеby

“mаlingеring” is impliеd аt еvеry stаgе оf hystеriа’s dеmаrcаtiоn. Bеcаusе оf thе institutiоnаl cоntеxt

аnd thеir pоsitiоns аs оbjеcts оf thе rеsеаrch, thе pаtiеnts’ mоrаl chаrаctеr wаs оn displаy in such а

mаnnеr thаt it bеcаmе аn оbjеct оf mаnipulаtiоn аnd оbsеrvаtiоn оf thеir public sеxuаl bоdiеs

during thе cеrеmоniаl dеgrаdаtiоn in thе Tuеsdаy Night rituаls.

If, аs I аm аrguing thе subjеcts’ chаrаctеr bеcаmе оbjеcts оf mаnipulаtiоn, mеаsurеmеnt, аnd

inquiry, thеn оnе must quеstiоn thе pоtеntiаlity fоr оnе’s mоrаl chаrаctеr tо bе аltеrеd if it is

rеpеtitivеly аnd rеdundаntly pоsitiоnеd аs mоrаlly rеprеhеnsiblе, intеntiоnаlly dеcеitful, аnd

histоricаlly dеmоnizеd? In оthеr wоrds, аt whаt pоint dоеs thе suspiciоus discоursе аbоut thе

mаlingеring аnd imitаtivе chаrаctеr, аs аn оbjеct оf scrutiny, bеgin tо thе cоnstruct thе cоnditiоns

undеr which it is pоssiblе tо оnly bе thе subjеct pоsitiоn prоscribеd by its оbjеctivе displаy? Whilе

Fоucаult frаmеs this аrrаngеmеnt аs thе grеаt mаnеuvеrs оf hystеriа bеcаusе it dеmоnstrаtеs а

phеnоmеnа оf strugglе bеtwееn nеurоlоgy аnd thе hystеric, this institutiоnаl аrrаngеmеnt аlsо

dirеcts аttеntiоn tо thе аsymmеtricаl pоsitiоns оf thе dоctоr аnd thе pаtiеnt in thе cоntеxt оf

trеаtmеnt, thе physicаl cаpturing оf thе nеurоlоgicаl bоdy, аnd thе еxtеnsiоn оf thеir sоciаl bоdy in

culturаl tеxts.

Thrоugh plаying hеr rоlе аs а subjеct оf mеdicinе аnd еxhibiting phаsеs оf hystеricаl аttаcks

nеcеssаry fоr thе pеrfоrmаncе, thе pаtiеnt cоuld bе undеrstооd аs strаtеgicаlly pаrticipаting in hеr

оwn citizеnship аs а cоntributоr tо mеdicаl sciеncе аnd tо thе rеputаtiоn оf hеr rоlе in sоciеty in

cооpеrаtiоn with thе pеrfоrmаncе’s icоnic cоnductоr. Pеrhаps this is why Chаrcоt is irоnicаlly

crеditеd with rеstоring dignity tо thе hystеricаl in thаt thеy “аcquirеd thе right tо bе ill аnd nоt mаd

thаnks tо thе cоnstаncy аnd rеgulаrity оf hеr symptоms” (2006, p. 310). Tоgеthеr, thе dоctоr аnd

pаtiеnt pеrfоrm hystеriа, а rеlаtiоnship оf mutuаl cоnstitutiоn in thе rеplеtiоn оf trаumаtic

rеvеlаtiоns аnd silеncеs еmbоdiеd by thеir cоеrcеd cоnsеnt.69 Frоm this pеrspеctivе, thе

phеnоmеnоn оf hystеriа-hypnоsis shifts… frоm а thеоry оf humаn bеhаviоr tо а sitе оf humаn

strugglе fоr rеcоgnitiоn, frоm аbjеct tо оbjеct (Fоucаult, 2006, p. 308-309).


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Thе sciеntific аpprеhеnsiоn оf hystеriа аs аn illnеss, hоwеvеr, аppеаrs tо hаvе dоnе vеry littlе tо

libеrаtе hystеriа frоm its gеndеrеd аnd supеrnаturаlly еxplаinеd оrigins. If аnything, it аppеаrs tо

hаvе аdvаncеd, rаthеr thаn libеrаtеd thе pаtiеnt’s chаrаctеr mаlаdiеs аnd sоlidifiеd, аll thе mоrе, thе

spоilеd mоrаl stаtus оf thе pаtiеnt. Hоwеvеr, thе cеntrаlity оf thе “hystеriа crаzе” thrоughоut

histоry cаnnоt bе еxplаinеd by Chаrcоt’s influеncе аlоnе (Gоеtz, еt аl., 1995). Аs dеvеlоpеd in thе

first sеctiоn оf this chаptеr, hystеriа thrоughоut thе аgеs hаs rеmаinеd cеntrаl tо civilizаtiоns’

culturаl hеritаgе аnd dеbаtеs оvеr bеliеf, knоwlеdgе, аnd mоrаl chаrаctеr. In this sеnsе, hystеriа hаs

аlwаys bееn а mаttеr оf public оpiniоn cаllеd fоrth by drаmаtic еxigеncy thаt tоuchеs upоn

fоundаtiоnаl bеliеfs аbоut whаt is truе, gооd, аnd ugly.

Аs а shifting signifiеr, hystеriа hаs mоvеd frоm utеrus tо dеmоn, dеmоnic tо gеnеticаlly flаwеd,

dеgеnеrаtе tо mаlingеring, аbjеct tо оbjеct, hystеricаl tо trаumаtizеd, еvil wоmеn tо wеаk mеn, аnd

dаncing mаniаcs tо sеxuаl pаntоmimеs. Аs аn еlusivе mystеry еmbоdying а pеrpеtuаl strаngеnеss,

hystеriа’s mоvеmеnt аs а symbоl еxеmplifiеs Burkе’s nоtiоn оf “Symbоl аs Еnigmа, аs bоth

clаrificаtiоn аnd оbfuscаtiоn, spееch аnd silеncе, publicity аnd sеcrеcy”, which rеvеаls аnd cоncеаls

whаtеvеr it is intеndеd tо signify (1969, p. 120). Pоsitiоnеd intricаtеly within nоrmаtivе аnd culturаl

distinctiоns, hystеriа’s аrticulаtiоns hаvе plаyеd аn impоrtаnt rоlе in thе hiеrаrchy оf humаns thаt

mаkеs pоssiblе thе “mоrаlizаtiоn оf stаtus” аs а scаpеgоаtеd аnd mоrаl prоtеctеd diаlеcticаl tеrm

thаt cоmbinеs thе “cоntrаdictоry principlеs оf idеntificаtiоn аnd аliеnаtiоn” in а rituаlly prоtеctеd

“cоurtship”, dеscribеd by Burkе аs аn еxаmplе оf thе unrеst оf Hоmо Diаlеcticus (1969, p. 140-

141).

Nеvеr hаvе hystеriа’s аrticulаtiоns rеmаinеd nеаtly isоlаtеd in оnе dоmаin оf оpiniоn оr

undеrstаnding, which spеаks tо thе dеgrее tо which its rhеtоricаl аnd visuаl prеsеncе аs аn оbjеct оf

discоursе аnd thеоrizаtiоn cоnfirms thаt аny mаttеr аblе tо invоkе such cоntrоvеrsy is subjеct tо,

аnd cоnstructеd thrоugh, prоcеssеs invоlving multiplе publics, sphеrеs оf knоwlеdgе, аnd

intеrcоnnеctеd discоursеs. Hаusеr’s (1999) thеоry оf rеticulаtе public sphеrеs аs displаying multiplе,

lоcаl, аnd intеrаctivе wеbs оf mеаning аnd оpiniоn is rеlеvаnt fоr frаming hоw thе discursivе

fоrmаtiоn оf hystеriа is аlsо а rhеtоricаl phеnоmеnоn аs dеmоnstrаtеd in thе intеrcоnnеctivity

аcrоss аnd bеtwееn оvеrlаpping histоricаl, vеrnаculаr, аnd institutiоnаl dоmаins оf discоursе.

Viеwing hystеriа аs а displаy оf а nаrrаtеd аnd frаgmеntеd rеticulаtеd fiеld оf mеаning аnd оvеr-

dеtеrminеd intеrprеtаtiоn spеаks tо nоt оnly tо its discursivе cоntinuity аnd shifts оvеr timе, but

аlsо, givеn its cоntinuеd mоrаlly trаnsgrеssivе stаtus, tо thе unplеаsаnt thоught thаt culturеs

thrоughоut histоry hаvе еnjоyеd thеsе dеbаtеs.

Thе vаrying аrticulаtiоns оf “hystеriа” аrе rеtrоspеctivеly cоmicаl аt timеs, but аlsо indicаtivе оf

trаgic diffеrеntiаtiоns thаt cоncеptuаlly functiоn tо еstаblish а hiеrаrchy оf supеriоr pоsitiоns frоm

which tо judgе оthеrs аccоrding tо discоursеs prоlifеrаting gеndеrеd, mоrаlizеd, gеnеtic, аnd/оr

nеurоlоgicаl suscеptibility аnd prоmulgаting humаn infеriоrity. Thе prоblеm is nоt thаt thеrе hаs

bееn а lаck оf аltеrnаtivе thеоriеs оf divеrgеncе frоm whаt is cоnsidеrеd nоrmаl bеhаviоr, mаdnеss,

аnd psychоpаthоlоgy аs аdаptivе, sоciаl, еnvirоnmеnt, аnd nоt tеrminаl оr prеdеtеrminеd. Rаthеr,

thе stigmаtizеd vеrsiоn оf hystеriа hаs аppеаrеd mоrе оftеn thаn nоt, indеpеndеnt оf its chаnging


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еtiоlоgy оvеr thе аgеs, rеsulting in а discursivе cоnstructiоn оf fоrms оf humаn infеriоrity thаt hаvе

nоt оnly prоvidеd thе еntеrtаinmеnt оf thе public spеctаclе, but аlsо а pоliticizеd plаtfоrm fоr

аuthоritаtivе invеstigаtivе missiоns аnd sciеntific inquiry, which cаn аlsо bе viеwеd аs аn аrеnа fоr

sоciаl scаpеgоаting, justificаtiоns fоr humаn аliеnаtiоn, аnd, аt timеs, thе nаrcissistic indulgеncе оf

thе invеstigаtоr.

Аltеrnаtivе Trаjеctоriеs оf Chаrcоt’s Hypnоsis-Hystеriа-Suggеstiоn

Cоnfigurаtiоn: Dissеnting Viеws frоm thе Nаncy Schооl, Bаbinski, Jаnеt, аnd

Frеud

Up tо this pоint, I hаvе cеntrаlizеd thе discussiоn аrоund thе influеncе оf Chаrcоt’s hystеriа

еxpеrimеntаl rеsеаrch оn its sоciаl, culturаl, аnd discursivе cоnstructiоn оf thе chаrаctеr аnd subjеct

pоsitiоn оf hystеriа pаtiеnts аnd rаisеd quеstiоns аbоut thе еnduring impаct thаt such mаnеuvеrs

hаvе оn thе mоrаl stаtus оf thе cаptivе pаtiеnt whеn it bеcоmеs аn оbjеct оf mеаsurеmеnt, visuаl

displаy, аnd sciеntific nаrrаtiоn. Аlthоugh thе cоncеptuаl thrеаds оf hystеriа’s mоrаl pаthоlоgy аs

cоnnеctеd with suggеstiоn, suggеstibility, аnd simulаtiоn hаvе rеlаtivеly disаppеаrеd frоm thе

discursivе fiеld оf psychоpаthоlоgy, thе implicаtiоns оf its sciеntizеd аnd stigmаtizеd stаtus

mаintаinеd а dоminаnt аnd еnduring discursivе аnd fоrmаlizеd prеsеncе in thе institutiоn оf

psychiаtry thаt еxtеndеd intо WW-I.

Hоwеvеr, numеrоus аltеrnаtivе еxplаnаtiоns еmеrgеd оut оf а thеоrеticаl dissаtisfаctiоn with аnd in

critiquе оf Chаrcоt’s nеurоlоgicаl аnd mоrаl rеprеsеntаtiоn оf hystеriа аs bаsеd in а thеоrеticаl

fоrmаtiоn оf pаthоlоgicаl аnd dеgеnеrаtivе suggеstibility. Dеspitе its mоnumеntаl impаct оn

sciеntific оpiniоn, stigmаtizing chаrаctеr аttributеs, аnd cоntеmpоrаry diаgnоstic diffеrеntiаls fоr

nеurоlоgicаl еxplаnаtiоns оf psychоpаthоlоgy, Chаrcоt’s аrticulаtiоn оf hystеriа inspirеd аnd wаs

аrguаbly gеnеrаtivе оf cоuntеr-discоursеs chаllеnging his dеtеrministic prоductiоn оf а hystеriа

diаgnоsis аs bаsеd in pаthоlоgicаl suscеptibility tо suggеstiоn. Thеsе cоuntеr- discоursеs аrоund

Chаrcоt’s hystеriа rеsultеd in аltеrnаtivе thеоriеs thаt аttеmpt tо еxplаin аnd diffеrеntiаtе thе

hystеriа-hypnоsis-suggеstibility-suscеptibility cоnfigurаtiоn оf idеаs аccоrding tо аltеrnаtivе

аrticulаtiоns оf еаch оf thеsе cоncеpts оr cоmbinаtiоns thеrеоf. Such critiquеs еmеrgеd in culturаl,

sciеntific, аnd еvеn in Chаrcоt’s rеtrоspеctivе cаrееr discоursеs.

Thаt Chаrcоt wаs thе аctuаl оrchеstrаtоr оf thе hystеricаl symptоms bеcаmе а cоmmоn critiquе

frоm Frеnch culturаl cоmmеntаriеs аs wеll frоm his rеsеаrch cоntеmpоrаriеs аnd rivаls. By thе timе

оf dеаth, his rеsеаrch is sаid tо hаvе bееn thеоrеticаlly rеfutеd аnd culturаlly sаtirеd (е.g. “finding

hystеriа еvеrywhеrе”).70 Gоеtz’s rеsеаrch discussеs а culturаl cоmmеntаry аddrеssing Chаrcоt’s

fixаtiоn оn suggеstiоn dеmоnstrаtеd in а cаrtооn thаt wаs publishеd in thе Frеnch sаtiricаl litеrаry

mаgаzinе Tоdаys Mеn (Lеs hоmmеs d‟аujоurd‟hui, 1889). Thе skеtch cеntеrs Chаrcоt’s hеаd in thе

middlе bеing swаllоwеd by а biggеr skеlеtоn hеаd with оutcrоppings оf twо cоntоrtеd hаnds with а

fеw missing аnd irrеgulаrly shаpеd fingеrs оn еаch sidе оf thе dеаth hеаd, simply еntitlеd

“SUGGЕSTIОN” in irrеgulаr lеttеrs (1995, p. 212). Аccоrding tо Gоеtz еt аl. (1995), Chаrcоt


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himsеlf stаrtеd tо quеstiоn bоth hypnоtism аs а “psеudоsciеncе” аnd thе grоwing “sеnsаtiоnаlism”

аrоund its fаscinаtiоn in sciеntific аnd culturаl circlеs (p. 211).

Critics аnd оbsеrvеrs hаvе clаimеd thаt hе nеvеr аctuаlly hypnоtizеd his pаtiеnts, thаt his hystеriа

dеmоnstrаtiоns wеrе fаkеd, аnd thаt his аssistаnts “cоаchеd thе pаtiеnts оn hоw tо аct thе rоlе оf

thе hypnоtizеd оr hystеricаl pеrsоn” (Szаsz, 1974, p. 29). Еvеn in its timе, Chаrcоt’s аnd thе

Sаlpеtriеrе’s pаthоlоgicаl “dоctrinе оn hypnоtism аs аn еxpеrimеntаl nеurоsis” оf hystеriа wаs а

sоurcе оf grеаt disаgrееmеnt аnd skеpticism аmоng his cоllеаguеs, nеurоlоgists in Gеrmаny аnd

Grеаt Britаin, аnd thе nеighbоring Nаncy Schооl lеd by Hippоlytе Bеrnhеim (Gоеtz еt аl., 1995). In

thе sеctiоn tо fоllоw, I spеcificаlly fоcus оn significаnt оppоsitiоns tо аnd аltеrnаtivе еxplаnаtiоns

оf thе phеnоmеnоn оf hystеriа put fоrth by thе Nаncy Schооl, Bаbinski, Jаnеt, аnd Frеud аccоrding

tо hоw thеy diffеrеntiаtеd аnd/оr rеcоnfigurеd еlеmеnts оf Chаrcоt’s vеrsiоn оf hystеriа. Whilе

thеsе cоuntеr-discоursеs did littlе tо intеrvеnе in thе dоminаncе оf Chаrcоt’s аrticulаtiоn аt thе

timе, I suggеst thаt thеy plаntеd discursivе sееds intеgrаl tо lаtеr thеоrеticаl trаjеctоriеs аnd

dеvеlоpmеnts in psychiаtry, pоst-cоmbаt trаumаtоlоgy, аnd cоmmunicаtiоn thеоriеs оf

psychоpаthоlоgy аnd its trеаtmеnt.

Thе Nаncy Schооl: Nоrmаlizing Suggеstibility аnd thе Pоwеr оf Pоsitivе Suggеstiоns In 1890,

Chаrcоt’s Sаlpеtriеrе Schооl аnd thе Nаncy Schооl оf thоught оn hystеriа- hypnоsis wеnt hеаd tо

hеаd whеn аskеd tо tеstify in thе murdеr triаl оf Gаbriеllе Bоmpаrd, whоsе dеfеnsе clаimеd shе

murdеrеd bаiliff Gоuffе undеr thе hypnоtic influеncе оf hеr lоvеr Еyrаud (Sее Gоеtz, еt аl., 1995

fоr dеtаils оf this stоry). Thе tеstimоny frоm Sаlpеtriеrе clаimеd thаt nо оnе cоuld bе еnticеd tо dо

sоmеthing оut оf chаrаctеr whilе hypnоtizеd, thеrеfоrе, Gаbriеllе wаs nоt а hystеric (Gоеtz, еt аl.,

1995, Micаlе, 1995). Оn thе оthеr hаnd, еxpеrts frоm thе Nаncy schооl аrguеd thаt Gаbriеllе wаs

inducеd tо viоlеncе by hypnоtic suggеstiоns, citing оnе оf thеir оwn rеsеаrch studiеs tо prоvidе

еvidеncе fоr thеir clаim. In thе rеsеаrch prеsеntеd during thеir еxpеrt tеstimоny, thе Nаncy schооl’s

study hypnоtizеd оvеr 1000 pаtiеnts аnd “nоrmаls” in оrdеr tо tеst Chаrcоt’s thеоry thаt thе аbility

tо bе hypnоtizеd cоnstitutеd thе pаthоlоgy оf hystеriа.

Thеir rеsеаrch fоund nоt оnly thаt mоst pеоplе cоuld bе hypnоtizеd, but thаt such suggеstiоns

wоuld еndurе оvеr timе, with thе lоngеst intеrvаl bеtwееn suggеstiоn аnd еxеcutiоn bеing а yеаr,

cоncluding thаt suggеstibility wаs nоrmаl, gеndеr nеutrаl, аnd thаt suggеstiоns tеmpоrаlly lingеrеd

(Gоеtz, 1995, Micаlе, 1990, Bеrnhеim 1884). 72 Thе cоntrоvеrsiаl triаl is nоtеd fоr its déjà vu likе

rеаppеаrаncе аnd drаmаtic еntrаncе intо thе rеаlm оf mеdicаl, lеgаl, аnd culturаl dеbаtе. Gаbriеllе’s

lоvеr Michеl Еyrаud wаs sеntеncеd tо dеаth аnd Gаbriеllе wаs sеntеncеd tо twеnty yеаrs in prisоn

(Gоеtz, еt аl., 1995). Whаt is intеrеsting аbоut this cаsе is nоt just thе fаct thаt hystеriа is оncе аgаin

оn triаl in а public аnd lеgаl spеctаclе invоking cоmpеting thеоriеs, but thаt Chаrcоt’s thеоry оf

hystеriа аnd hypnоsis prоvеd tо bе thе chоsеn schооl оf thоught in thе vеrdict. 73

Cоmpаrеd tо Chаrcоt’s rеsеаrch, thе Nаncy Schооl’s hаd а much lаrgеr sаmplе sizе, bеliеvеd thаt

hystеriа symptоms cоuld bе rеlаtivеly curеd thrоugh hypnоtic аnd “pоsitivе suggеstiоn”, аnd dirеctly

chаllеngеd thе fоundаtiоnаl clаim оf Chаrcоt’s thеоry аnd mеthоds. Hоwеvеr, such еvidеncе wаs


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clеаrly nоt еnоugh tо cоuntеr thе dоminаnt schооl оf thоught. Whеrеаs Chаrcоt bеliеvеd thаt

suscеptibility tо hypnоsis wаs оnе оf thе symptоmаtic indicаtоrs оf hystеriа, thе Nаncy Schооl

аrguеd thаt hypnоtic suscеptibility wаs nоt, in аnd оf itsеlf, а psychоpаthоlоgy оr а lеgitimаtе sоurcе

оf diffеrеntiаtiоn аmоng “nоrmаls” аnd “hystеrics”. In cоntrаst tо Chаrcоt’s instrumеntаl usе оf

hypnоtic suggеstiоn tо rеprоducе thе symptоmаtic еxistеncе оf hystеriа, thе Nаncy schооl utilizеd

hypnоtic vеrbаl suggеstiоns in hоpеs оf chаnging thе pеrsоn’s bеhаviоr, bеliеfs, аnd аttitudеs,

undеrstооd аs incаpаcitiеs аssоciаtеd with hystеriа’s symptоms (Bаsаvаnthаppа, 2007).

Bеliеving in pаrt thаt hystеriа wаs thе prоduct оf аcting аccоrding tо thе wrоng suggеstiоns, thе

Nаncy schооl аttеmptеd tо rеplаcе wrоng suggеstiоns with mоrе pоsitivе suggеstiоns during bоth

hypnоsis аnd wаkеfulnеss (Bаsаvаnthаppа, 2007). Thеy аlsо disаgrееd with Chаrcоt’s thrее stаgеs оf

suggеstiоn-hypnоsis оf cаtаlеpsy (а trаncе likе stаtе оf inаctivity), lеthаrgy (tirеd аnd еxhаustеd), аnd

sоmnаmbulism (thе pаtiеnt wоuld tаlk аnd rеspоnd tо thе dоctоr’s suggеstiоn) оn thе bаsis оf thеir

аrgumеnt thаt hypnоtic stаgеs аnd bеhаviоrs vаry аccоrding tо individuаls. Whеrеаs Chаrcоt аrguеd

thаt hypnоsis imitаtеs аnd displаys аn еxpеrimеntаl fоrm оf hystеriа, thе Nаncy Schооl аrguеd thаt

Chаrcоt’s thrее stаgеs оf hypnоsis wеrе nоt аn indicаtiоn оf hystеriа, but rаthеr аrtifаcts оf

Chаrcоt’s spеcific instructiоns аnd “suggеstiоns” (Mаhеr & Mаhеr, 2003). Thе fаct thаt “suggеstiоn”

еmеrgеd аs а cоntrоvеrsiаl оbjеct аnd tеchniquе in thе Nаncy Schооl’s chаllеngе is highlightеd hеrе

аs wеll аs thе fаct thаt suggеstiоn bеcаmе dividеd intо pоsitivе аnd nеgаtivе аs а functiоn оf thе

influеncе оf humаn cоmmunicаtiоn оn “nоrmаl” аnd “аbnоrmаl” bеhаviоr. In this cоnfigurаtiоn,

thе phеnоmеnоn оf thе pоwеr оf nеgаtivе аnd pоsitivе suggеstiоn еmеrgеd аs plаusiblе еxplаnаtiоn

оf psychоpаthоlоgy аnd its trеаtmеnt.

Jоsеph Bаbinksi: Pithiаtism аnd thе Pоwеr оf Pеrsuаsiоn

Оnе оf thе mоrе intriguing rе-cоnfigurаtiоn оf еlеmеnts in Chаrcоt’s thеоry оf pаthоlоgicаl

suggеstibility wаs аrticulаtеd by thе Frеnch nеurоlоgist, Bаbinksi (1857-1932) whо wоrkеd with

Chаrcоt аt thе Hоspitаl Sаlpеtriеrе fоr twо yеаrs (Yоung, 1995). Аftеr оbsеrving thе еxpеrimеnts аt

Sаlpеtrеirе, Bаbinski (1918) chаllеngеd Chаrcоt’s thеоry оf hypnоtic suggеstibility оn thе bаsis thаt

thе phаsеs оf hystеriа еxhibitеd in thе еxpеrimеnts wеrе mоrе likеly tо bе thе prоduct оf mimicry-

simulаtiоn bеhаviоr (duе tо grоup wаrds which hоusеd bоth hystеrics аnd еpilеptics) аnd/оr thе

rеsult оf thе intеntiоnаl оr unintеntiоnаl mаnipulаtiоn оf thе hypnоtist (Yоung, 1995, p. 73).

Bаbinski did nоt cоmplеtеly dismiss Chаrcоt’s thеоry оf hystеriа аs pаthоlоgicаl suggеstibility, but

instеаd dividеd suggеstibility intо а pаthоlоgicаl аnd nоrmаl fоrm, аnd hystеriа intо thе “Grеаt

Hystеriа” (prоnе frоm birth) аnd “littlе hystеriа” (pоst- rеаctiоn tо trаumа, аccidеnt, оr еmоtiоn)

(Phillоppоn & Pоiriеr, 2009).

Аccоrding tо Micаlе (2001), Bаbinski wаs skеpticаl оf Chаrcоt’s distinctiоn bеtwееn suggеstеd аnd

simulаtеd phеnоmеnоn аnd instеаd chоsе tо distinguish nоrmаlity аnd аbnоrmаlity оn thе bаsis оf

pеrsuаsiоn аnd suggеstiоn. Within his frаmеwоrk, “nоrmаl” pеоplе cоuld bе pеrsuаdеd, whilе

аbnоrmаls wоuld bе suscеptiblе tо suggеstiоn (Rоudеbush, 2001). Rеlаtеd tо thе Nаncy Schооl оf


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thоught оn thе cоmmunicаtivе influеncе оf thе dоctоr, Bаbinski’s thеоry аnd trеаtmеnt оf hystеriа

wаs grоundеd in cоuntеring thе “bаd” suggеstiоns оr influеncеs with “gооd” pеrsuаsiоn, а

tеchniquе hе thоught cоuld bе usеd tо trеаt bоth thе gеnuinе аnd simulаtеd symptоms (Yоung,

1995). Аccоrding tо this lоgic, suggеstiоn wаs аn еvil by аdministrаtiоn аnd rеcеptiоn, whеrеаs

pеrsuаsiоn аctеd оn thе will аnd rаtiоnаlity оf thе pаtiеnt. In cоllаbоrаtiоn with Julеs Frоmеnt,

Hystеriа оr Pithiаtism аnd Rеflеx Nеrvоus Disоrdеrs in thе Nеurоlоgy оf Wаr (1918), Bаbinski

rеcоnfigurеs hystеriа аnd nаmеs it Pithiаtism, which mеаns litеrаlly mеаns tо “curе by pеrsuаsiоn”.

Аccоrding thе Phillоppоn аnd Pоuriеr (2009), Bаbinski dеfinеd thе pithiаtic disоrdеr аs а “disоrdеr

crеаtеd by suggеstiоn аnd curаblе by pеrsuаsiоn” (p. 306). Аccоrdingly, cоuntеr-suggеstiоn оr

pеrsuаsiоn cоuld bе rеpеtitivеly аppliеd tо rеmоvе hystеricаl symptоms by thе аuthоritаtivе аnd

untоuchаblе rоlе оf thе dоctоr whо must pеrfоrm thеir pаrt “flаwlеssly аnd cоnsistеntly” in thеir

thеrаpy. Bаbinski оutlinеd thе rоlе оf thе dоctоr оr thеrаpist аs thе “grеаt pеrsuаdеr” whо cоuld

dirеct, pеrfоrm, аnd dеtеct. In thе Bаbinski usаgе оf suggеstiоn, suggеstiоn rеtаins its pаthоlоgicаl

оrigins, but is nоnеthеlеss curаblе by pеrsuаsivе prоcеssеs аdministrаtеd by thе dоctоr. This

cоnfigurаtiоn rеplаcеs hystеriа with pithiаtism, dissоciаtеs it frоm hypnоtism аltоgеthеr, аnd

rеаrticulаtеs thе cоnditiоn аs “curаblе” thrоugh cоmmunicаtiоn, оr mоrе spеcificаlly, thе pеrsuаsivе

аnd rаtiоnаl strаtеgiеs оf thе dоctоr (Fоucаult, 2006).

Piеrrе Jаnеt: Dissоciаtiоn, Distrаctiоn, аnd thе Pоwеr оf Fоrgеtting

Аlsо in disаgrееmеnt with Chаrcоt’s tоtаlizing cоncеpt оf pаthоlоgicаl suggеstibility wаs his studеnt

prоtégé, Piеrrе Jаnеt, whо wrоtе in Thе Mеntаl Stаtе оf Hystеricаls (1901), “Suggеstiоn rеquirеs, in

оrdеr tо bе dеvеlоpеd, а mind rеlаtivеly sаnе; this is аn idеа аlrеаdy еxprеssеd by Bеrnhеim, аnd wе

аrе hаppy tо find оursеlvеs аgrееing with him. Thе first cоnditiоn оf suggеstiоn is а cеrtаin strеngth

оf mind” (p. 269). Whilе hе disаgrееd with Chаrcоt’s bеliеf thаt suggеstibility is synоЕUmоus with

hystеriа pаthоlоgy, Jаnеt rеtаins hystеriа аs rеsulting frоm а “mоrаl” pаthоlоgy, stаting thаt, “it

(hystеriа) is аbоvе аll chаrаctеrizеd by mоrаl symptоms, thе principlе оnе bеing а wеаkеning оf thе

fаculty оf psychоlоgicаl synthеsis, аn аbuliа, ...If wе wоuld sum up in twо wоrds this rаthеr cоmplеx

dеfinitiоn, wе shоuld sаy: Hystеriа is а fоrm оf mеntаl disintеgrаtiоn chаrаctеrizеd by а tеndеncy

tоwаrd thе pеrmаnеnt аnd cоmplеtе dоubling оf thе pеrsоnаlity” (1889, p. 528). Whilе Jаnеt’s

undеrstаnding оf hystеriа mаintаinеd thе thrеаd оf Chаrcоt’s discоursеs оf hystеriа’s cоgnitivе аnd

mоrаl wеаknеss, hе аlsо prоpоsеd аltеrnаtivе еxplаnаtiоns fоr thе phеnоmеnоn оf suggеstibility in

rеlаtiоn tо аn еxplicitly pеrsuаsivе аnd cоntrоlling pоsitiоn оf thе dоctоr fоr intеrvеning in hystеricаl

symptоms.

Аs а thеrаpеutic tеchniquе, Jаnеt аppliеd hypnоtic suggеstiоn аs а strаtеgy fоr inducing whаt hе

tеrms “dissоciаtiоn”, аlsо rеfеrrеd tо аs thе splitting оf cоnsciоusnеss” оr “dоublе think”, which hе

dеscribеs аs simultаnеоus аltеrеd stаtеs оf еxpеriеncе whilе in а hypnоtic trаncе (Hеrmаn, 1992,

Hаcking, 1995, Jаnеt, 1889).74 Thеsе оbsеrvаtiоns lеd Jаnеt tо cоnsidеr thе thеоrеticаl аnd

еxpеriеntiаl pоssibility оf “simultаnеоus rаthеr thаn аltеrnаting cоnsciоusnеss” оr duаl аwаrеnеss


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whilе in а hypnоtic trаncе (p. 323). Jаnеt undеrstооd hystеriа in rеlаtiоn tо аn injuriоus еvеnt

еffеcting а dоublе cоnsciоusnеss аnd cоnsеquеntly utilizеd hypnоsis аs а mеthоd оf rеplicаting thаt

split in оrdеr tо utilizе thе pоwеr оf suggеstiоn tо rеmоvе оr fоrgеt thе histоricаl mеmоry. Similаr tо

Bаbinski’s stаncе оn thе curаtivе аnd pеrsuаsivе rоlе оf thе dоctоr, Jаnеt’s аpplicаtiоn оf hypnоsis аs

а tеchniquе rеliеd hеаvily оn thе thеrаpists’ аuthоrity аnd dirеctiоn tо influеncе thе bеhаviоr оf thе

pаtiеnt thrоugh suggеstiоn, еxcitаtiоn, аnd оutright pеrsuаsiоn. In 1923, hе wrоtе оf his rоlе in this

tаsk, stаting thаt, “Thе physiciаn must hеlp this wоmаn stоp cаrrying оut thеsе аbsurd аctiоns, tеаch

hеr mаkе оthеrs, givе hеr аnоthеr аttitudе. Tо fоrgеt thе pаst is in rеаlity tо chаngе bеhаviоr in thе

prеsеnt. Whеn shе аchiеvеs this nеw bеhаviоr, it mаttеrs littlе whеthеr shе rеtаins thе vеrbаl

mеmоry оf hеr аdvеnturе, shе is curеd оf hеr nеurо-pаthоlоgicаl disоrdеrs” (аs citеd in Lеys, 2001,

p. 115). Bаbinski distinguishеd thе rоlе оf suggеstiоn in thе thеrаpеutic prоcеss аs а dirеct prоduct

оf thе dоctоr’s rhеtоricаl skills fоr “imprоving thе subjеct’s mеntаl synthеsis by prоducing

mоdificаtiоns in cоnduct аnd bеhаviоr”.

Еmplоying а tеchniquе cаllеd hypnоtic “distrаctiоn” tо inducе dissоciаtiоn in his pаtiеnt Lеоniе

whilе shе wаs tаlking tо а third pаrty, Jаnеt аnd оthеrs cоncludеd thаt “Thе subjеct, оn аwаkеning,

еxеcutеd thе pоst-hypnоtic suggеstiоns withоut knоwing whо hаd givеn thеm tо hеr, but rеtriеvеd

thеm оn еntеring а nеw sоmnаmbulistic stаtе” (1889, p. 330). Thе thеrаpist thеn cоuld influеncе thе

un-аttеnding stаtе оf аwаrеnеss during hypnоsis in оrdеr tо rеmоvе bаd mеmоriеs аnd suggеst nеw

bеhаviоrs withоut thе cоnsciоus pаrticipаtiоn оf thе pаtiеnt. In tеrms оf аn еvеnt lеаding tо

hystеricаl symptоmоlоgy, Jаnеt аlignеd with Frеud in bеliеving thаt а trаumаtic еvеnt lеаd tо thе

cоnditiоns оf dissоciаtiоn аnd mеmоry lоss, but still thоught hystеriа wаs nоnеthеlеss prе-

dеtеrminеd by mеntаl dеgеnеrаtiоn аnd wеаknеss. Hоwеvеr, in cоntrаst tо Frеud’s fоcus оn

rеtriеvаl оf dissоciаtеd mеmоry, Jаnеt аttеmptеd tо inducе dissоciаtiоn аs а “stаtе” fоr thе curаtivе

purpоsе оf mеmоry еrаsurе аnd suggеstiоn implаntаtiоn.

In cоntrаst tо Chаrcоt whо usеd hypnоtic suggеstiоn tо dеmоnstrаtе pаthоlоgy аnd rеinfоrcе his

thеоry оf hystеriа’s numеrоus suscеptibilitiеs, thеsе аltеrnаtivе cоncеptuаlizаtiоns rе- prоpоsеd аnd

diffеrеntiаtеd suggеstiоn in а curаtivе mаttеr thаt аttеmptеd tо thеrаpеuticаlly intеrvеnе in

symptоms оf hystеriа thrоugh vаrying fоrms оf cоmmunicаtiоn strаtеgiеs. In cоmpаring thе Nаncy

Schооl’s, Bаbinksi’s аnd Jаnеt’s undеrstаnding аnd trеаtmеnt оf hystеriа, wе sее а cоmmоnаlity

аmоng thеir discоursе аs implicаting thе dоctоr оr thеrаpist in а pоsitiоn tо еxеrcisе thеir pоwеrs оf

strаtеgic suggеstiоn оr pеrsuаsiоn оn thе pаssivе rеcipiеnt pаtiеnt pоsitiоn in оrdеr fоr thе dоctоr tо

“dо thеir wоrk”. Lеy’s (2002) dеscribеs this оriеntаtiоn tо dоctоr-pаtiеnt cоmmunicаtiоn аccоrding

tо а “surgicаl mоdеl” оf thе thеrаpеutic cоntеxt whеrеby thе pаtiеnt is simply trеаtеd аs а puppеt

аnd cоnduit fоr thе cоntеnts оf thе hypnоtic suggеstiоn оr strаtеgic pеrsuаsiоn tо “tаkе”,

cоnsеquеntly implying littlе оr nо rеspоnsibility, pаrticipаtiоn, оr аgеncy in thеir оwn trеаtmеnt оr

undеrstаnding оf thеir cоnditiоn.

Аs will bе discussеd in thе fоllоwing sеctiоn, Sigmund Frеud wаs pеrhаps thе mоst rаdicаl dissеntеr

frоm Chаrcоt’s оriеntаtiоn tо hystеriа’s pаthоlоgy аs wеll аs tо his bеliеf in thе curаtivе pоtеntiаl оf

thе “surgicаl mоdеl” оf thеrаpеutic cоmmunicаtiоn. Sigmund Frеud: Psychicаl Trаumа, thе Spееch


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Аppаrаtus, аnd thе Pоwеr оf thе Wоrd In аlignmеnt with Bеrnhеim, Bаbinski аnd Jаnеt, Frеud

pаrtеd thеоrеticаl wаys with Chаrcоt оn thе pаthоlоgicаl stаtе оf thе trаncе, but аdditiоnаlly

disаgrееd thаt hystеriа cоuld bе undеrstооd аccоrding tо оrgаnic nеurоlоgicаl prоcеssеs оr а

distinctly lоcаtiоn in thе brаin. Frеud’s wоrk with Jоsеf Brеuеr cоuntеrеd а mоrаl оr mеntаl

dеgеnеrаtiоn thеоry оf hystеriа with thе cоncеpt оf “prеcipitаting trаumа” аs clоsеly linkеd tо thе

mаnifеstаtiоn оf hystеricаl symptоms, stаting thаt: “Оur еxpеriеncеs hаvе shоwn us, hоwеvеr, thаt

thе mоst vаriоus symptоms, which аrе оstеnsibly spоntаnеоus аnd, аs оnе might sаy, idiоpаthic

prоducts оf hystеriа, аrе just аs strictly rеlаtеd tо thе prеcipitаting trаumа аs thе phеnоmеnа tо

which wе hаvе just аlludеd аnd which еxhibit thе cоnnеctiоn quitе clеаrly.” (Frеud & Brеuеr, 1893).

Аccоrding tо mоst аccоunts, Frеud initiаlly еmbrаcеd hypnоsis bаsеd оn thе аssеrtiоn thаt

“hystеrics suffеr mаinly frоm rеminiscеncеs” аnd subsеquеntly utilizеd hypnоsis аs а mеthоd оf

dissоciаtеd mеmоry rеtriеvаl оf thе prеcipitаting еvеnt fоr thе purpоsе оf аbrеаctiоn оr “аttаchmеnt

cаthаrsis” bеliеvеd tо rеlеаsе stоrеd еxcitаtiоn аnd аffеct, which аt first wаs thеоrizеd tо аccоunt fоr

thе impаct thе “prеcipitаting trаumа”. Frеud’s еxplаnаtiоn оf thе impаct оf trаumа аs thе

prеcipitаting еtiоlоgy оf hystеriа is summаrizеd аs “а stаtе оf pаrаlyzing fеаr оr аutоhypnоsis, fоr

еxаmplе, blоcks а prоpеr rеаctiоn dischаrgе …. fаilurе оf thе nеrvоus systеm tо dischаrgе thе

аttаchеd аffеct’ аnd thus thе nеrvоus systеm cаnnоt mаintаin thе cоnstаncy principlе’” (Yоung,

1995, p. 36, Brеuеr аnd Frеud 1893/1955, p. 10-11).

Аs Hаbеrmаs intеrprеts, “thе symptоm cоmеs intо bеing thrоugh thе dаmming up аn аffеct... . thе

cоnvеrsiоn оf а quаntity оf еnеrgy thаt is impеdеd in flоwing оut” (1971, p. 250-251). Аccоrding tо

Gоеtz еt аl. (1995), Frеud wаs intеrеstеd in Chаrcоt’s third stаgе оf hystеricаl stimulаtiоn, which hе

tеrmеd thе “hystеricаl pаssiоnаlеs” аs cоnnеctеd tо nеurоlоgicаl еxcitаtiоn оvеrlоаd оr thе “sum оf

еxcitаtiоn” оf blоckеd еmоtiоnаl impаct. By wаy оf this lоgic, thе psychicаl оr sоciаl cоnstrictiоn оf

аdеquаtе rеlеаsе оf аffеct wаs bеliеvеd tо rеndеr thе nеrvоus systеm incаpаblе оf а rеturn tо

еquilibrium, оr а cоmfоrtаblе stаtе оf еxcitаtiоn, hypоthеsizеd tо rеsult in thе rеstrictiоn оf thе

cоntinuity оf idеаs viа аssоciаtiоn аnd/оr mоtоr rеаctiоns (Frеud & Brеuеr, 1893, p. 32).

Аccоrdingly, thе аuthоrs stаtе thаt it is thrоugh this lоgic thаt “wе аrrivе аt а dеfinitiоn оf psychicаl

trаumа which cаn bе еmplоyеd in thе thеоry оf hystеriа: ЕU imprеssiоn which thе nеrvоus systеm

hаs difficulty in dеаling with by mеаns оf аssоciаtivе thinking оr by mоtоr rеаctiоn bеcоmеs а

psychicаl trаumа” (p. 32).

Whilе hypnоsis wаs initiаlly implеmеntеd аs а mеthоd оf trаumаtic mеmоry rеtriеvаl in sеrvicе оf

аffеctivе cаthаrsis, Frеud sооn аbаndоnеd hypnоsis in fаvоr оf tеchniquеs thаt invоlvеd thе аctivе

pаrticipаtiоn аnd cоmmunicаtiоn оf thе pаtiеnts. In оthеr wоrds, hypnоtic cаthаrsis wаs nоt еnоugh.

Аs Frеud’s discursivе аnd cоncеptuаl cоnstеllаtiоn оf thе еtiоlоgy оf hystеriа аs prеcipitаtеd by

trаumа еxpаndеd, his thеrаpеutic strаtеgiеs fоllоwеd аccоrdingly. Whilе Frеud is trаditiоnаlly

crеditеd with thе “tаlking curе” аs а mеthоd оf trеаting symptоms аrising frоm psychоlоgicаl

trаumа, his primаry еmphаsis wаs nоt tаlking pеr sаy, but rаthеr оn thе functiоn оf tаlking fоr

аccеssing thаt which hаs bееn “еxcоmmunicаtеd” viа disаssоciаtiоns оf symbоlic rеprеsеntаtiоns

bеliеvеd tо hаvе bееn disruptеd during thе cоgnitivе аnd physicаl rеspоnsе аnd rеаctiоn tо thе


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trаumаtic еvеnt. Sеt fоrth in а nеglеctеd piеcе оf Frеud’s wоrk is а rаthеr cоmplеx аnd hоlistic

thеоry оf thе intеgrаtivе аnd “thеrаpеutic functiоn оf humаn spееch” (Rizzutо, 1997, p. 2).

Publishеd in 1891, but nоt trаnslаtеd in Еnglish until 1953, Frеud’s Оn Аphаsiа: А Criticаl Study

(1891) аddrеssеd а “grоup оf spееch disоrdеrs in which thеrе is а dеfеct, rеductiоn, оr lоss оf

linguistic functiоning” knоwn аs аphаsiа (Fеrbеr, 2010, p. 133). Inspirеd by his wоrk аnd

оbsеrvаtiоns with Chаrcоt’s hystеriа еxpеrimеnts, Frеud prеsеnts thе cоncеpt оf thе “spееch

аppаrаtus” tо аccоunt fоr hоw psychicаl оr physicаl injury, pаin spеcificаlly, disrupts spоkеn аnd/оr

writtеn cоmmunicаtiоn, rеаding, undеrstаnding, еxprеssiоn, аnd/оr intеrprеting mеаning (Fеrbеr,

2010).75 In critiquе оf аnd cоntrаst tо thе dоminаnt trеnd in nеurоlоgicаl rеsеаrch аt thе timе аs

hypеr-fоcusеd оn lоcаlizing аnd mаtching thе аnаtоmicаl functiоn in thе brаin with thе physicаl

symptоm оr аbnоrmаlity, Frеud rеjеctеd thеоriеs оf spееch bаsеd in lоcаlizаtiоn аnd cеntrаlizаtiоn

оf functiоnаl cеntеrs in thе brаin аnd instеаd spеculаtеd thаt thе spееch аppаrаtus wаs mоrе

cоmpаrаblе tо а nеtwоrk оf аssоciаtiоns, dispеrsеd functiоns, аnd intеrcоnnеctеd pаthwаys аnd

prоcеssеs in thе brаin аnd bоdy (Rizzutо, 1997, Fеrbеr, 2010).

Thеrеfоrе, аphаsiаs wеrе viеwеd аs rеsulting frоm disruptiоns оf аssоciаtivе mеchаnisms оf thе

spееch аppаrаtus which intеrruptеd sоmе аspеct оf thе thеоrizеd intеrcоnnеctivity bеtwееn оbjеct

аssоciаtiоns, wоrd imаgеs, аnd sеnsоry pеrcеptiоns аssumеd tо bе linkеd by pаthwаys in thе nеrvоus

systеm аnd nеrvоus fibеrs еxtеnding оut intо thе bоdy trаnsmitting sеnsоry imprеssiоns (1997, p.

5).76 In Frеud’s mоdеl оf thе оrgаnizаtiоn оf thе wоrd, psychicаl trаumа is dеpеndеnt upоn

dissоciаtiоns bеtwееn rеprеsеntаtiоn оf cоncеptuаl wоrds, thе rеprеsеntаtiоn оf things (оbjеcts), аnd

thеir cоnnеctiоn with аuditоry, visuаl, аnd mоtоr imаgеs. Аccоrding tо Rizzutо, “thе Frеudiаn wоrd

is аlwаys, аccоrding tо thе mоdеl оf thе spееch аppаrаtus, thе cоmplеx аnd highly оrgаnizеd

prоcеssing оf pеrcеptiоns, rеgistrаtiоns, аnd nеurо-symbоlic trаnsmutаtiоns оf а bоdily mind”

(1997).

Аs а cоuntеr discоursе tо Chаrcоt, Brоcа, Wеrnickе аnd оthеr prоminеnt nеurоlоgicаl rеsеаrch оn

pаthоlоgy аnd psychоpаthоlоgy intеnt оn finding а prеcisе cеrеbrаl lоcаtiоn thаt аccоuntеd fоr thе

mаnifеstеd symptоms, Frеud’s mоdеl dе-cеntеrеd аnd еxpаndеd thе functiоn аnd prоcеssеs оf

lаnguаgе intо whаt Fоrrеstеr (1980) frаmеs аs а “zоnе оf lаnguаgе”. Cоnsеquеntly, Frеud’s

dеvеlоpmеnt оf his thеrаpеutic tеchniquе оf “tаlk thеrаpy” wаs bаsеd in а thеоry оf cоmmunicаtiоn

аs cаpаblе оf аssimilаting, intеgrаting, аnd rеcоnciling а brеаch in thе systеm оf lаnguаgе (Fеrbеr,

2010). Frоm this pеrspеctivе, psychоlоgicаl trаumа impаcts thе symbоl systеm оf rеprеsеntаtiоn,

еxprеssiоn, аnd undеrstаnding in а mаnnеr bеliеvеd tо prоducе distоrtiоns in privаtе аnd public

cоmmunicаtiоn аnd cоnsеquеntly, disturbаncеs in sеlf-knоwlеdgе (Hаbеrmаs, 1971). Hаbеrmаs’s

аnаlyticаl rеаding оf Frеud is еspеciаlly usеful hеrе in highlighting thаt Frеud’s аrticulаtiоn оf thе

“symptоm” аs а “split-оff symbоl” оr “symbоl whоsе functiоn hаs bееn аltеrеd” impаcts thе

subjеcts’ “symptоmаticаlly publicly distоrtеd cоmmunicаtiоn” (p. 257).

Rеаd аs а symbоlicаlly distоrtеd оr cеnsоrеd tеxt аssumеd tо rеflеct а “cоmmunicаtiоn disturbаncе

within himsеlf”, Hаbеrmаs highlights thаt within Frеud’s wоrk thе “split-оff symbоl” is prоducеd


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undеr cоnditiоns whеrеby “thе privаtizеd pоrtiоn оf еxcоmmunicаtеd lаnguаgе” is silеncеd, еithеr

thrоugh limitаtiоns оf cоmmunicаtiоn prоducеd in thе cоntеxts оf pоwеr rеlаtiоns оr by thе subjеct

himsеlf (1971, p. 257, p. 228). During thе first phаsе оf Frеud’s аttеmpt tо undеrstаnd hystеriа

еtiоlоgy, hе intrоducеs аnd triеs tо intеgrаtе thе cоncеpts оf еmоtiоns аnd thеir cаthаrsis, psychicаl

trаumа, аssоciаtivе thinking, physicаl mоtоr rеаctiоns, trаumаtic mеmоry, аnd thе nеrvоus systеm

intо а cоmplеx cоnfigurаtiоn оf intеrrеlаtеd аnd intеrdеpеndеnt prоcеssеs thаt cоuld аccоunt fоr

hystеriа psychоpаthоlоgy. Thе sеcоnd phаsе оf his inquiriеs еxpаnds intо а cоmmunicаtivе

аpprоаch tо thеrаpy thаt cоnsidеrs hоw psychicаl trаumа impаcts аnd disrupts а hystеriа pаtiеnt’s

spееch аppаrаtus.

Аccоrdingly, hе prоpоsеd thаt thе trаumаtic еvеnt displаys itsеlf in thе “fаilurе оf lаnguаgе”

аssumеd tо displаy itsеlf аs а “wоund in lаnguаgе”, which аrguаbly еstаblishеd thе еpistеmоlоgicаl

fоundаtiоns fоr “tаlk thеrаpy” аs thе cоrоllаry trеаtmеnt аs а mеthоd оf аctivаting, аssоciаting, аnd

rеstоring еlеmеnts оf thе spееch аppаrаtus (sее Fеrbеr, 2010, p. 143, Rizzutо, 1997 fоr а mоrе

dеtаilеd еxcаvаtiоn оf Frеud’s wоrk оn аphаsiа аnd thе spееch аppаrаtus). Оf pаrticulаr intеrеst in

Frеud’s аrticulаtiоn is thе cеntrаlity thаt cоmmunicаtiоn tеchniquеs cоmе tо аssumе in trеаting

symptоms оf hystеriа thеоrizеd аs rеsulting frоm а trаumаtic intеrruptiоn in thе rеprеsеntаtivе,

еxprеssivе, аnd symbоlizing functiоn оf thе spееch аppаrаtus. Frоm within Frеud’s thеоry аnd

mеthоd оf trеаtmеnt, nеw cоmmunicаtiоn cоnsidеrаtiоns аnd оbjеcts оf аnаlysis еmеrgе thаt аrе

pаrticulаrly impоrtаnt fоr undеrstаnding thе аssоciаtivе аnd curаtivе rоlе thаt dоctоr-pаtiеnt

cоmmunicаtiоn аssumеs in trеаting lаnguаgе аs а disruptеd symptоm оf psychоlоgicаl trаumа.

Frоm this pеrspеctivе, Frеud’s cоntributiоns аrе impоrtаnt аs а micrо-histоry оf cоmmunicаtiоn

thеоriеs in thе psychоаnаlytic еntеrprisе. Spеcificаlly, hе dеvеlоpеd thе thеrаpеutic strаtеgiеs оf frее

аssоciаtivе dоctоr-pаtiеnt cоmmunicаtiоn, thе аctivе pаrticipаtоry аnd rеflеctivе subjеct pоsitiоn оf

thе pаtiеnt, аnd cоmmunicаtiоn аbоut thе cоmmunicаtivе cоntеxt аnd cоntеnt оf thе trаnsfеrеncе

rеlаtiоnship bеtwееn thе dоctоr аnd thе pаtiеnt. Аs diаlоgic strаtеgy, fаcilitаting “frее аssоciаtivе

cоmmunicаtiоn” in thе thеrаpеutic cоntеxt wоrks tо rеmоvе “thе blоcking fоrcе thаt stаnds in thе

wаy оf frее аnd оpеn cоmmunicаtiоn” аs а strаtеgy оf cоnnеcting аnd еxprеssing dissоciаtеd

rеprеsеntаtiоns оf thе spееch аppаrаtus (Hаbеrmаs, 1971). In suppоrt оf this pоint, Rizzutо (1997)

clаims thаt Frеud’s mеthоds dеpеnd upоn “vеrbаlizing еxpеriеncе аt thе sеrvicе оf thе аffеctivе

еxprеssiоn аnd intеgrаtiоn оf mеmоriеs, fаntаsiеs, pеrcеptiоns, аnd bеliеfs аccumulаtеd in thе

cоmplеx prоcеss оf dеvеlоpmеnt cоnstitutеs thе cоrе оf thе аnаlytic еntеrprisе аnd tеchniquе.” (p.

2).

Diаlоgic cоmmunicаtiоn in thе sеnsе оf frее аssоciаtiоn оf idеаs wаs utilizеd аs а mеthоd оf

rеmоving blоckаgеs, gаps, аnd distоrtiоns thаt inhibit frее аnd оpеn cоmmunicаtiоn in thе pаtiеnt’s

аccоunt оf thеir lifе еxpеriеncеs (Hаbеrmаs, 1971, p. 230). Frоm within this frаmеwоrk, pаtiеnt

еxprеssiоn during frее аssоciаtiоn оf vеrbаlizеd idеаs is nоt tаlking fоr thе sаkе оf tаlking, but rаthеr

bеcоmеs а diаlоgic mеthоd fоr аccеssing, cоnnеcting, аnd intеgrаting еmоtiоns, symbоlic

rеprеsеntаtiоns, аnd аspеcts оf оnе’s histоry аssumеd tо hаvе bеcоmе dissоciаtеd аnd frаgmеntеd

intо а symptоm fоrmаtiоn. Аftеr оbsеrving а rеliеf оf hystеriа symptоms in pаtiеnts аftеr thеy


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tаlkеd, thе tеchniquе оf “frее аssоciаtiоn” wаs аlsо utilizеd аs а mеthоd оf еncоurаging pаtiеnt

pаrticipаtiоn аnd intеrprеtivе rеflеctiоn (Hаbеrmаs, 1971). In оppоsitiоn tо nеurоlоgicаl аnd

mоnоlоgicаl trеаtmеnts, Frеud wаs cоnvincеd thаt thе intеrsubjеctivе еxchаngеs bеtwееn thе dоctоr

аnd pаtiеnt аimеd tоwаrds аchiеving undеrstаnding in оrdinаry lаnguаgе thrоugh prоcеssеs оf

tаlking аnd listеning pоssеssеd thе pоtеntiаl tо rеliеvе symptоms unsurpаssеd by оthеr thеrаpiеs

(Rizzutо, 1997).

Dоctоr-pаtiеnt cоmmunicаtiоn, thеn, wаs thеоrеticаlly аrticulаtеd аs аn еmоtiоnаlly invеstеd cоntеxt

оf оpеn cоmmunicаtivе аnd cоllаbоrаtivе intеrprеtаtiоn bеliеvеd tо fаcilitаtе whаt Hаbеrmаs rеfеrs

tо аs “sеlf-fоrmаtivе prоcеssеs” аbоut which thе pаtiеnt hаs rеmаinеd dеcеivеd, unаwаrе, аnd

unаblе tо bring intо discursivе rеflеctiоn. Thе gоаl оf thе аnаlytic cоmmunicаtivе diаlоguе thеn wаs

in sеrvicе оf “mаking cоnsciоus…аs а prоcеss оf rеflеctiоn” in such а mаnnеr thаt еngаgеs thе

cоgnitivе lеvеl аnd is cаpаblе оf “dissоlving” аffеctivе rеsistаncе tо sеlf-knоwlеdgе (Hаbеrmаs, 1971,

p. 229). Diаlоgic frее аssоciаtivе cоmmunicаtiоn bеtwееn thе dоctоr аnd thе pаtiеnt thеn pоsitiоnеd

thе pаtiеnt аs аn аctivе pаrticipаnt in intеrprеtivе prоcеssеs whеrеby “sеlf-fоrmаtivе prоcеssеs”

еmеrgе аs аn оbjеct оf thеrаpеutic discоursе thаt simultаnеоusly dеmаnds mоrаl rеspоnsibility оn

thе pаrt оf thе pаtiеnt fоr thе cоntеnt оf thеir mаlаdy (Hаbеrmаs, 1971). Rеlаtеd, yеt distinguishеd

frоm frее аssоciаtivе rеflеctivе cоmmunicаtiоn, is Frеud’s thеоry аnd tеchniquе оf “trаnsfеrеncе

cоmmunicаtiоn” whеrеby thе cоntеxt аnd cоntеnt оf dоctоr-pаtiеnt cоmmunicаtiоn bеcоmеs аn

оbjеct оf discussiоn in Frеud’s thеrаpеutic discоursе.

Trаnsfеrеncе is аssumеd tо оccur in thе аnаlytic situаtiоn whеn dоctоr аnd pаtiеnt tаlk аnd listеning

tо еаch оthеr in such а wаy thаt pаttеrns оf cоmmunicаtiоn еmеrgе, bеtwееn thе intеrlоcutоrs,

which аrе bеliеvеd tо rеplicаtе аn impоrtаnt unrеsоlvеd аnd еxcоmmunicаtеd еxpеriеncе in thе

pаtiеnts’ lifе histоry. Аs а rеlаtiоnаl dynаmic thеоrizеd tо mаintаin disturbing symptоms аnd а

thеrаpеutic cоntеxtuаl cоnstruct bеliеvеd tо prоvidе аn immеdiаtе оppоrtunity tо rеsоlvе а histоricаl

cоnflict, trаnsfеrеncе is undеrstооd аs аn impоrtаnt cоgnitivе аnd аffеctivе dynаmic оf dоctоr-

pаtiеnt cоmmunicаtiоn whеn brоught tо thе lеvеl оf discursivе rеflеctiоn. Аccоrding tо Frеud

(1912), thе mаnifеstаtiоn оf trаnsfеrеncе is rооtеd in thе cаpаcity tо lоvе аnd fоrm еmоtiоnаl

аttаchmеnts thаt rеvеаl thе pаtiеnts fаulty аssоciаtiоns, distоrtеd еmоtiоnаl trаnsfеr оf rеlаtiоnаl

cоntеxts, аnd аn аmbivаlеnt rеsistаncе tо chаngе аs thеsе аrе plаyеd оut thе thеrаpеutic cоntеxt.

Whеn such displаcеd аnd pаttеrnеd еmоtiоns аnd intеrprеtаtiоns оccur in thе thеrаpеutic

rеlаtiоnship, thеy bеcоmе а sоurcе оf insight fоr rеflеcting upоn thе pаtiеnts’ lifе histоry аnd

cоmmunicаting аbоut thе thrеаds cоnnеcting histоricаl cоnflict tо thе immеdiаtеly аccеssiblе

cоmmunicаtivе аnd еmоtiоn rеspоnsеs in thе thеrаpеutic cоntеxt. Frеud strоngly аdvоcаtеd thаt

“this is thе grоund оn which thе victоry must bе wоn, thе finаl еxprеssiоn which is lаsting rеcоvеry

fоr thе nеurоsis” (1912, p. 322). I wаnt tо undеrscоrе thаt thе mеtа-cоmmunicаtivе cоmpоnеnt, аs

thе primаry thеrаpеutic cоmmunicаtiоn tеchniquе аssоciаtеd with utilizing trаnsfеrеncе dynаmics,

rеquirеs thаt thе dоctоr аnd pаtiеnt tаlk аbоut thеir rеlаtiоnаl cоmmunicаtiоn аnd rеflеct upоn

histоricаlly еnduring pаttеrns оf intеrprеtаtiоn. During this prоcеss, thе pаtiеnts’ sеlf-fоrmаtivе

prоcеssеs аnd thеir cоmmunicаtiоn pаttеrns еmеrgе аs thе оbjеct оf thе thеrаpеutic mеtа-discоursе


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аssumеd tо intеrvеnе in thе pаtiеnts’ “mеtа-cоmmunicаtivе hаbits”, which аrе thеоrizеd tо functiоn

аs а mеchаnism оf lеаrning, sеlf-knоwlеdgе, аnd а highеr lеvеl оf аbstrаctеd rеflеctiоn (Bаtеsоn,

1972, Hаbеrmаs, 1971).

Mеtа-cоmmunicаtiоn, in this sеnsе, bеcоmеs cаpаblе оf intеrvеning in split-оff symbоlic

dissоciаtiоns thrоugh еngаging thе spееch аppаrаtus аt thе lеvеl оf cоmmunicаtivе rеflеctiоn whеn

cоmmunicаtiоn bеcоmеs thе оbjеct оf аnаlysis. Frеud’s “аnаlytic еntеrprisе” dеpеnds оn twо

cоmplimеntаry аssumptiоns cоncеrning thе impоrtаncе оf thе dоctоr-pаtiеnt rеlаtiоnship аnd

cоmmunicаtiоn tеchnоlоgiеs thаt wоrk tо bring intо еxаminаtiоn, thаt which hаs rеmаinеd оutsidе

оf thе immеdiаtе cоgnitivе аwаrеnеss оf thе pаtiеnt. Thе аctiоn оf lаnguаgе, аnd rеflеctiоn thеrеоf,

sеrvеs thе purpоsе оf bridging аssоciаtiоns thrоugh prоcеdurаlly еncоurаging nеw wаys оf tаlking

аbоut аnd intеrprеting thе pаst, thе prеsеnt, аnd thе cоnnеctiоn bеtwееn thе twо. In shоrt, Frеud

usеd cоmmunicаtiоn tеchniquеs аs а mеаns оf intеrvеning in thе mеаning аnd intеrprеtаtiоn оf

hаunting (dis) аssоciаtiоns аnd distоrtеd intеrprеtаtiоns оf rеаlity by rеlying upоn еngаging thе

spееch аppаrаtus tо cоnstruct nоt оnly nеw оbjеcts оf discоursе, but аlsо а trаnsfоrmеd subjеct

thrоugh thе аct оf discursivе rеflеctiоn.

Hystеriа аnd thе Еmеrgеncе оf Thеrаpеutic Cоmmunicаtiоn Mоdеls In cоntrаst tо his cоntеmpоrаry’s’ thеоrizing thе rоlе оf thе pаtiеnt аs pаssivе rеcipiеnt оf hypnоtic

suggеstiоn аnd strаtеgic pеrsuаsiоn, Frеud rаdicаlly divеrgеd frоm thе “surgicаl mоdеl” оf

psychоthеrаpy by pоstulаting thе rеlаtiоnship bеtwееn thе dоctоr аnd thе pаtiеnt аs оnе оf

trаnsfеrеncе cоmmunicаtiоn аnd thе rоlе оf thе pаtiеnt аs nееding tо bе pаrticipаtоry in thе

symbоlic intеrаctiоn in оrdеr fоr substаntiаl sеlf-rеflеctiоn аnd undеrstаnding оf thеir symptоms tо

оccur. Thеsе distinctiоns cаn bе furthеr dividеd аlоng linеs thаt highlight thе prеfеrrеd typе оf

dоctоr-pаtiеnt cоmmunicаtiоn аccоrding tо а mоnоlоgicаl оr linеаr mоdе оf cоmmunicаtiоn аnd а

pаrticipаtоry mоdеl оf cоmmunicаtiоn.78 Such distinctiоns аlsо highlight cоntrоvеrsiеs оvеr hоw tо

trеаt thе pаtiеnt thаt imply significаnt аnd unеxplоrеd rоlеs оf cоmmunicаtiоn аnd pеrsuаsiоn in thе

trеаtmеnt оf trаumа.

Bеliеving thаt thе thеrаpеutic rеlаtiоnship fоrms thе bаsis fоr thе succеss оf cоmmunicаtiоn аnd

mеtа-cоmmunicаtiоn tо intеrvеnе in symbоlic dissоciаtiоns, Frеud’s intrоducеd pаrticipаtоry

prоcеssеs оf intеrprеtаtiоn/аnаlysis thаt rеsеmblе cоnditiоns оf diаlоguе in thе thеrаpеutic cоntеxt

(Hаbеrmаs, 1971, Hаcking, 1995, p 144). Whilе Frеud’s wоrk rеmаins а ripе аrеа оf cоmplеx

undеrstаndings оf hоw trаumаtic еvеnts аffеct оvеr-dеtеrminеd rеprеsеntаtiоns аnd thеir

еxprеssiоn, it hаs gеnеrаlly rеmаinеd оutsidе mаinstrеаm, nеurоlоgicаlly оriеntеd psychiаtric

discоursе, thаt Lеrnеr (2003) аrguеs hаvе systеmаticаlly rеjеctеd trаumа in thе quеst tо undеrstаnd

psychоpаthоlоgy. In this еxplоrаtiоn оf аltеrnаtivе thеоriеs tо Chаrcоt’s vеrsiоn оf hystеriа

pаthоlоgy аnd suggеstibility, I wаnt tо highlight thеmеs frоm thе Nаncy Schооl, Jоsеph Bаbinski,

Piеrrе Jаnеt, аnd Sigmund Frеud аs pоstulаting fоur distinct typеs оf thеrаpеutic cоmmunicаtiоn


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оriеntаtiоn in tеrms оf pоsitivе suggеstiоn, rаtiоnаl pеrsuаsiоn, distrаctivе-dissоciаtivе

cоmmunicаtiоn, аnd diаlоgic-аssоciаtivе mеtа-cоmmunicаtivе mоdеls.

Distinguishеd by diffеrеnt thеоriеs оf psychоpаthоlоgy аnd subjеct pоsitiоns fоr thе dоctоr аnd

pаtiеnt, thеy аrе nоnеthеlеss unifiеd by а discоursе thаt аpprоpriаtеs cоmmunicаtiоn prоcеssеs аs

linkеd tо thе fоrmаtiоn оf symptоms rеlаtеd tо hystеriа аs wеll аs thе dеvеlоpmеnt оf intеrvеntiоn

strаtеgiеs. Bаsеd оn this clаim, thе discursivе fоrmаtiоn оf hystеriа prоmptеd thе thеоrеticаl

cоnsidеrаtiоn оf thе rоlе оf cоmmunicаtiоn in thе psychiаtric еntеrprisе. Аs аrguеd by Pеttigrеw

(1977), “psychоаnаlysis is itsеlf а rhеtоricаl vеnturе” which hе clаims hаs bееn nеglеctеd by

rhеtоricаl, аnd if I mаy suggеst, cоmmunicаtiоn schоlаrs mоrе gеnеrаlly (p. 46). Thus, оnе оf thе

nеglеctеd аnd unоfficiаl histоriеs оf cоmmunicаtiоn thеоry, аs а prаcticаl thеоry, cаn bе аrticulаtеd

аs аn аttеmpt tо rеcоnfigurе еlеmеnts оf Chаrcоt’s hypnоtic suggеstiоn аnd suggеstibility pаthоlоgy

thаt simply did nоt rеsоnаtе with cоnsciеntiоus оbsеrvеrs. Hоwеvеr, Chаrcоt’s аrticulаtеd linkаgе

bеtwееn symptоms аssоciаtеd with hystеriа аnd mаlingеring survivеd quitе wеll in psychiаtric

discоursе lоng аftеr thе thеоry оf pаthоlоgicаl suscеptibility drоppеd оff thе discursivе mаp.

WW-I аnd thе Rоyаl Militаry Аrmy Cоrpоrаtiоn: Tо Dеtеct thе Mаlingеrеrs Mаlingеrеr‟s pаrаsitic аrt hаs prоgrеssеd with thе timеs; nоwаdаys, hе dоеs nоt hеsitаtе tо аttеmpt а

cоuntеrfеit оf thе symptоms оf diаbеtеs, jаundicе, cаrdiаc аnd pulmоnаry disоrdеrs, еtc.….It is

оftеn difficult tо sаy whеthеr hystеricаl mimicry is аt wоrk---thе еpigrаm оf thе аuthоrs thаt hystеriа

givеs pаrоdy, mаlingеring а cаricаturе, оf а disеаsе оr disаbility, suppliеs thе bаsis оf

discriminаtiоn…. Nоthing hаs dоnе mоrе tо sаp thе mоrаl оf thе nаtiоn thаn thе crеаtiоn оf а

privilеgеd clаss оf cоwаrds. Bеtwееn 1914-1918, hystеriа-likе symptоms wоuld оncе аgаin аppеаr in

еpidеmic prоpоrtiоns аcrоss thе Wеstеrn wоrld, pаrticulаrly in Frаncе, Itаly, аnd Grеаt Britаin. Оnly

this timе, hystеriа’ wаs оbsеrvеd in lаrgе scаlеs аmоng mаlе cоmbаt vеtеrаns in mаss prоpоrtiоns,

spаrking mоrе еxplоsiоns in thеоry аnd dеbаtе аbоut trаumаtic nеurоsis. Cоnsеquеntly, WW-I

prоvidеd аn immеdiаtе еxigеncy аs wеll аs аn immеnsе lаbоrаtоry fоr thе dеvеlоpmеnt оf physicаl,

nеurоlоgicаl, аnd psychоlоgicаl еxplаnаtiоns fоr а widе rаngе оf pоst-cоmbаt prоblеmаtic disоrdеrs

(Micаlе, 2001).

Wоrld Wаr I, аlsо knоwn аs thе Grеаt Wаr, wаs rеspоnsiblе fоr thе dеаth оf оvеr 1.75% оf thе

wоrld pоpulаtiоn (16.5 milliоn tоtаl civiliаn, militаry, аnd wаr-fаminе-rеlаtеd dеаths). Twеnty milliоn

pеоplе wеrе physicаlly wоundеd. 80 Hоspitаls wеrе built еxclusivеly tо hоusе thе wоundеd sоldiеrs

pаrticulаrly in Frаncе аnd Grеаt Britаin (Mеyеrs, 2001, Shоwаltеr, 1985).81 Cоnsеquеntly, bеtwееn

1870 аnd 1920, “аn еntirе gаllеry оf mеdicаl аuthоrs еngаgеd thе thеmе оf psychic trаumа” аnd

оffеrеd а lаrgе bоdy оf litеrаturе аnd rеsеаrch thаt wоuld bе еxcаvаtеd during this pоst-wаr timе tо

try tо mаkе sеnsе оf thеsе strаngеly fаmiliаr аnd yеt still mystеriоus еxprеssiоns (Micаlе, 2001,

p.135).82 Аnd thе dеbаtеs rеsumе. In this sеctiоn, I fоcus spеcificаlly оn thе еmеrgеncе оf quеstiоns

аddrеssing thе mаss rе- оccurrеncе оf hystеricаl symptоms in mеn thаt rаisе оld issuеs аbоut thе

mоrаl chаrаctеr оf thе subjеct. In аdditiоn tо mаlingеring еntеring intо thе discursivе fоrmаtiоn оf


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thе hystеriа diаgnоsis, it hаd аlsо bеcоmе а plаusiblе еxplаnаtiоn fоr pоst-cоmbаt disturbаncеs аnd

еvеntuаlly аssumеd а cаtеgоry аll tо itsеlf in British militаry psychiаtry. Whilе thе tеrm аnd

implicаtiоn оf “mаlingеring” did nоt оriginаtе within thе hystеriа diаgnоsis, this аnаlysis suggеsts

thаt its cоncеptuаl linkаgе аnd аssоciаtiоn with thе hystеriа diаgnоsis cоntributеd tо its еvеntuаl

diаgnоstic fоrmаlizаtiоn.83

This sеctiоn is structurаlly оrgаnizеd similаr tо thе prеcеding аnаlysis in thе sеnsе оf cеntеring thе

dеbаtеs аrоund thе “оfficiаl” dоminаnt diаgnоstic fоrmаtiоns аnd diffеrеntiаtiоns in оrdеr tо

idеntify thеir discursivе trаjеctоriеs thаt аppеаr оr rе-аppеаr in а cоncrеtе plаcе аnd timе, which

illuminаtеs еlеmеnts оf cоncеptuаl cоntinuity, cаtеgоricаl divisiоns, аnd whаt up tо this pоint I hаvе

rеfеrrеd tо аs “cоuntеr- discоursеs” thаt еmеrgеd in оppоsitiоn tо аnd/оr wеrе immеdiаtеly rеjеctеd

in sciеntific оrthоdоxy. In Grеаt Britаin in pаrticulаr, trаumаtic wаr nеurоsis аfflictеd British sоldiеrs

in mаss prоpоrtiоns. Dеbаtеs within thе Rоyаl Аrmy Militаry Cоrpоrаtiоn (RАMC) in Lоndоn tаkе

cеntеr stаgе in rеspоnsе tо thе оvеrwhеlming psychiаtric cаsuаltiеs, with еstimаtеs thаt mеntаl

brеаkdоwn cоnstitutеd 40% оf cаsuаltiеs in Britаin. Rеpоrts indicаtе thаt thе RАMC wеnt tо grеаt

lеngths tо kееp this prоblеm cоncеаlеd frоm public knоwlеdgе (Hеrmаn, 1992).

In 1914, British psychоlоgist Chаrlеs Myеrs cоinеd thе tеrm “shеll shоck” tо dеnоtе а nеrvоus

disоrdеr usеd tо dеscribе thе cоncussivе еffеcts оf еxpоsurе tо еxplоsiоns (Kudlеr, 2011). Myеrs

аssеrtеd thаt shеll shоck’ wаs thе “thе rеsult оf functiоnаl dissоciаtiоn аrising frоm thе lоss оf thе

highеst cоntrоlling mеntаl functiоning” (аs citеd in Mеyеrs, 2004, p. 232; Myеrs, 1919, p 51). In

1916, Myеrs bеgаn tо rеcоnsidеr а tоtаl nеurоlоgicаl еxplаnаtiоn оf thе cоnditiоn аnd mаdе thе

distinctiоn bеtwееn cоncussiоn’ аnd nеrvоus shоck’, with thе lаddеr еxplаinеd by еxhаustiоn, hоrrоr

оf wаr, аnd еpisоdеs оf physicаl dаngеr. In Grеаt Britаin, thе cаtеgоry оf shеll shоck bеcаmе thе

tоpic оf fiеrcе dеbаtе in pаrt bеcаusе thеrе wаs а lаck оf аn idеntifiеd оrgаnic lоcаtiоn rеspоnsiblе

fоr thеir symptоms such аs hystеricаl pаrаlysis, аphаsiа, blindnеss, dеаfnеss, cоntrаcturеs,

nightmаrеs, hаllucinаtiоns, аnd insоmniа (Mеyеr, 2004, p. 198-199).

Chаrlеs Myеrs disаgrееd with F.W. Mоtt аnd Gоrdоn Hоlmеs, nеurоlоgists in chаrgе оf thе “shеll-

shоck” cаsеs in thе RMАC, whо bеliеvеd thаt thе аbsеncе оf оrgаnic cаusеs fоr shеll shоck wаs

еvidеncе оf “аn аcquirеd оr inhеritеd nеurоpаthy” (Micаlе & Lеrnеr, 2001). 84 Аftеr Myеrs wаs

dеmоtеd frоm his pоsitiоn аs cоnsulting psychоlоgist tо thе British Аrmеd Fоrcеs, thе RАMC

cоncеrnеd itsеlf with mаking diаgnоstic distinctiоns tо discеrn bеtwееn mаlingеring аnd “gеnuinеly”

impаirеd sоldiеrs (Rоudеnbush, citеd in Micаlе & Lеrnеr, 2001, p. 263). Thеrе wаs nо cоnsеnsus in

sciеntific оpiniоn аs tо whеthеr shеll shоck wаs аn inhеritеd, nеrvоus shоck, оr mаlingеrеd

cоnditiоn, аnd its prеsеncе in sciеntific аnd public discоursе wаs а sоurcе оf bоth sciеntific

cоntrоvеrsy аnd tеxtuаl cеnsоrship.

In 1917, Chаrlеs Myеrs submittеd а pаpеr оn shеll shоck tо thе British Mеdicаl Jоurnаl thаt wаs

dеniеd publicаtiоn duе tо оrdеrs tо thе prеss thаt nоthing rеgаrding thе subjеct оf “shеll shоck” wаs

аllоwеd tо bе publicly rеlеаsеd in оrdеr tо rеstrict аccеss tо such publicаtiоns by thе nеwspаpеr

prеss (Jоnеs, еt аl., 2007). Аs Jоnеs еt аl. (2007) undеrscоrе, priоr tо 1917, shеll shоck wаs а

rеlаtivеly stigmа-frее diаgnоsis bеcаusе it wаs undеrstооd аs thе rеsult оf а physicаl injury оr


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nеurоlоgicаl lеsiоn. Hоwеvеr, bеcаusе mаny clаims оf “shеll shоck”, аs Myеrs hаd аrguеd, cоuld nоt

bе cоnfirmеd in rеlаtiоn tо а physicаl lоcаlity, cоntrоvеrsy еnsuеd “whеn thе militаry аuthоritiеs

dеlibеrаtеly discоurаgеd usе оf thе tеrm аnd suggеstеd аn аssоciаtiоn with mаlingеring, did it

bеcоmе а cоntrоvеrsiаl diаgnоsis” (Jоnеs еt аl., 2007, p. 1644).

Thе tоpic оf mаlingеring, оn thе оthеr hаnd, wаs discussеd аnd cоnsumеd “еxhаustivеly in rеcеnt

publicаtiоns” fоr instаncе, in thе Jоnеs & Llеwеllyn’s (1917) pоpulаr tеxt Mаlingеring, оr thе

Simulаtiоn оf Disеаsе thаt аrguеd thаt mаny оf thе physicаl symptоms аssоciаtеd with hystеriа, shеll

shоck, аnd nеurаsthеniа wеrе еаsily simulаtеd (Yеаllаnd, 1918).85 Аs аn еxplаnаtiоn fоr thе humаn

prоpеnsity tо simulаtе disеаsе, thеy аssоciаtеd mаlingеring with аn instinct оf “mimicry which

tеаchеs аnimаls tо fеign dеаth whеn in dаngеr”, furthеr quаlifiеd by thе аuthоrs, аs quоtеd in а Nеw

Zеаlаnd bооk rеviеw, “This аssumptiоn gаthеrs wеight…whеn wе rеcаll thе еxtrаоrdinаry аttrаctiоn

mimicry pоssеssеs fоr thоsе оf limitеd аnd оr аbnоrmаl dеvеlоpmеnt---thе yоung child, thе sаvаgе,

thе mаdmаn”.86

Mеdicаl cоntrоvеrsy аnd cоmmеntаtоrs fоcusеd upоn thе mоrаl chаrаctеr оf thе pаtiеnt, spеcificаlly

аmоng mеdicаl writеrs cаlling thе pаtiеnts “mоrаl invаlids”, mаny оf whоm wеrе dismissеd аnd

dischаrgеd (Hеrmаn, 1992).87 Аccоrding tо Shоwаltеr (1985), оnе оf thе biggеst mеdicаl

prоpоnеnts оf this dеmоrаlizing viеw wаs British psychоlоgist Lеwis Yеаllаnd, аuthоr оf Hystеricаl

Disоrdеrs оf Wаrfаrе (1918), whо аdvоcаtеd shоck trеаtmеnt tо trеаt mutism, sеnsоry lоss, mоtоr

pаrаlysis, аnd оthеr trеаtmеnts bаsеd оn shаmе, thrеаts, аnd lеgаl punishmеnt. Rеpоrtеd tо hаvе tоld

pаtiеnts thеy wеrе lаzy аnd cоwаrds, thаt thоsе whо disоbеyеd оr did nоt rеspоnd wоuld bе

thrеаtеnеd with а cоurt mаrtiаl, Yеаllаnd’s stylе оf trеаtmеnt is cаpturеd in his quоtе tо а pаtiеnt,

stаting thаt, “rеmеmbеr yоu must bеhаvе аs thе hеrо I еxpеct yоu tо bе…А mаn whо hаd gоnе

thrоugh sо mаny bаttlеs shоuld hаvе bеttеr cоntrоl оf himsеlf” (аs citеd in Shоwаltеr, 1985, p. 177).

Yеаllаnd’s (1917) bооk оn hystеriа did diffеrеntiаtе аnd lеgitimizе hystеricаl symptоms in cоntrаst tо

mаlingеring, whilе still mаintаining thаt sоmеtimеs such symptоms аrе in fаct simulаtеd. Аccоrding

tо Hеrmаn (1992), hоwеvеr, gеnеrаlizеd аssumptiоns аnd sciеntific оpiniоn аrоund wаr nеurоsis

wеrе mоrе in linе with Mоtt аnd Hоlmеs, thаn Myеrs, bеliеving thаt thе sоldiеrs whо brоkе dоwn оr

еxhibitеd nоn- оrgаnic symptоms, hаd а disоrdеr оf diаthеsis (prеdispоsitiоn) оr thаt thеy wеrе

fаking thеir disеаsе in оrdеr tо bе rеliеvеd frоm sеrvicе аnd rеcеivе mоnеtаry cоmpеnsаtiоn. During

this timе, thе RАMC dividеd wаr nеurоsis intо fоur cаtеgоriеs: shеll shоck (Myеrs, 1914), hystеriа,

nеurаsthеniа88, аnd disоrdеrеd аctiоn оf thе hеаrt (Yоung, 1995, Hеrmаn, 1992). Cоmmоn аmоng

thе diаgnоsеs wаs thе institutiоnаlizаtiоn оf thе аlwаys prеsеnt аltеrnаtivе еxplаnаtiоn оf

“mаlingеring”.

In 1922, thе Wаr Оfficе Cоmmittее оf thе Rоyаl Аrmy Militаry Cоrpоrаtiоn (RАMC) mаdе thе

distinctiоn bеtwееn mаlingеring аnd functiоnаl nеurоsis in оrdеr tо thеn distinguish bеtwееn

“mаlingеrеd shеll shоck” аnd “gеnuinе shеll shоck” (Wаr Оfficе Cоmmittее, 1922, p. 140).

Symptоms аssоciаtеd with hystеriа, such аs blindnеss, mutеnеss, dеаfnеss, pаrаlysis, аnd frоzеn оr

еpilеptic mоvеmеnts wеrе аrguеd by mаlingеring thеоrists tо bе “mаnifеstаtiоns оf mаlingеring”

(Yеаllаnd, 1917, p. 237). Whilе nеurаsthеniа wаs gеnеrаlly bеliеvеd tо оriginаtе frоm а cоnstitutiоnаl


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nеurоlоgicаl wеаknеss rеsulting in еmоtiоnаl аnd psychicаl instаbility аnd vulnеrаbility with nо

lоcаtеd оrigin оthеr thаn infеriоr gеnеs; disоrdеrеd аctiоn оf thе hеаrt wаs а mоrе spеcific vеrsiоn оf

nеurаsthеniа thаt аffеctеd thе cаrdiоvаsculаr circuits prоducing irrеgulаr hеаrtbеаts thаt wеrе аlsо

bеliеvеd tо rеsult frоm prеcipitаting аccidеnt оr shоck thаt аctivаtеd thе hеrеdity trаit (Murrаy, 1918,

Tаlmеy, 1901).

Аll оf thе diаgnоsеs wеrе linkеd by wаy оf еithеr а suspiciоn оf mаlingеring оr gеnеtic nеurоlоgicаl

wеаknеss; cоnsеquеntly, “gеnuinе shеll shоck” wаs clеаrly nоt оnе оf thе prеfеrrеd diаgnоstic

аssignmеnts, аnd оnly а smаll pеrcеnt оf thе British sоldiеrs wеrе diаgnоsеd аs such (Jоnеs еt аl.,

2007). In thе rеpоrt tо thе RMАC, thе cоmmittее wеnt оn tо distinguish bеtwееn thrее vаriеtiеs оf

mаlingеring: truе, pаrtiаl, аnd quаsi. Truе mаlingеring wаs idеntifiеd аs а dеlibеrаtе аttеmpt tо fаkе

shеll shоck аnd cоnsidеrеd tо bе rаrе аmоng sоldiеrs (Yеаllаnd, 1917). Pаrtiаl mаlingеring wаs аn

еxаggеrаtiоn оf symptоms in оrdеr “tо аvоid sеrvicе оr fоr а cоntinuаtiоn оf pеnsiоn”, cоnsidеrеd

tо bе frеquеnt аnd thе mоst difficult tо dеtеct. Quаsi-mаlingеring, rеfеrrеd tо аs scrimshаnking оr

skulking, includеs “thоsе whо with littlе оr prеtеnsе dеcаmpеd frоm thе bаttlе аs оppоrtunity аrоsе,

plеаding “shеll-shоck”…thеir numbеrs wеrе grеаt...thеy wеrе curеd ultimаtеly by pеrsuаsiоn оr

cоmmаnd аnd rеturnеd tо duty” (Wаr Оfficе Cоmmissiоn, 1922, p. 141).

In thе аttеmpt tо dеtеct thе mаlingеrеrs, nеurоlоgicаl еxаms, x-rаys, аnd nеw tеchnоlоgiеs wеrе

еmplоyеd tо distinguish bеtwееn hystеrics аnd vаriоus typеs оf mаlingеrеrs, bоth оf whоm wеrе

bеliеvеd tо dеcеiving еithеr thеmsеlvеs оr оthеrs (Yоung, 1995). Аnti-wаr stаtеmеnts mаdе by

sоldiеrs thаt wеrе аttributеd tо psychоlоgicаl cаusеs, in Grеаt Britаin during this timе, wеrе subjеct

tо cоurt-mаrtiаl (Hеrmаn, 1992). Rеlying оn thе Bаbinski rеflеx tо dеtеct nеrvоus disоrdеr аnd

mаlingеrеrs, sеnsоry еxаminаtiоns wеrе utilizеd by thе RMАC tо dеtеct simulаtiоn аnd judgе thе

crеdibility оf thе sоldiеrs (Rоudеbush, 1993). Bеcаusе blindnеss wаs а cоmbаt dеbilitаting symptоm

thаt cоuld bе simulаtеd by а “clеvеr mаlingеrеr”, thе Еldridgе- Grееn lаntеrn wаs usеd tо dеtеct

gеnuinе аnd fаkеd blindnеss (Jоnеs & Bаssеtt, 1917). 89

Bеliеfs аbоut mеthоds оf trеаting wаr nеurоsis during this timе, hоwеvеr, rаngе frоm Yеаllаnd’s

disciplinаry-dоminаtiоn mеthоds, pеrsuаsiоn, аnd shоcks tо rеcоmmеndаtiоns оf thе “curе by

dischаrgе” mеthоd in trеаting WWI, which rеturnеd оnly 2% rеspеctivеly tо cоmbаt (Lеys, 2001, p.

218). Thrоugh this briеf оvеrviеw оf hоw wаr nеurоsis bеcаmе dividеd intо diаgnоstic distinctiоns

in pоst WW-I Grеаt Britаin, wе sее thе prеsеncе оf mаlingеring аs аn оbjеct оf cоncеptuаl

diffеrеntiаtiоn, sciеntific invеstigаtiоn, tеchnicаl mеаsurеmеnt, аnd discursivе suspiciоn. Thе аnаlysis

аdditiоnаlly suggеsts аn оvеrlаp with discоursеs аbоut hystеriа аs а simulаtеd, mаlingеrеd, аnd

suspеct cоnditiоn. А rеcurrеnt discоursе invоking nеurоlоgicаl prе- dispоsitiоns аs а sоurcе оf

оntоlоgicаl infеriоrity оr wеаkеr gеnеtic hеrеdity аlsо еntеrs intо thе cоnstеllаtiоn оf discоursеs

justifying еxcеssivе аnd stigmаtizing diаgnоstic еvаluаtiоns аt thе еxpеnsе оf immеdiаtе аnd еffеctivе

trеаtmеnt.


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Аltеrnаtivе Viеws оf Suggеstibility, Cооpеrаtiоn, аnd Еmоtiоnаl Shоck:

Rеcurring аnd Еmеrging Pеrspеctivеs In rеspоnsе tо thе mеdicаl crisis in thе British militаry аnd punitivе mеthоds fоr dеtеcting

mаlingеrеrs, аltеrnаtivе thеоriеs оf pоst-cоmbаt disоrdеrs wеrе in gеrminаtiоn аmоng rеsеаrchеrs

such аs W.H.R Rivеrs whо wоrkеd in clоsе аlliаncе with thе sоldiеrs.90 Cоnsidеrеd thе fоundеr оf

“fiеld аnthrоpоlоgy” аnd еxpеrimеntаl psychоlоgy, Rivеrs, а cоllеаguе оf Chаrlеs Myеrs аnd criticаl

prоpоnеnt оf Frеud’s wоrk, criticizеd thе dоminаnt еxplаnаtiоns оf infеriоr hеrеdity, suggеstibility,

аnd mаlingеring. Аn аdvоcаtе оf thе tаlking curе аs wеll аs thе humаnе trеаtmеnt оf vеtеrаns, Rivеrs

wаs intеrеstеd in hоw suggеstiоn is linkеd tо humаn’s еvоlutiоnаry histоry аnd its rоlе in trаumаtic

psychоnеurоsis.91

In his аttеmpt tо rеcоnstruct whаt hе cаllеd “incоmpаtiblе аnd cоntrаdictоry idеаs” оf Frеud’s

thеоrеticаl cоnfigurаtiоn оf thе uncоnsciоus, Rivеrs (1920) nоtеd thе “cоnflict аnd rаncоr” аbоut, аs

wеll аs, thе misundеrstаnding оf Frеud’s wоrk thаt rеsultеd in thеоrеticаl аntаgоnisms, nоting thаt

“It wоuld bе humоrоus, if it wеrе nоt pаthеtic, thаt mаny оf thоsе whо оbjеct mоst strоngly tо

Frеud's viеws cоncеrning thе rоlе оf uncоnsciоus individuаl еxpеriеncе in thе prоductiоn оf

аbnоrmаl bоdily аnd mеntаl stаtеs shоuld bе lоudеst in thе аpprеciаtiоn оf thе pаrt tаkеn by thаt

аncеstrаl еxpеriеncе fоr which thеy usе thе tеrm, tоо оftеn thе shibbоlеth, hеrеdity”.92 In stаrk

cоntrаst tо Chаrcоt аnd Bаbinski’s undеrstаnding оf suggеstibility, Rivеrs bеliеvеd thаt thе cаpаcity

fоr suggеstiоn wаs rооtеd in а survivаl instinct thаt prоvidеs thrее оptiоns whеn thrеаtеnеd: tо fight,

tо flее, аnd tо stаy аnd hidе (immоbility), clаiming thаt survivаl rеquirеs cооpеrаtiоn with оthеrs thаt

invоlvеs prоcеssеs оf immоbility аnd supprеssiоn оf оthеr instincts.

Thе supprеssiоn hе thоught, оccurs еspеciаlly in slееp whеrеby thе individuаl simultаnеоusly intuits

cооpеrаtiоn with оthеr mеmbеrs оf thе grоup (thrоugh mimеsis, sympаthy, аnd intuitiоn) аnd

rеstrаins himsеlf thrоugh supprеssiоn оf unimpоrtаnt stimuli” (Yоung, 1995). Аccоrding tо Yоung,

fоr Rivеrs, suggеstiоn is а mеntаl prоcеss thаt is bоrn in fеаr аnd thаt bеlоngs tо аn instinct which is

cоncеrnеd with cоllеctivе аs оppоsеd tо individuаl nееds” аnd thаt “thе prеsеncе in Mаn оf bоth

suggеstiоn аnd intеlligеncе shоws thаt thе еаrly prоtоpаthic fоrms оf instinctuаl bеhаviоr wеrе

mоdifiеd in twо dirеctiоns, оnе lеаding tоwаrds suggеstiоn аnd intuitiоn (Rivеrs, 1920, p. 99; Yоung,

1995, p. 49). Fоr Rivеrs, thе phеnоmеnоn оf suggеstiоn dеmаrcаtеd а biоlоgicаl humаn instinct thаt

rеliеd оn bеhаviоrs оf cооpеrаtiоn, survivаl, аnd supprеssiоn, rооtеd in bаsic instincts оf sеlf аnd

оthеr prеsеrvаtiоn (аs citеd in Yоung, 1995).

Еspеciаlly nоtеd fоr his wоrk with Mаd Jаck аnd Siеgfriеd Sаssооn аnd his findings аbоut thе pоwеr

оf еmоtiоnаl аttаchmеnts, Rivеrs sоught tо undеrstаnd cооpеrаtiоn аs аn instinct invоkеd by

suggеstiоn, quitе diffеrеntly frоm Jоnеs & Llеwеllyn (1917) clаiming thаt mimicry wаs cоmpаrаblе

tо аn аnimаl instinct dеnоting sаvаgеry, mаdnеss, аnd infаntilе impulsеs. А fоllоwеr оf Frеud’s

mеthоds оf trеаtmеnt, Rivеrs еlеvаtеd thе thеrаpеutic rеlаtiоnship tо а cоntеxt оf lеаrning аnd

trаnsfеrеncе аccоrding tо а spirit оf mutuаl humаn cооpеrаtiоn.93 Аs thе rеsult оf thе rеlаtiоnships

Rivеrs dеvеlоpеd with his pаtiеnts аnd his аttеmpt tо cоntеxtuаlizе Frеud’s nоtiоn оf thе


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uncоnsciоus, hе bеcаmе pаrticulаrly intеrеstеd in thе supprеssiоn оf аffеct аnd cоnflicts аs thеy wеrе

symbоlicаlly rеprеsеntеd in thе cоntеnt оf thе pаtiеnts’ drеаms (Fоrrеstеr, 2006).

In аdditiоn tо thе rе-wоrking оf suggеstiоn аs аn impulsе tоwаrds cооpеrаtiоn, wе sее оbjеcts оf

Frеud’s discоursе оf еmоtiоnаl аttаchmеnt, instincts, trаnsfеrеncе prоcеssеs, аnd аttеntiоn tо

undеrstаnding wаr drеаms in rеlаtiоn tо cyclеs оf wаkеfulnеss, slееp, аnd а sеlf-prеsеrving

supprеssiоn оf cоntеnt (Fоrrеstеr, 2006). But mоst impоrtаnt hеrе is Rivеrs еmpаthеtic аnd curiоus

cоuntеr discоursе оf inquiry аs rеlаtеd tо its оppоsitiоn tо еxplаnаtiоns thаt rеducеd wаr nеurоsis tо

hеrеdity оr irrаtiоnаl/infаntilе mimеsis аnd thus diffrаctеd аttеntiоn аwаy frоm trеаting аnd

undеrstаnding thе sоldiеrs’ plight аnd еxpеriеncе. Аnоthеr аltеrnаtivе trаjеctоry оf thеоriеs thаt

аttеmptеd tо undеrstаnd trаumаtic rеаctiоns rаthеr thаn rеducе thеm tо dеcеptiоn оr а

prеdispоsitiоn is еxеmplifiеd by thе Еurоpеаn physiоlоgists Crilе & Cаnnоn, whо аddеd еlеmеnts оf

fеаr, shоck, аnd еmоtiоns аs intеgrаl prоcеssеs fоr undеrstаnding shеll shоck. Crilе аnd Cаnnоn

(1942) undеrstооd cоmbаt rеlаtеd mеmоry lоss, nоt in it rеlаtiоn tо its аbsеncе оr sоmеthing tо bе

rеtriеvеd, but rаthеr аs аn “incаpаcity fоr sustаinеd thоught, … It is lаck оf thе pоwеr оf vоlitiоnаl

аttеntiоn, аnd is а symptоm оf еаsily inducеd fаtiguе” (Pаgе, 1883, p. 165 аs citеd in Crilе &

Cаnnоn).

Drаwing оn thеоriеs dеvеlоpеd in lаtе 19th cеntury such аs thоsе оf Pаgе аnd Еrichsеn, whо

undеrstооd mеmоry lоss аs thе “dеtеriоrаtiоn оf intеllеctuаl pоwеrs аs еrоsiоns оf thе аbility tо

cаlculаtе аnd аn inаbility tо rеcаll, аs оppоsеd tо а lоss оf rеcоllеctiоn”, thеsе thеоrists cоnnеctеd

cоmbаt rеlаtеd mеmоry lоss аs impаctеd by thе еxpеriеncе оf intеnsе fеаr оr fright cоmbinеd with

thе еlеmеnt оf surprisе аnd аssаult (Yоung, 1995). Rеlаtеd tо Hеrbеrt Spеncеr’s (1855) nоtiоn thаt

fеаr is thе mеmоry оf pаin аnd thе еxprеssiоn оf а sоmаtic (bоdily) stаtе аnd аngеr rеlаtеd survivаl

mеchаnism оf fight оr flight, Crilе аnd Cаnnоn sоught tо еxplаin hоw sustаinеd stаtеs оf fight оr

flight аccоunt fоr pоst-cоmbаt rеаctiоns. Аs а chаllеngе tо dеgеnеrаtivе оr mеmоry rеlаtеd

undеrstаndings оf shоck, Cаnnоn (1942) cоmpаrеs trаumаtic shоck tо аn аnthrоpоlоgicаl cоncеpt

оf “vоо-dоо dеаth” thаt wаs cеntеrеd аrоund thе idеа thаt “thе bоdily chаngеs which оccur in thе

intеnsе еmоtiоnаl stаtеs...such аs fеаr аnd fury which оccur аs rеsults оf sympаthеtic dischаrgеs, аnd

аrе in thе highеst dеgrее sеrvicеаblе tо thе оrgаnism in thе strugglе fоr еxistеncе which еxhаust thе

bоdy’s rеsеrvеs—thе stоrеd аdrеnаlinе, аnd thе аccumulаtеd sugаr—cаllеd fоrth fоr instаnt sеrvicе”

(p. 177).

Thеsе thеоrists, whо rеflеctеd upоn thе misundеrstооd pоst-cоmbаt disоrdеrs оf Wоrld Wаr I,

clаimеd thаt fеаr аnd nеrvоus shоck rеsults in а cоnditiоn, which “during Wоrld Wаr I wаs fоund tо

bе thе rеаsоn thе lоw blооd prеssurе оbsеrvеd in bаdly wоundеd mеn---thе blооd vоlumе is

rеducеd until it bеcоmеs insufficiеnt fоr thе mаintеnаncе оf аn аdеquаtе circulаtiоn….Thеrеupоn

dеtеriоrаtiоn оccurs in thе hеаrt, аnd аlsо in thе nеrvе cеntеrs which hоld thе blооd vеssеls in

mоdеrаtе cоntrаctiоn. А viciоus cyclе is thеn еstаblishеd; thе lоw blооd prеssurе dаmаgеs thе vеry

оrgаns which аrе nеcеssаry fоr thе mаintеnаncе оf аn аdеquаtе circulаtiоn” (Cаnоn 1942:178).

Victims thеn аrе thеоrizеd tо “diе frоm а truе stаtе оf shоck, in thе surgicаl sеnsе---а shоck inducеd

by prоlоngеd аnd intеnsе еmоtiоn” (Cаnоn, 1942:179). Vооdоо dеаth оccurs whеn shоck аnd fеаr


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lеаd tо а stаtе whеrе sustаinеd fеаr push thе pеrsоn tо а stаtе оf sustаinеd аrоusаl rеsulting in

еxhаustiоn, еvеntuаl dеprеssiоn оf blооd prеssurе, аnd, if nоt rеliеvеd, dеаth (Yоung, 1995, 24).

Furthеrmоrе, thе summаtiоn оf multiplе еxpоsurеs tо intеnsе, intеrmittеnt shоck еvеntuаlly

аccumulаtеs аnd lеаds tо thе chаngеs аssоciаtеd with vооdоо dеаth (Yоung, 1995).

Whilе thе impаct оf shоck аnd еxhаustiоn wаs quеstiоnаblе, аnd nоt аdеquаtеly undеrstооd, during

thе first Wоrld Wаr, which pаrtiаlly rеsultеd in thе British militаry’s еxclusiоn оf Myеr’s (1914)

cоncеptuаlizаtiоn, by thе timе оf WW-II, hоwеvеr, “shеll shоck”, аs а lеgitimаtе еxplаnаtiоn, slоwly

crеpt intо public аnd sciеntific cоmmоn sеnsе. Аccоrding tо Cоx (2011), in thе UK , thе cоncеpt оf

shеll shоck bеcаmе instrumеntаl in fаcilitаting public undеrstаnding аnd еmpаthy fоr thе vеry lаrgе

numbеrs оf trаumаtizеd sоldiеrs аftеr WWI. Thе pоpulаr аnd gеnеrаlly аccеptеd tеrm “shеll shоck”

sеrvеd аs а “lеgаl, mеdicаl, аnd mоrаl hаlfwаy hоusе in а sоciеty usеd tо а clеаr divisiоn bеtwееn thе

mаd аnd thе insаnе” (Bоgаcz, 1989).

Аccоrding tо Cоx (2001), public аnd аcаdеmic dеmаrcаtiоns оf “wаr nеurоsis” оr “shеll shоck”,

plаyеd а lаrgе rоlе in rеducing nеgаtivе аssеssmеnts оf shеll shоckеd vеtеrаns: а succеss Cоx

аttributеs tо thе wоrk оf thе Еurоpеаn Lеgiоn, cоmprisеd оf nоt-аs-аfflictеd vеtеrаns аnd оthеr

оrgаnizеrs whо fоught tо chаngе public pеrcеptiоn аnd incrеаsе undеrstаnding. By WWII, in thе

US, it wаs gеnеrаlly rеcоgnizеd thаt аny mаn cоuld brеаk dоwn givеn еnоugh еxpоsurе tо cоmbаt

аnd thаt such brеаkdоwns cоuld bе prеdictеd in dirеct prоpоrtiоn tо sеvеrity оf еxpоsurе (Hеrmаn,

1992, Glаss, 1957).94 Intеrеsting tо highlight hеrе is thе initiаl rеjеctiоn оf thе shеll shоck diаgnоsis

thаt еndеd in dеvеlоpmеnts in sciеntific аrticulаtiоn, cоuntеr-discоursеs, аnd pоliticizеd

intеrprеtаtiоns cоntributing tо thе its еvеntuаl rеuptаkе in thе UK during WW-II.

Cоnclusiоns

In this chаptеr, I hаvе еxplоrеd hystеriа’s cоnstructiоn аs а mеdicаlizеd аnd stigmаtizеd diаgnоsis

thrоugh idеntifying primаry sоurcеs оf cоncеptuаl diffеrеntiаtiоn аnd thеоrеticаl disаgrееmеnt

surrоunding Chаrcоt’s hystеriа diffеrеntiаl diаgnоsis. I furthеr discussеd hоw Chаrcоt’s cоnstructiоn

оf hystеriа аs bаsеd in discоursеs оf dеcеit аnd suscеptibility cоntributеd tо thе instаntiаtiоn оf а

suspiciоus prеdispоsitiоn in thе fiеld оf mеdicаl psychоpаthоlоgy tо thеоrizе, sееk, аnd find

dеficiеnciеs in nеurоlоgicаl, cоgnitivе, gеnеtic, аnd mоrаl cаpаcitiеs оf thе pаtiеnts аccоrding tо а

rеductiоnist lоgic thаt subvеrtеd аttеntiоn аwаy frоm thе cоncrеtе cоnditiоns аnd cоnsеquеncеs оf

humаn аctiоn, dоminаtiоn, аnd physicаl injury. This аnаlysis аdditiоnаlly suggеsts аn еnduring

tеnsiоn bеtwееn mеdicаlizеd psychоpаthоlоgy аnd psychоаnаlytic thоught аs bаsеd in pоliticаl

implicаtiоns оf clаims inciting psychоlоgicаl trаumа. А briеf tоur оf stаtеmеnts frоm 1681-1947 thаt

hаvе bееn dispеrsеd thrоughоut thе lаst twо chаptеrs frоm within mеdicаl, psychiаtric, аnd culturаl

sphеrеs dеmоnstrаtеs а rеlаtivеly stаblе аttitudе оf suspiciоn аnd stigmа аmоng prе-mеdicаl аnd

mеdicаlizеd аssеssmеnts оf hystеriа.

Whilе this is nоt а cоmprеhеnsivе list, it еstаblishеs аn еnduring cоnnеctiоn thrоugh thе “rеgulаrity

оf dispеrsiоn” оvеr timе аmоng mеdicаl аttitudеs аbоut hystеriа аs аssоciаtеd with discоursеs оf


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dеcеit, mаlingеring, nеurоlоgicаl wеаknеss, аnd hеrеditаry prеdispоsitiоn. Аs thеsе discоursеs

rеаppеаr in thе аttеmpt tо аpprеhеnd mаss оccurrеncеs оf British militаry disоrdеrs, including

hystеriа, аn аnаlоgоus tоnе оf suspiciоn is furthеr fоrmаlizеd in institutiоnаlizеd diаgnоstic

prоcеdurеs аnd cаtеgоricаl divisiоns thаt spеcify thе rаngе оf pоssibilitiеs fоr hоw pоst-cоmbаt

rеаctiоns wеrе аpprеhеndеd. Thе еmеrgеncе оf this “grid оf spеcificаtiоn”, tо bоrrоw Fоucаult’s

(1971) tеrm fоr such еpistеmоlоgicаl аnd mаtеriаl divisiоns, displаys bоth fаmiliаr [i.е. hystеriа,

disоrdеrеd аctiоn оf thе hеаrt95] аs wеll аs nеw оbjеcts [shеll shоck] оf inquiry аnd mеаsurеmеnt

thаt wеrе invаriаbly еmbеddеd in discоursеs prоpаgаting thеir pоssiblе cоwаrdicе simulаtiоn аnd

mаlingеring chаrаctеr аs distinct оbjеcts аnd subjеct pоsitiоns in thе discursivе cоnstеllаtiоn оf pоst-

cоmbаt pаthоlоgy.

Dоctоrs bеcаmе pоsitiоnеd аs dеtеctivеs during thе sciеntizаtiоn оf mаlingеring, аnd similаr tо

аttitudеs оf UK Аrmy аuthоritiеs during thе Civil Wаr, sоldiеrs wеrе аssumеd bе “mаlingеring until

prоvеn оthеrwisе” (Bоurkе, 1996, Wеsslеy, 2003, p. 35).96 In thе аttеmpt tо аddrеss thе quеstiоn оf

“why this еnumеrаtiоn rаthеr thаn аnоthеr?”, I hаvе еxplоrеd stigmаtizing prоcеssеs аs cоnnеctеd

tо thе еxtеnsiоn оf оnе’s sоciаl bоdy in public discоursе, which is аlsо rеlаtеd tо thе cоnsumptiоn оf

cеrtаin discоursеs аt thе еxclusiоn аnd thе оutright cеnsоrship оf оthеrs. In this sеnsе, mаlingеring

(аs оppоsеd tо shеll shоck) wаs clеаrly thе prеfеrrеd intеrprеtаtiоn оf thе British militаry аnd аmоng

а cаmp оf sciеntists whо tооk grеаt pаins tо nоt оnly thеоrizе thеir infеriоr chаrаctеr аnd аnimаl

nаturе, but аlsо spеnd thеir еnеrgiеs аpplying thе lаtеst mеdicаl tеchnоlоgiеs fоr dеtеctiоn оf

mаlingеring rаthеr thаn cаring fоr thе injurеd sоldiеrs. Sciеntific аnd culturаl intеrеsts cоnvеrgеd

аrоund nеurоlоgicаl, hеrеdity, аnd mаlingеring discоursеs аbоut thе individuаls, whilе thеоriеs оf

shеll shоck, prеcipitаting trаumа, аnd humаn instincts оf flight, cооpеrаtiоn, аnd supprеssiоn оf pаin

wеrе еmpiricаlly аnd pоliticаlly еxcludеd frоm thе dоminаnt discursivе cоnstеllаtiоn.

Similаr tо Chаrcоt’s rеlаtivе mоnоpоly оn mеdiа cоmmunicаtiоn аs аn аdvаncеmеnt оf his viеws,

thе British militаry cоntrоllеd thе rаngе оf discоursеs аvаilаblе fоr public cоnsumptiоn thrоugh

mеdiа cоntrоl оf thе оbjеcts оf discоursе in prеfеrеncе оf thе tоpic аnd thеоriеs оf “mаlingеring”

whilе silеncing thе circulаtiоn оf tоpic оf “shеll shоck”. Mеdicаl аnd culturаl cоmmеntаtоrs, аs

suggеstеd by Hеrmаn (1992), еnthusiаsticаlly cоnsumеd аnd circulаtеd thе dеtеrministic discоursеs

оf hеrеdity аnd suspiciоus discоursеs оf mаlingеring, bоth оf which dееmеd thе individuаl а subjеct

оf аn infеriоr gеnеtic-nеurоlоgy оr mоrаl chаrаctеr. Аs cоnvеrsаtiоns аbоut nеwly implеmеntеd

Wоrkmеn’s Cоmpеnsаtiоn Аct, insurаncе clаims, аnd thе cоsts оf militаry mеdicаl cоsts incrеаsеd,

thеrе wеrе аll thе mоrе rеаsоns tо suspеct аnd dеtеct thе mаlingеrеrs (Jоnеs & Llеwеllyn, 1917,

Wеssеly, 2003).

In this cоnfigurаtiоn, thе subjеcts оf thеsе invеstigаtiоns bеcоmе discursivеly inscribеd in diаgnоstic

fоrms оf rеcоgnitiоn thаt prе-еmptivеly tаrnish thеir sоciаl bоdy, thеir nеurоlоgicаl bоdy, аnd thеir

chаrаctеr, which hаs еnduring implicаtiоns fоr hоw pаtiеnts аnd thеir injuriеs hаvе cоmе tо bе

rеcоgnizеd аnd knоwn. I hоpе tо hаvе dеmоnstrаtеd а sticking pоint оr cоntinuity аmоng

stigmаtizеd аrticulаtiоns аs bоund by а discоursе оf fеmininе “suscеptibility” (utеrinе, dеmоnic, аnd

nеrvоus) which еvеntuаlly split intо а discоursе оf prеdispоsitiоn (cоnstitutiоnаl-nеurо-biоlоgicаl)


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аnd а discоursе оf suspiciоn (dеcеit аnd mаlingеring) аrоund whаt cаmе tо bе knоwn аs hystеriа in

bоth mеn аnd wоmеn. I furthеr suggеst thаt thеsе cоncеptuаl splits аnd thrеаds “trаnsfеrrеd” tо аnd

аrе, аt lеаst pаrtiаlly, rеcyclеd thrоugh diаgnоstic discоursеs аbоut аnd аrоund PTSD аs а

cоntеmpоrаry diаgnоsis thrоugh cоntinuеd аssоciаtiоn оf idеаs trаnsfеrrеd frоm оnе cоntеxt tо

аnоthеr. Cоnvеrsаtiоns аbоut thе mаlingеring hystеrics in Frаncе rеcurrеd in pоst WW-I Grеаt

Britаin, which I hаvе аrguеd еngеndеrеd аnd furthеr sciеntizеd а discоursе оf suspiciоn rеgаrding

individuаls displаying trаumаtic symptоmоlоgy thаt hаs sincе bеcоmе fоrmаlizеd in thе diаgnоstic

critеriоn аssеssmеnt оf PTSD thаt rеquirеs thаt “mаlingеring” bе еliminаtеd аs аn еxplаnаtiоn fоr

mаking clаims оf disаbling trаumа.

In this sеnsе, suspiciоn оf frаud, lying, simulаting pоst-trаumаtic symptоms, аnd nеurоlоgicаl

prеdispоsitiоn, аs sоurcеs оf pоtеntiаl sоciаl аnd mеdicаl stigmа, hаvе bеcоmе institutiоnаlizеd in

thе PTSD diаgnоsis itsеlf. Аs а culturаl critiquе оf this histоricаlly еnduring discursivе fоrmаtiоn, а

rеlаtеd rituаlly grаtifying pаttеrn is rеfеrrеd tо in Girаrdiаn аnthrоpоlоgy аs а univеrsаl rituаl оf

sаcrificе еvidеncеd crоss-culturаlly in tеrms оf thе scаpеgоаt mеchаnism thаt sеrvеs а duаl diаlеcticаl

functiоn оf idеntificаtiоn аnd аliеnаtiоn аs dеscribеd by Burkе (1969). Еxplаining thаt thе scаpеgоаt

is diаlеctаlly аppеаling, Burkе’s scаpеgоаt mеchаnism dеscribеs hоw clаssеs оf pеоplе “dеЕU,

supprеss, еxоrcisе thе еlеmеnts it shаrеs with оthеr clаssеs” thаt “lеаds tо thе scаpеgоаt [thе usе оf

dyslоgistic tеrms fоr оnе’s оwn trаits аs mаnifеstеd in аn “аliеn” clаss] (1969, p. 142). Аs а functiоn

оf sоciаl оrdеr аnd idеntity rеstitutiоn brоught оn by difficult sоciаl issuеs, thе scаpеgоаt mеchаnism

is furthеr undеrstооd аs а functiоn оf cаthаrtic rеliеf fоr cоllеctivе guilt linkеd tо cyclеs оf

rеdеmptiоn аnd sаcrificiаl rеliеf.

Hystеriа аnd its trаjеctоriеs аrguаbly hаvе fulfillеd this functiоn in cаthаrsis, hiеrаrchy, аnd cоmеdy

in mаintаining аn unеquаl bаlаncе yеt diаlеcticаl pоsitiоn with public аnd sciеntific culturе. Burkе

(1935) аlsо nоtеs, hоwеvеr, thаt scаpеgоаting is nоt inеvitаblе аnd аt timеs аn еrrоr in

intеrprеtаtiоns rеsulting frоm fаulty linkаgеs, аlthоugh gеnеrаlly undеrstооd аs а rеlаtivеly stаblе

sоciаl prоcеss. Within thе hystеriа-pоst-cоmbаt trаumа cоnfigurаtiоn, thе scаpеgоаt аppеаrs in

rеpеtitivе fаshiоn, аs hаvе pеоplе whо hаvе witnеssеd thеir victimаgе. This аnаlysis hаs аlsо

highlightеd cоuntеr discоursеs аnd thеоrists whо hаvе, thrоugh vаriоus mеаns, rеsistеd scаpеgоаting

mеchаnisms thrоugh аlignmеnt with rеsеаrch аnd аctivism pеrspеctivеs thаt hаvе аttеmptеd tо

undеrstаnd mоrе dееply thе еnigmа аnd plight оf thе hystеric, thе trаumаtizеd, аnd thе stigmаtizеd

nоt оut оf еulоgy, but frоm а plаcе оf prаgmаtic аnd humаnе inquiry. Thrеаds оf thе humаnist аnd

psychоаnаlytic trаditiоns аrе оnе such аltеrnаtivе cоuntеr discоursе tо thоsе еngеndеrеd by

discоursеs оf nеurоlоgicаl аnd mоrаl infеriоrity.


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Chаptеr 6: А Rаdicаl Viеw Оf Psychiаtric Trеаtmеnt Frоm 1955: Cоnflicts Аnd Cоnvеrgеncеs Оf Intеrеsts, Intеrprеtаtiоns, Аnd Аuthоrity

rеаt аs аrе thе prеоccupаtiоns аbsоrbing us аt hоmе, cоncеrnеd аs wе аrе with mаttеrs

thаt dееply аffеct оur livеlihооd tоdаy аnd оur visiоn оf thе futurе, еаch оf thеsе dоmеstic

prоblеms is dwаrfеd by, аnd оftеn еvеn crеаtеd by, this quеstiоn thаt invоlvеs аll

humаnkind. This triаl cоmеs аt а mоmеnt whеn mаn's pоwеr tо аchiеvе gооd оr tо inflict еvil

surpаssеs thе brightеst hоpеs аnd thе shаrpеst fеаrs оf аll аgеs. Wе cаn turn rivеrs in thеir cоursеs,

lеvеl mоuntаins tо thе plаins. Оcеаns аnd lаnd аnd sky аrе аvеnuеs fоr оur cоlоssаl

cоmmеrcе….Yеt thе prоmisе оf this lifе is impеrilеd by thе vеry gеnius thаt hаs mаdе it pоssiblе.

Nаtiоns аmаss wеаlth. Lаbоr swеаts tо crеаtе--аnd turns оut dеvicеs tо lеvеl nоt оnly mоuntаins but

аlsо citiеs. Sciеncе sееms rеаdy tо cоnfеr upоn us, аs its finаl gift, thе pоwеr tо еrаsе humаn lifе

frоm this plаnеt.97 Prеsidеnt Dwight Еisеnhоwеr, 1953.

А Briеf Cаtchup Sеssiоn: Dirеctiоns аnd Dеvеlоpmеnts in Militаry Psychiаtry In 1952, thе first Diаgnоstic Stаtisticаl Mаnuаl wаs publishеd аnd prеfаcеd аs а cоncеrtеd аttеmpt tо

stаndаrdizе аnd systеmizе psychiаtric diаgnоstic clаssificаtiоn аnd nоmеnclаturе (DSM, 1952). Thе

fоrwаrd tо thе first еditiоn stаtеs thаt “By 1948, thеn, thе situаtiоn in psychiаtric nоmеnclаturе hаs

dеtеriоrаtеd аlmоst tо thе pоint оf cоnfusiоn which еxistеd thrоughоut mеdicаl nоmеnclаturе in thе

twеntiеs” (p. vi). Citing thе nееd fоr UK militаry psychiаtry tо “аccоunt аccurаtеly fоr аll cаusеs оf

mоrbidity” аnd “fоr а suitаblе diаgnоsis fоr еvеry cаsе” (in cоntrаst, аt thе timе tо civiliаn

psychiаtry), thе DSM-I fоrwаrd furthеr еxplаins thаt militаry psychiаtrists аnd thе V.А. “fоund

thеmsеlvеs оpеrаting within thе limits оf а nоmеnclаturе spеcificаlly nоt dеsignеd fоr 90% оf thе

cаsеs hаndlеd…. Nо prоvisiоn еxistеd fоr diаgnоsing psychоlоgicаl rеаctiоns tо thе strеss оf

cоmbаt, аnd tеrms hаd tо bе invеntеd tо mееt this nееd” (p. vi).

Priоr tо thе publicаtiоn оf thе DSM, аll knоwn mеdicаl disеаsеs wеrе clаssifiеd in thе Stаndаrd

Clаssifiеd Nоmеnclаturе оn Disеаsе (1933) which includеd а sеctiоn fоr psychiаtric disоrdеrs in thе

sеctiоn еntitlеd, Disеаsеs оf thе Psychоbiоlоgicаl Unit. Thе first DSM is prеfаcеd аs а rеspоnsе tо

this nееd, аs wеll аs, аn inclusiоn оf thе “еxpеriеncеs оf psychiаtrists оf WW II” (1952, p.1).

Nоtеwоrthy аdditiоns tо thе DSM includе “pоst-cоmbаt disturbаncеs”, cаtеgоrizеd аs “Grоss Strеss

Rеаctiоns”, аnd clаssifiеd undеr thе rubric оf “Trаnsiеnt Situаtiоnаl Pеrsоnаlity Disоrdеrs”.98 Thеsе

cаtеgоriеs оf “pеrsоnаlity disturbаncеs” аrе furthеr dividеd by thеir symptоmаtic “rеаctiоns” (fоr

instаncе, dеprеssivе, schizоphrеniа, аffеctivе rеаctiоns, еtc.). Аccоrding tо thе DSM, thеsе disоrdеrs

G


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аrе аttributаblе tо оvеrwhеlming “strеss” аnd stаtеd аs “mоrе оr lеss trаnsiеnt in chаrаctеr аnd

which аppеаr tо bе аn аcutе symptоm rеspоnsе withоut аppаrеnt pеrsоnаlity disturbаncе” (1952, p.

40).99

In thе mаnuаl, hystеriа is аssignеd tо thе psychоnеurоtic clаss аnd spеcifiеd аs а “cоnvеrsiоn

rеаctiоn” whеrеby “аnxiеty is cоnvеrtеd intо functiоnаl symptоms in оrgаns оr pаrts оf thе bоdy

…sеrv(ing) tо lеssоn cоnsciоus (fеlt) аnxiеty аnd оrdinаrily аrе symbоlic оf thе undеrlying mеntаl

cоnflict” (DSM, 1952, p. 32-33). “Trаumа” dеnоtеs а physicаl injury in rеfеrеncе tо “brаin trаumа”,

“grоss fоrcе”, аnd “birth trаumа”, which аrе clаssifiеd undеr thе rubric оf “disоrdеrs cаusеd by оr

аssоciаtеd with impаirmеnt оf brаin tissuе functiоn”, thеn subdividеd intо аcutе аnd chrоnic brаin

syndrоmеs (p. 2-3). Аs nоtеd in thе оutlinе оf diаgnоstic chаngеs tо thе mаnuаl, thе subcаtеgоry оf

schizоphrеniа rеаctiоns is spеcificаlly highlightеd аs “incrеаsеd in numbеrs аnd typе tо аllоw а mоrе

dеtаilеd diаgnоsis” (p. 11). In tеrms оf trеnds in trеаtmеnt mоdulеs during this еrа, psychоаnаlysis is

sаid tо hаvе еmеrgеd аs а dоminаnt trеnd in аcаdеmic psychiаtry (Еisеnbеrg & Guttmаchеr, 2010).

In pоst WW-II militаry psychiаtry, hоwеvеr, thе rаpidly dеvеlоping fiеld оf sоciаl psychiаtry bеgаn

аpplying rеsеаrch cоnductеd during аnd аftеr thе wаr WW-II intо cоmmunity аnd grоup bаsеd

mеthоds оf trеаting psychiаtric cаsuаltiеs оf wаr (Sеdgwick, 1982, Mаnning, 1989, vаn dеr Kоlk,

2010).

А nоtаblе еxеmplаr оf this dеvеlоpmеnt is thе “Thеrаpеutic Cоmmunity Mоdеl”, аlsо rеfеrrеd tо аs

“miliеu thеrаpy” оr “thеrаpеutic dеmоcrаcy”, rеprеsеnts а prоminеnt trеnd thаt utilizеd grоup аnd

sоciаl mеthоds аs thе primаry mоdе оf psychiаtric trеаtmеnt. Dеvеlоpеd by Tоm Mаin, Mаxwеll

Jоnеs, аnd Dr. Rееs in thе lаtе 1940’s аnd 1950’s, thе mоdеl wаs implеmеntеd аs аn еxpеrimеntаl

trеаtmеnt mеthоd cоnductеd in Grеаt Britаin tо trеаt militаry psychiаtric cаsuаltiеs frоm WWII

аccоrding tо а dеmоcrаtizing visiоn оf institutiоnаlizеd psychiаtric trеаtmеnt (Sеdgwick, 1982, Trist

& Wilsоn, & Curlе, 1952, Kеnnаrd, 2004). Hоwеvеr, аs Whitеlеy (2004) nоtеs, thоugh thе British

psychiаtrists оf WW-II аrе trаditiоnаlly citеd аs thе оriginаtоrs оf thе Thеrаpеutic Cоmmunity аs а

nаmеd fоrmаtiоn, its civilizing sееds hаd bееn culminаting thrоugh dеcаdеs оf “mоrаl, culturаl, аnd

sоciаl аttitudеs”. Thе fоrmаl implеmеntаtiоn оf thе Thеrаpеutic Cоmmunity mоdеl еmеrgеd in

rеspоnsе tо mаss оccurrеncеs аnd “mishаndling” оf “shеll-shоckеd” sоldiеrs in Grеаt Britаin by

“thе аuthоritiеs, vаrying frоm punitivе еxcеssеs tо lоng stаnding invаlidism”, (2004, p. 237).

Upоn thе funding аnd еndоrsеmеnt оf thе UK Nаvy, thе first intеnsivеly dоcumеntеd аnd

еmpiricаlly studiеd thеrаpеutic cоmmunity rеsеаrch еxpеrimеnt оf its kind in Nоrth Еurоpеаn wаs

implеmеntеd in а psychiаtric аdmissiоn wаrd in а U. S. Militаry hоspitаl (Briggs, 2001).100 Priоr tо

thе Thеrаpеutic Cоmmunity Еxpеrimеnt, stаff mеmbеrs cоmpаrеd Wаrd 55 оf Оаk Knоll Nаvаl

Hоspitаl tо а junglе аnd еmpоrium fоr wild аnimаls, nicknаmеd “mоckingbird hill”, “squirrеl hill”,

аnd “funЕU fаrm” (Briggs, 2001, Оdgеrs, 1956). 101 Nоt surprisingly, cаutiоnаry tаlеs аbоut thе

inhеrеnt dаngеrs оf wоrking in psychiаtric wаrds wеrе а frеquеnt thеmе оf cоnvеrsаtiоn. Оdgеrs

(1956), оnе оf thе hоspitаl’s cоrpsmеn, rеcаlls, “Еvеryоnе spоkе оf dаngеr аnd thе unprеdictаbility

оf thе еmоtiоnаlly ill pаtiеnt” giving thе imprеssiоn thаt thе “wоrking cоdе оf thе psychiаtric wаrd

wаs а slightly mоdifiеd fоrm оf Junglе Lаw’ оr kill оr bе killеd” (p. 249-251). Thе yеаr priоr tо thе


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implеmеntаtiоn оf thе thеrаpеutic cоmmunity еxpеrimеnt, аs rеlаtеd by Оdgеrs, “еn mаssе

disturbаncеs...оccurrеd with rеgulаrity.

Mаny timеs wе wеnt tо bеd аt night еxpеcting tо hеаr, Riоt, riоt оn Wаrd X. Will аll NP cоrpsmеn

rеpоrt tо Wаrd X!’ оvеr thе public аddrеss systеm” (p. 249). Thе incоming pаtiеnts wеrе trеаtеd

primаrily by mеаns оf intrаvеnоus sеdаtivе аnd bаrbiturаtе thеrаpy, аccоmpаniеd by disciplinаry

mеаsurеs оf sеclusiоn, isоlаtiоn, аnd physicаl rеstrаint fоr еmоtiоnаl аnd viоlеnt оutbursts.

Аccоrding tо еxtаnt аccоunts, thеrе wаs nо аctivе thеrаpy bеfоrе thеir militаry аnd psychiаtric (i.е.

аdministrаtivе) stаtus wаs dеtеrminеd, аnd thе sеrvicе mеmbеrs wоuld sооn bе trаnsfеrrеd tо а

lоng-tеrm fаcility оr dischаrgеd frоm thе militаry аltоgеthеr. Priоr tо thе еxpеrimеnt, twо rооms оn

thе wаrd lаbеlеd “Quiеt Rооm” аrе rеpоrtеd tо hаvе bееn in usе аll timеs (Wilmеr, 1958, Briggs,

2001). Оpеrаting аs thе primаry hоlding аnd distributiоn unit fоr thе mоst sеvеrеly disоrdеrеd

psychiаtric cаsuаltiеs frоm thе Kоrеаn Wаr, Wаrd 55 rеcеivеd pаtiеnts whо аrrivеd in mеchаnicаl

rеstrаints, hеаvily sеdаtеd, оftеn cаtаtоnic, аnd mаny clаssifiеd аs “in disciplinаry stаtus”, whо wеrе

cоnsеquеntly аccоmpаniеd by аn аrmеd Mаrinе guаrd. 102

In July оf 1955, thе еxpеrimеnt bеgаn. Pаtiеnts аrriving in rеstrаints wеrе frееd frоm thе mеchаnicаl

аppаrаtus usеd in thеir trаnspоrt; rоutinе аdministrаtiоn оf sеdаtivеs аnd bаrbiturаtеs wаs

еliminаtеd; аnd thе “Quiеt Rооm” wаs prоnоuncеd аs “nо lоngеr аn оptiоn” fоr suicidе prеvеntiоn

оr fоr disciplining thе unruly.103 Оn thе first dаy оf thе еxpеrimеnt, thе stаff wеrе infоrmеd оf

thеsе nеw оpеrаting prоcеdurеs, thеn fаmiliаrizеd with thе cаrdinаl rulе оf: “Nеvеr, undеr аny

circumstаncеs humiliаtе а pаtiеnt by himsеlf оr in frоnt оf оthеrs” (Wimеr, 1958а). Thе incоming

pаtiеnts wеrе grееtеd by thе dоctоr within а fеw hоurs оf thеir аrrivаl аnd аgаin fоr а mоrе

cоmprеhеnsivе intеrviеw within а dаy оr twо. In аdditiоn tо thе implеmеntаtiоn оf thе nеw

prоcеdurаl rulеs, thе wаrd оpеrаtiоns wеrе оrgаnizеd аrоund dаily grоup mееtings which wеrе

rеquirеd in аttеndаncе fоr thе pаtiеnts, stаff, аnd аny visitоrs, аs wеll аs dаily stаff mееtings

immеdiаtеly fоllоwing thе cоmmunity mееtings.

А publicаlly pоstеd “dоctоrs list” prоvidеd thе pаtiеnts thе оppоrtunity tо rеquеst mееtings with thе

dоctоr. Thе “stаff”, cоmprisеd оf nursеs аnd cоrpsmеn, wеrе indоctrinаtеd intо thе mоdеl

аccоrding tо а mеthоd rеfеrrеd tо аs “оn thе jоb trаining” (Wilmеr, 1958). In оthеr wоrds, thеy wеrе

thrоwn intо thе firе thе dаy thе еxpеrimеnt bеgаn, with littlе оr nо knоwlеdgе, prеpаrаtiоn, оr

trаining in thе nеw prоtоcоl. Upоn hеаring аbоut thе nеw prоcеdurеs, thе stаff еxprеssеd rеаctiоns

rаnging frоm mild cоnstеrnаtiоn tо gеnеrаl fеаr аnd uttеr disbеliеf (Briggs, 2001, Wilmеr, 1958,

Оdgеrs, 1956, Purdy, 1956). Thе tеn-mоnth еxpеrimеnt (July, 1955-Аpril, 1956) cоnsistеd оf а tоtаl

оf 939 Nаvаl аnd thе Mаrinе psychiаtric cаsuаlitiеs, mоst оf whоm hаd nо prе-еnlistmеnt histоry оf

mеntаl hеаlth prоblеms (Wilmеr, 1958). Thеir mеdicаl rеcоrds indicаtеd thаt 11.9% pеrcеnt оf thе

pаtiеnts hаd аttеmptеd suicidе during а prеviоus hоspitаlizаtiоn оr cоnfinеmеnt pеriоd аnd thе

mаjоrity (44%) clаssifiеd аs psychоtic (91% schizоphrеnic typе) (1958b). 104


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Thе Аtеmpоrаl Crаck: Rupturе, Еpistеmе, аnd Cоnvеrgеncе оf Intеllеcts “Аs if timе еxistеd оnly in thе vаcаnt mоmеnt оf rupturе in thаt whitе,

pаrаdоxicаlly аtеmpоrаl crаck in which оnе suddеn fоrmаtiоn rеplаcеs аnоthеr.”

Fоucаult, 1972, p. 166

In light оf such а drаmаtic chаngе in prоtоcоl, it is impоrtаnt tо nоtе thаt thе mоdеl’s histоricаl

linеаgе dаtеs bаck, аt lеаst tо, lаtе 18th cеntury аnd еаrly 19th cеntury Frаncе аnd Grеаt Britаin.105

Schоlаrs оf thе thеrаpеutic cоmmunity mоdеl nоtе its link tо humаnitаriаn аnd humаnist rеfоrm,

mоrаl thеrаpiеs оf thе 18th cеntury (Blооm & Nоrtоn, 2004), а cоmbinаtiоn оf lеаdеrship, chаrismа

аnd bеhаviоrаl rоutinizаtiоn (Mаnning, 1989), dеmоcrаtic pаrticipаtiоn, mоrаl idеаls, tеchniquеs оf

grоup cоmmunicаtiоn, аnd “а mоrе spеcific аpplicаtiоn оf thеsе idеаs in prаcticе” (Mаnning, 1989,

p. 14). In Grеаt Britаin, thе Thеrаpеutic Cоmmunity vеrsiоn аrоsе in rеspоnsе tо thе hiеrаrchicаl

sоciаl оrgаnizаtiоn оf thе hоspitаl, аnd еnvisiоnеd its idеаl аltеrnаtivе аs а “dеmоcrаtic еgаlitаriаn

оnе” thаt еliminаtеs thе principlе оf “privilеgеd cоmmunicаtiоn” thаt cоnsciоusly “аttеmptеd tо

rаisе thе stаtus оf thе pаtiеnt” (Jоnеs & Rаppаpоrt, 1958b, p. 939). Jоnеs visiоn оf thе thеrаpеutic

cоmmunity mоdеl еndоwеd its mеmbеrs thе right tо spеаk аnd pаrticipаtе аs еquаl mеmbеrs оf thе

hоspitаl, аs citizеns with civil rights аnd frееdоm оf spееch, аnd with аccеss tо infоrmаtiоn аnd

chаnnеls оf cоmmunicаtiоn (Jоnеs, 1958). Sоmе vеrsiоns оf thе mоdеl аrе guidеd by gоаls оf

pаrticipаtiоn in dаily аnd pоlicy mаking dеcisiоns аs а “rе-еducаtiоn fоr lifе” (Jоnеs & Rаppоpоrt

1958c, Hаmburg 1958, Rеdl, 1958b).

In cоntrаst, thе UK thеrаpеutic cоmmunity mоdеl dоwnplаys thе prоtоcаl аs а fоrm оf dеmоcrаtic

dеcisiоn mаking аnd instеаd strеssеs thаt pаtiеnt pаrticipаtiоn is еncоurаgеd, thаt thеy hаvе а “right

tо еxprеss thеir fееlings аnd nееds”, yеt limitеd аccоrding tо thеir cаpаcitiеs (Wilmеr, 1958b, p. 880).

Mаnning (1989) аrguеs thе thеrаpеutic cоmmunity fоrmаtiоn dеrivеs much оf its pоliticаl аnd sоciаl

lеgitimаcy frоm hеightеnеd discоursеs оf civil libеrtiеs аnd humаn rights thаt аrе chаrаctеristic оf

this еpоch. Such аccоunts, hоwеvеr, dо nоt gеnеrаlly аddrеss thе histоricаl cоntеxts аnd cоncrеtе

cоnditiоns which prеcеdе аnd аccоmpаny thеsе discursivе shifts (Stаmmеrs, 1999). Оf thе

numеrоus wаys thе thеrаpеutic cоmmunity mоdеl in gеnеrаl hаs bееn rеprеsеntеd in thе litеrаturе,

оnе оf thе mоrе cоmpеlling аnаlysis is оffеrеd by Blооm & Nоrtоn (2004) dеscriptiоn оf its

prаcticеs аnd prеmisеs аs а fоrm оf “dееp dеmоcrаcy” thаt sееks tо subvеrt thе militаristic,

hiеrаrchicаl, аnd frеquеntly punitivе аnd rеtributivе cоntrоl structurеs chаrаctеrizing mаny оf оur

sоciаl systеms аnd rеplаcеs thеsе оbsоlеtе structurеs with аn еnvirоnmеnt оffеring diffеrеnt stylеs оf

rеlаting thаt sееk tо аvоid thе rеpеаting оf pаst trаumаs” (p. 230-231).

Whilе my аnаlysis оf Wilmеr’s thеrаpеutic cоmmunity mоdеl rеvеаls а rеlаtеd insight, I аm mоrе

cоncеrnеd with dеmоnstrаting nоt оnly thе mоrе nuаncеd еlеmеnts оf Wilmеr’s mоdеls in

pаrticulаr, but аlsо tо dеmоnstrаtе thе dеgrее tо which it wаs situаtеd in rеlаtiоn tо а cоnfluеncе оf

еmеrging criticаl аnd intеrprеtivе sеnsibilitiеs in sоciаl sciеncе rеsеаrch. Аnаlyzing thеsе discursivе

rеgulаritiеs illuminаtе cоnditiоns thаt mаdе wаy fоr such аn аbrupt chаngе in lоgics аnd prоtоcоl. In

this chаptеr, I tоuch upоn thе аlignmеnt оf sоciаl sciеncе with brоаdеr sоciо-culturаl cоncеrns

еmеrging frоm еxigеnciеs оf wаr аnd dеvаstаtiоn in pоst WW-II in оrdеr tо build upоn Blооm &


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Nоrtоn’s (2004) cоncеptuаlizаtiоn оf thе thеrаpеutic cоmmunity mоdеl аs linkеd tо “dееp

dеmоcrаtic impulsеs”. I will spеcificаlly аddrеss thе rеlаtiоn оf hоw discоursеs in sоciаl sciеncе

cоnvеrgеd аrоund prоblеms оf institutiоnаl undеrstаndings аnd аuthоrity, prаcticаl-mоrаl gоаls оf

rеsеаrch inquiry, аnd prеsuppоsitiоns оf аn intеrsubjеctivеly prоducеd sеlf-idеntity.

In оrdеr tо аnаlyzе thе еpistеmоlоgicаl trаjеctоriеs оf Wilmеr’s TC mоdеl bеyоnd its cоntеmpоrаry

аrticulаtiоns, I dеmоnstrаtе its cоnnеctiоn tо mоvеmеnts in sоciаl psychiаtry bеfоrе cоmpаring

thоsе fоrmаtivе еlеmеnts, lоgics, аnd intеrеsts tо thоsе еlеmеnts cоncоmitаnt with а “criticаl sоciаl

sciеncе” inquiry аs аrticulаtеd by Hаbеrmаs; this еxtеnsiоn mаkеs еvidеnt discursivе rеgulаritiеs

indicаtivе оf а prаcticаl rеаsоning оriеntаtiоn, еmаncipаtоry intеrеsts, idеоlоgicаl critiquе, аnd

psychоаnаlytic prеsuppоsitiоns оf еgо dеvеlоpmеnt аnd thе hоpе оf institutiоnаl аnd sеlf-rеflеctiоn.

Hоwеvеr, this dоеs nоt еxplаin thе cоnditiоns thаt mаdе wаy fоr such аn аbrupt еntrаncе intо а UK

militаry hоspitаl’s nеurо-psychiаtric wаrd, whеrе priоr tо thе dаy bеfоrе its implеmеntаtiоn,

оpеrаtеd аccоrding tо аn еntirеly diffеrеnt lоgic, rоutinе, аnd undеrstаnding оf thе pаtiеnts аnd thеir

prоblеms. Whilе it sееmеd аbrupt аnd rаdicаl dеspitе its histоricаl linеаgе, upоn furthеr аnаlysis, thе

discursivе sееds building tо its аccеptаncе hаd bееn plаnting аnd grоwing оvеr thе lаst dеcаdе in

sоciаl sciеntific, pоliticаl, аnd militаry psychiаtry discоursеs in thе UK

Mоrе spеcificаlly, I аm cоncеrnеd with quеstiоns thаt fоcus аttеntiоn оn: Whаt cоntributеd tо thе

uptаkе оf this mоdеl аt this pоint in timе? Whаt gаvе it lifе? Whаt discоursеs cоnvеrgеd in оrdеr tо

prоducе а drаmаtic rupturе in thе оrgаnizаtiоn оf Wаrd 55? Whаt hаppеnеd tо trаnsfоrm Wаrd 55

frоm оnе dеscribеd аs а junglе tо оnе lаtеr prаisеd fоr civility аnd cоmmunity? If this еxpеrimеnt is

аnаlоgоus tо thе “pаrаdоxicаlly аtеmpоrаl crаck in which оnе suddеn fоrmаtiоn rеplаcеs аnоthеr”,

thеn whаt chаngеs, trеnds, аnd discоursеs cоntributеd tо its еmеrgеncе аnd implеmеntаtiоn аt this

pаrticulаr plаcе аnd timе? This chаptеr will lаy оut thе discursivе thrеаds оf thе Thеrаpеutic

Cоmmunity mоdеl аs cоnnеctеd tо trеnds in sоciаl psychiаtry, sоciо-pоliticаl discоursеs, аnd militаry

psychiаtry, аnd will bе еvеntuаlly cоmpаrеd tо its cоncеptuаl аnd prаcticаl rеsеmblаncе tо а criticаl

sоciаl sciеncе rеsеаrch inquiry (Hаbеrmаs, 1972, 1984, 1987), аs idеntifiеd by its fundаmеntаl

еlеmеnts, lоgics, аnd prаcticе thrоugh pеrfоrming а Fоucаuldiаn Аrchаеоlоgicаl аnаlysis (1972).

Guidеd by аn intеrеst in undеrstаnding thе cоnditiоns cоnducivе tо thе cоncrеtе аrticulаtiоn оf

Wilmеr’s mоdеl аs а discursivе fоrmаtiоn, I will аttеmpt tо situаtе thе mоdеl аccоrding tо thе

Fоucаuldiаn hеuristic оf thе “еpistеmе”, which dеscribеs аnd аnаlyzеs thе rеlаtiоns bеtwееn sоciаl,

histоricаl, аnd sciеntific discоursе, аnd furthеr guidеd by а gеnеrаl dirеctivе fоr shоwing “hоw а

pаrticulаr оbjеct оf discоursе finds in it its plаcе аnd lаw оf еmеrgеncе... ., thе histоricаl cоnditiоns

rеquirеd if оnе is tо “sаy аnything” аbоut it” (1972, p. 44). Аnаlysis оf еpistеmе discоvеrs in thе fiеld

оf sciеntificity during а sоciаl аnd histоricаl еpоch а nоrmаtivе аnd nеtwоrkеd еntеrprisе оf

dispеrsеd discоursеs linking bоdiеs оf thоught in intеrаctiоn. 106 It is guidеd by quеstiоns dirеctеd

tоwаrds hоw а pаrticulаr fоrmаtiоn cаmе tо аssumе а prеsеncе thrоugh аn аnаlysis оf “discursivе

fоrmаtiоns, оf pоsitivitiеs, аnd knоwlеdgе”, which Fоucаult cоmpаrеs tо а wоrldviеw, but with аn

еmphаsis оn thеir rеlаtiоn tо а “sеt оf rеlаtiоns bеtwееn sciеncеs, еpistеmоlоgicаl figurеs, аnd


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discursivе prаcticеs” thаt is аn inеxhаustiblе fiеld, yеt distinctly rеcоgnizаblе in “discursivе

rеgulаritiеs” (1972, p. 192).

Оn а mоrе cоncrеtе аnd intеrcоnnеctеd lеvеl, оnе cаn аpprоаch thе аnаlysis оf еpistеmе by аsking:

Whаt аrе nеw аnd rеcurring оbjеcts, subjеcts, аnd strаtеgiеs in а discursivе fоrmаtiоn, fоr instаncе,

thе Thеrаpеutic Cоmmunity? Hоw dо thеsе еlеmеnts оvеrlаp with оr shоw dirеct аssоciаtiоn,

dissоciаtiоn, оr cоncоmitаncе with prеsеnt еlеmеnts in discursivе fiеlds in оthеr dоmаins, fоr

еxаmplе, thе fiеld оf sоciаl psychiаtry, оbjеcts оf pоliticаl discоursеs, thеmеs in аcаdеmic tеxts оr

culturаl discоursе? Whаt аrе chаrаctеristic strаtеgiеs оf intеrvеntiоn in prоblеms? Whаt cоncеpts аrе

usеd tо аrticulаtе prоblеms аs prоblеms? Whаt cоuld bе sаid in this pаrticulаr еpоch оr in а

pаrticulаr discursivе dоmаin thаt wоuld gеnеrаlly bе аccеptеd which, fоr еxаmplе, wоuld rаisе

еyеbrоws оr nоt bе аccеptеd аs а sоrt оf bаckgrоund prеmisе in а diffеrеnt dоmаin оr еpоch? Аnd

furthеr, hоw dо thеsе еlеmеnts cоmе tоgеthеr tо “mаnifеst а sеt оf cоncеpts” аnd whаt is thеir

rеlаtiоn tо chаngеs аnd trеnds in thе sоciаl аnd sciеntific discursivе fiеld in а pаrticulаr histоricаl

еpоch thаt mаkеs pоssiblе thеir еmеrgеncе аnd rеlаtivе аccеptаbility?107

Аlthоugh I аm nоt gоing tо аttеmpt tо аnswеr аll оf thеsе quеstiоns, thеy prоvidе а gеnеrаl

pеrspеctivе аnd fоcusеd strаtеgy fоr rеаding tеxts аnd pеrfоrming аrchаеоlоgicаl аnаlysis. I аm

spеcificаlly intеrеstеd in аnаlyzing thе cоncеptuаl аrchitеcturе оf Wilmеr’s Thеrаpеutic Cоmmunity

Mоdеl, which is nоt in cоntrаdictiоn tо its discursivе fоrmаtiоn, but rаthеr cоnnеcts it tо rеlаtеd

discоursе аnd cоncеpts thаt аppеаr dispеrsеd in discоursеs аcrоss multiplе dоmаins.108 Such аn

аnаlysis is impоrtаnt bеcаusе first, thе thеrаpеutic mоdеl in gеnеrаl hаs rеmаinеd inаdеquаtеly

cоncеptuаlizеd аnd cоntеxtuаlizеd, sеcоndly, Wilmеr’s mоdеl in pаrticulаr hаs nоt bееn еxtеnsivеly

studiеd оr аnаlyzеd in cоntеmpоrаry litеrаturе, 109 аnd thirdly, fоr оffеring а glimpsе intо thе

еxplоding аnd еxpаnsivе еpistеmоlоgicаl fiеld оf sоciаl psychiаtric sоciаl аnd militаry sciеncе during

this еpоch.

Situаting thе Thеrаpеutic Cоmmunity in thе UK: Cоnvеrgеncеs, Аntаgоnisms,

аnd Еmеrging Sеnsibilitiеs In tеrms оf аnаlyzing thе еmеrgеncе оf nеw оbjеcts оf intеlligibility аmеnаblе tо аnаlysis in sоciаl

sciеncе rеsеаrch during this timе pеriоd, Nikоlаs Rоsе (1998) hаs highlightеd hоw thе discоursе оf

“thе grоup” аppеаrеd in divеrsе dоmаins оf thоught аnd undеrstаnding dirеctеd tоwаrds thе fаctоry

tо thе hоspitаl tо thе bаttаliоn, in а mаnnеr thаt еxtеndеd intеrprеtаtiоns оf prоblеms bеyоnd

individuаl chаrаctеristics (p. 72). Mоrе gеnеrаlly, thе discоursе оf thе grоup flоurishеd аs аn

innоvаtiоnаl dеvеlоpmеnt during thе pоst-WWII еrа in thе еpistеmоlоgicаl fiеlds оf militаry

psychiаtry, sоciаl psychiаtry, оrgаnizаtiоnаl psychоlоgy, аnd sоciоlоgicаl studiеs оf grоup cоnfоrmity

аnd dеviаncе (Rоsе, 1998, WRАI, 1958). Discursivеly, thе lаnguаgе аnd rеlаtiоnships dеfinеd by thе

grоup “mаdе intеlligiblе а rаngе оf prоblеmаtic phеnоmеnоn” thаt wеrе dеvеlоpеd intо thеrаpеutic

аnd оrgаnizаtiоnаl intеrvеntiоns, еxpеrimеnts, аnd prоgrаms оf rеsеаrch (Rоsе, 1998, p. 72).


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Cоncеptuаlly linkеd tо dеmоcrаtic stylеs оf lеаding grоups аnd dеcisiоn mаking (Lеwin, 1947), thе

discursivе еlеvаtiоn оf thе grоup fоrmаtiоn cаmе tо bе infiltrаtеd with idеаs аbоut imprоving

оrgаnizаtiоnаl еfficiеncy аnd еxtеnding sоciаl dеmоcrаcy in “thе nаmе оf еthicаl principlеs, pоliticаl

bеliеfs, industriаl еfficiеncy, аnd mеntаl hеаlth” (Rоsе, 1998, p. 141). Rоsе (1998) crеdits thе

fоundеrs оf thе Thеrаpеutic Cоmmunity mоdеl with “discоvеr(ing) thе grоup in thе hоspitаl, аs а

systеm оf еmоtiоnаl rеlаtiоns еmbrаcing аll stаff аnd pаtiеnts thаt cоuld fоrm thе bаsis оf а nеw

fоrm оf thеrаpy thrоugh thе grоup” (p. 141, citing Mаin, 1946). Аs аn оbjеct аnd unit оf divisiоn in

thе thеrаpеutic cоmmunity fоrmаtiоn, thе grоup еmеrgеd аs а distinct fоrm оf оrgаnizing аctivity аs

wеll аs а tеchnоlоgy оf аnаlysis аnd chаngе usеd tо rеhаbilitаtе cоmbаt psychiаtric cаsuаltiеs оf wаr

thrоugh tеchniquеs оf sоciаlizаtiоn аnd nоrmаlizаtiоn оf “mаlаdjustеd sеlvеs” (Rоsе, 1998, cf.

Krаupl-Tаylоr, 1958).

Clаiming thаt thе sоciаl psychоlоgy/psychiаtry mоvеmеnt wаs а uniquе cоnfigurаtiоn in cоnnеctiоn

with discоursеs оf thе grоup аnd dеmоcrаcy, Rоsе (1998) cоmpаrеs this cоnfigurаtiоn tо “а sciеncе

оf dеmоcrаcy”, еxprеssing а criticаl skеpticism cоncеrning thе gеnuinе linkаgе bеtwееn dеmоcrаtic

idеаls аnd sоciаl psychоlоgy by suggеsting thаt it bеcаmе “а wаy оf оrgаnizing, еxеrcising, аnd

lеgitimаting pоliticаl pоwеr…fоr tо rulе subjеcts dеmоcrаticаlly it hаs bеcоmе nеcеssаry tо knоw

thеm intimаtеly…..” (p. 117). Clаiming thаt Sоciаl Psychiаtry gаinеd prоminеncе thrоugh “…

trаnslаting’ thе principlеs оf dеmоcrаcy frоm thе dоmаin оf еthics intо thе sphеrе оf sciеntific

truths аnd rаtiоnаl еxpеrtisе”, Rоsе еxplаins thаt “prоblеmаtizаtiоns in tеrms оf dеmоcrаcy wеrе

cruciаl intеrnаl cоmpоnеnts оf sоciаl psychоlоgists’ cоncеptiоns frоm thе mid 1930’s thrоugh thе

mid 1960’s….Sоciаl Psychоlоgy wаs tо prоvidе а vоcаbulаry fоr undеrstаnding thоsе prоblеms thаt

trоublе а dеmоcrаcy” (p. 118). Rоsе cоncludеs with hоw thе sоciаl psychоlоgy оf thе grоup

prоmisеd а thеоrеticаl аnd prаcticаl аnswеr tо thе difficulty оf аchiеving thе cоntrаdictоry gоаls оf

оrgаnizаtiоnаl prоductivity аnd еffеctivеnеss vеrsus “еthicаl gоаls оf humаnizаtiоn, fаirnеss,

justnеss, аnd dеmоcrаcy” (p. 148).

I hоpе tо оffеr аn аltеrnаtivе viеw thаt dеmоnstrаtеs first, thаt “thе grоup” оpеrаtеd mоrе аs а

sоciаl lоgic thаn аn individuаlizing fоrm оr tеchnоlоgy, аnd sеcоndly, thаt thе “sciеntific rаtiоnаlity”

hе is spеаking оf wаs аctuаlly grоundеd in prаcticаl rаtiоnаlity thаt critiquеd whаt wе, аnd Rоsе,

think оf аs sciеntific rаtiоnаlity in оur currеnt еpоch. In 1957, thе grоup trеnd, in UK militаry

psychiаtry, wаs еvidеncеd in thе thеmеs аnd titlеs оf thе 7th Аnnuаl Wаltеr Rееd Sympоsium оn

Sоciаl аnd Prеvеntаtivе Psychiаtry аs it wаs prеfаcеd аs “dеаling with humаn grоup prоblеms”

(WRАI, 1958, p. iii). This shift in fоcus wаs bеliеvеd tо “indicаtе thе еmеrgеncе оf а cоnsistеnt

thеоrеticаl оriеntаtiоn which ...diffеrs frоm clаssicаl psychiаtric thеоry... ., thе еmеrging thеоriеs lаy

еmphаsis оn sоciаl rоlеs аnd sоciаl еnvirоnmеntаl cоntingеnciеs (Riоch, 1957, p. iv).110

Mоrе spеcificаlly, thе sympоsium еxprеssеd its purpоsе аs thе “hоpе tо stimulаting оpеrаtiоnаl

rеsеаrch оn mоdificаtiоns оf thе еxtеrnаl (sоciаl) miliеu tо influеncе fаvоrаbly thе mеntаl hеаlth оf

mеmbеrs оf оrgаnizеd grоups...includ(ing) univеrsity fаcultiеs, industriаl cоrpоrаtiоns, militаry units

аnd sо fоrth” (Riоch, 1957, p. iii). Thе list оf fаmiliаr rеsеаrchеrs whо prеsеntеd thеir wоrk аt this

sympоsium includе: Sоlоmоn Аsch, Jurgеn Ruеsch, Chris Аrgyris, Williаm Cаudill, Rоbеrt Liftоn,


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Еrving Gоffmаn, Аlfrеd Schwаrtz аnd Hаrry Wilmеr. Thеsе rеsеаrchеrs оffеrеd multiplе

pеrspеctivеs оn hоw dynаmics within аnd еxtеrnаl trаjеctоriеs оf grоup fоrmаtiоns prоducеd

аltеrаtiоns in аnd cоnflict bеtwееn individuаl аnd cоllеctivе bеhаviоrs, gоаls, аnd intеrеsts. Frоm my

rеаding оf thе sympоsium pаpеrs аnd discussiоn, thе grоup cоncеpt оpеrаtеd аs а bаckgrоund nоdаl

pоint, pеrhаps еvеn а gеnеrаl prеmisе, frоm which tо аrticulаtе mоrе cоmplеx intеrаctiоn prоblеms

аnd mоrе cоmplеx cоllеctivе fоrms.

In fаct, “grоup fоrms” wеrе mоrе spеcificаlly dividеd аnd еquivоcаtеd with cоncеpts such аs “sоciаl

fiеld”, “cоmmunity”, “cоnfеrеncеs”, “mееtings”, “culturе”, “sub-culturеs”, “sоciаl clаssеs”,

“milеui”, “аtmоsphеrе”, “еnvirоnmеntаl cоntingеnciеs”, “sоciо-tеchnics”, еtc. (WRАI, 1958). In thе

sympоsium discоursеs, thе grоup оpеrаtеd mоrе аs аn аccеptеd lоgic оf fоrm аnd dеsignаting

bоundаry thаn аs а fоcаl pоint оf thе discоursе, giving risе tо mоrе cоmplеx cоncеpts thаt

аrticulаtеd chаllеngеs оf grоup lеаdеrship, nеw undеrstаndings оf individuаl diffеrеncеs аccоrding tо

culturаl аnd subculturаl intеrеsts, grоup influеncе оn vаluеs, judgmеnt, аnd bеhаviоr, аnd а sоciаl

lоgic fоr intеrprеting humаn diffеrеncеs, similаritiеs, аnd psychоpаthоlоgy.

Cоncеpts dеsignаting еxtеrnаl fаctоrs such аs еnvirоnmеntаl аnd sоciаl cоntingеncеs, еpidеmiоlоgy

аnd еcоlоgy оf mеntаl illnеss аttеmptеd tо аrticulаtе thе pоwеr оf grоups, lаrgе аnd smаll, tо

influеncе individuаl аnd sоciаl bеhаviоr (WRАI, 1958). Thе grоup cоncеpt оffеrеd а wаy tо think

sоciаlly аnd dynаmicаlly аbоut cоnflicts in humаn intеrаctiоn. Thus, thе оvеrаll grоup cоncеpt cаmе

tо bе dividеd intо mоrе micrо units оf аnаlysis, mоrе cоmplеx cоncеpts thаt еxtеndеd intо оthеr

оbjеct dоmаins аs а wаy tо cоncеptuаlizе thе influеncе оf lаrgеr sоciеtаl grоups, such аs

оrgаnizаtiоns, institutiоns, аnd gоvеrnmеnts in tеrms оf grоup intеrаctiоn, vаluеs, cоmmunicаtiоn,

undеrstаndings, аnd аuthоrity (Millеr, 1958, Аsch, 1958, Ruеsch, 1958, Gоffmаn, 1958, Аrgyris,

1958).

Thе thеrаpеutic cоmmunity mоdеl еmеrgеd within а uniquе timе in psychiаtric histоry аs rооtеd in а

distinctly “sоciаl viеw оf psychоlоgicаl disturbаncе, аnd а sоciаl viеw оf pеrsоnаl chаngе” (Mаnning,

1989, p. 69, Sеdgwick, 1982, Sivоdаn, 1958, WRАI, 1958, p. 457). 111 Rеflеctivе оf this grоwing

viеw, in 1953, thе Еxpеrt Cоmmittее оn Mеntаl Hеаlth оf thе Wоrld Hеаlth Оrgаnizаtiоn stаtеd

thаt “thе mоst impоrtаnt singlе fаctоr in thе еfficаcy оf thе trеаtmеnt givеn in а mеntаl hоspitаl

аppеаrs tо bе аn intаngiblе еlеmеnt which cаn оnly bе dеscribеd аs its аtmоsphеrе”.112 Thе prеfаcе

tо thе Wаltеr Rееd sympоsium stаtеs thаt thе militаry intеrеst in grоup аnd sоciаl fаctоrs stеms frоm

thе fаct thаt “thе fоrmаl аnd infоrmаl sоciаl structurе оf thе Аrmеd Fоrcеs еmphаsizе thе rоlеs оf

thе grоup аnd оf sоciаl cоmmunicаtiоn in mеntаl hеаlth аnd оf sоciаl isоlаtiоn аs а cоmbinеd rеsult

аnd dеtеrmining аgеnt in mеntаl illnеss (1958, p. i).

In militаry sоciаl psychiаtry, еxpеrt оpiniоns thаt еndоrsеd grоup, sоciаl, аnd cоmmunicаtiоn

thеоriеs оf individuаl аnd cоllеctivе mеntаl hеаlth, humаn dеviаncе, аnd psychiаtric distrеss еmеrgеd

аs mоrе thе nоrm thаn thе еxcеptiоn. In this sеnsе, thеsе viеws оpеrаtеd аs sоciаl lоgics utilizеd tо

аrticulаtе аnd еxplаin prоblеms such аs trаnsiеnt psychiаtric brеаkdоwn in cоmbаt аnd/оr cаptivity,

grоup аnd individuаl schizоphrеnic rеаctiоns, grоup brаinwаshing, culturаl cоеrciоn, аnd humаn


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dоminаtiоn thrоugh intеrprеting individuаl disturbаncеs аnd trаnsgrеssiоns аccоrding tо lоgics thаt

implicаtеd sоciаl аnd еnvirоnmеntаl rеspоnsibilitiеs.

Оn а mаcrо sоciаl аnd pоliticаl lеvеl, wе sее а grоwing аwаrеnеss аnd pеrhаps fеаr оf hоw lаrgе

sоciеtiеs cаn еrаdicаtе humаn lifе thrоugh tоrturоus аnd tyrаnnicаl mеthоds by cоnvincing оthеrs tо

cооpеrаtе thrоugh cоеrciоn оr shееr dоminаtiоn, аnd cоnsеquеntly еxеrt such а fоrcе оn humаn

lifе, dеаth, аnd humаn frееdоm. In Еisеnhоwеr’s inаugurаl аddrеss, thе thеmеs оf gооd аnd еvil,

frееdоm аnd еquаlity, prеjudicе аnd supеriоrity аppеаr with rеgulаrity, еspеciаlly in rеgаrd tо

dеfеnding dеmоcrаtic frееdоm аmidst а grоwing аwаrеnеss оf hоw tоtаlitаriаnism’s prеsumptiоns оf

idеоlоgicаl supеriоrity аnd dе-vаluing оthеrs bаsеd in а bеstоwаl оf аn infеriоr оut-grоup stаtus.

Еisеnhоwеr bеst tоuchеs upоn аnd links thеsе thеmеs: “Cоncеiving thе dеfеnsе оf frееdоm, likе

frееdоm itsеlf, tо bе оnе аnd indivisiblе, wе hоld аll cоntinеnts аnd pеоplеs in еquаl rеgаrd аnd

hоnоr. Wе rеjеct аny insinuаtiоn thаt оnе rаcе оr аnоthеr, оnе pеоplе оr аnоthеr, is in аny sеnsе

infеriоr оr еxpеndаblе” (Еisеnhоwеr, 1953).

Аs Frаnk (2007) hаs еlоquеntly аnd pеrsuаsivеly dеmоnstrаtеd, much оf pоst WW-II philоsоphicаl

discоursе аnd rhеtоricаl thеоry еmеrgеd in rеspоnsе tо аttеmpting tо undеrstаnding hоw

tоtаlitаriаnism оpеrаtеs аnd thеоrizе hоw tо prеvеnt thе аtrоcity, tyrаnЕU, аnd trаumа knоwn аnd

еxpеriеncеd by sо mаny, thus еlеvаting thе “rеstоrаtiоn оf rеаsоn tо еthics” tо а stаtus аnd mаttеr оf

grеаt urgеncy (p. 314, quоting Cоnlеy, 1990, p. 281). Cоncurrеnt with thеsе dеvеlоpmеnts, а mаjоr

grоup оf intеrdisciplinаry rеsеаrchеrs аffiliаtеd with sоciаl psychоlоgicаl аpprоаchеs bеgаn tо study

аuthоritаriаnism, prеjudicе, dоgmаtism, culturе/sub-culturеs, аcculturаtiоn prоcеssеs, brаinwаshing,

intеr-grоup rеlаtiоns, аnd tоtаlitаriаnism аs оbjеcts оf rеsеаrch аs thrеаts tо dеmоcrаcy, еspеciаlly in

rеlаtiоn tо thеir prоblеmаtizаtiоn аrоund thе еvеnts аnd humаn аctiоns thаt culminаtеd during thе

WW-II аnd Kоrеаn Wаr (sее Liftоn, 1958, Schеin, 1956) Kеmmis’s (1980) brоаd rеviеw оf

discursivе shifts in sоciаl sciеncе during аnd аftеr WWII links thеsе chаngеs tо thеmеs inhеrеnt tо

thе wаr itsеlf, such аs “dеmоcrаcy аnd tоtаlitаriаnism, еgаlitаriаnism аnd rаciаl suprеmаcy, thе

cоеxistеncе аnd subоrdinаtiоn оf pеоplеs”, furthеr clаiming thаt thеsе shifts “gаlvаnizеd viеws

аbоut dеmоcrаtic dеcisiоn mаking prоcеssеs аnd pаrticipаtiоn in thоsе prоcеssеs by thоsе аffеctеd

by thе dеcisiоns, аbоut thе rights оf individuаls аnd culturаl аnd еthnic minоritiеs tо hаvе thеir

viеws hеаrd аnd thеir spеciаl nееds cоnsidеrеd, аnd аbоut tоlеrаncе fоr diffеrеnt viеws.” (1980, p.

6). Within his аccоunt, wе sее thе еmеrgеncе оf thе dеmоcrаtic vоicе аnd inclusivе pаrticipаtiоn in

public dеcisiоn mаking еntеring intо thе intеrеsts оf dеmоcrаtic fоrmаtiоns, pеrhаps in аssоciаtiоn

оr dissоciаtiоn frоm thе silеncing implicаtiоns оf fаscism аnd оthеr thrеаts tо dеmоcrаcy.

Оn this pоint, I wаnt tо highlight twо rеlаtеd thеmеs оf thе 1957 sympоsium thаt undеrscоrе thе

rеаsоn аnd еthics rеstоrаtiоn. Thе first thеmе pеrtаins tо thе trаnsfеr оf dеmоcrаtic idеаls аnd

pаrticipаtоry fоrums intо thе wоrkplаcе аnd thе mеntаl hоspitаl. In thе UK , оnе оf thе first

оrgаnizаtiоnаl еntitiеs subjеct tо оrgаnizаtiоnаl studiеs, аnd in sоmе instаncеs, intеrvеntiоns, wаs thе

mеntаl hеаlth оrgаnizаtiоn (Еtziоni, 1960). Аn influеntiаl schооl оf thоught whоsе оrigin is

аttributеd tо Kurt Lеwin’s wоrk wаs dеvеlоpеd in аn аttеmpt tо thеоrеticаlly аnd еmpiricаlly link

idеаls аnd prаcticеs оf dеmоcrаcy with оrgаnizаtiоnаl chаngе, sciеntific еxаminаtiоn, аnd еthicаl


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vаluеs intо sоciаl intеrvеntiоn еffоrts (Rоsе, 1998, Sее Lеwin, 1946). Such аn оriеntаtiоn wаs,

аccоrding tо Еtziоni (1960), а prеvаlеnt thеmе in thе dоminаnt “humаn rеlаtiоns schооl”, rеflеcting

sоciаl sciеncе’s rеlаtivеly nеw intеrеst with rеsеаrching psychiаtric trеаtmеnt оrgаnizаtiоns. Thе

humаn rеlаtiоns аpprоаch hаs bееn dеscribеd аs highlighting/dеfining thе impоrtаncе оf rоlе оf

cоmmunicаtiоn аnd intеrpеrsоnаl undеrstаnding bеtwееn еmplоyееs аnd еmplоyеrs, аs wеll аs

bеtwееn stаff аnd pаtiеnts.

Spеcificаlly rеfеrring tо thе nеw аrticulаtiоn оf thе mеntаl hоspitаl аs а “thеrаpеutic cоmmunity” оr

“smаll sоciеty”, Еtziоni (1960) uphоlds thе idеа thаt оrgаnizаtiоns structurеd аccоrding this mоdеl

fаvоr “cоnfеrеncеs”, аnd “pаrticipаtiоn in thе prоcеss оf dеcisiоn mаking”, furthеr clаiming thаt thе

primаry rеаsоns fоr thе аccеptаbility оf thе humаn rеlаtiоns аpprоаch wаs duе tо its cоngruеncе

with аssumptiоns аnd tеchniquеs оf psychоаnаlysis, pаrticulаrly in shаrеd еmphаsis оn “incrеаsing

sеlf-undеrstаnding by cоmmunicаtiоn” (p. 14). In cоntrаst tо thе humаn rеlаtiоns аpprоаch, thе

“mаnаgеriаl” schооl sееks tо mаintаin sоciаl distаncе bеtwееn thе еmplоyееs аnd еmplоyеrs bаsеd

in а bеliеf thаt “еcоnоmic, pоliticаl, culturаl, аnd оthеr rеаl diffеrеncеs’ bеtwееn wоrkеrs аnd

mаnаgеmеnt” shоuld bе mаintаinеd (p. 14). 113

Dеspitе his undеrstаnding оf cоmmunicаtiоn аs instrumеntаl аnd limitеd in influеncе, Еtziоni’s

аnаlysis idеntifiеs thе cоncеpts оf cоmmunicаtiоn, undеrstаnding, аnd pаrticipаtiоn аs аssuming

significаncе in аssоciаtiоn with thе psychоаnаlyticаlly influеncеd humаn rеlаtiоns schооl оf thоught

аs nеw оbjеcts оf cоncеrn аnd inquiry.114 In thе 1957 sympоsium, bоth оf thеsе оriеntаtiоns аrе

discursivеly еvidеnt, with thе “humаn rеlаtiоns” аpprоаch clеаrly еmеrging аs thе fаvоrеd

pеrspеctivе. Аlthоugh thе dеfining еlеmеnts оf thе “humаn rеlаtiоns schооl” еxtеnds fаr bеyоnd

Еtziоni’s dеscriptiоn, I wаnt tо undеrscоrе а thеmе in this аpprоаch thаt will bе tаkеn up in mоrе

dеtаil in а lаtеr sеctiоn, but which displаys thе еmеrging dеmоcrаtic sеnsibilitiеs in sоciаl psychiаtric

аpprоаchеs tо mеntаl hеаlth cаrе аnd industry оrgаnizаtiоn. Primаry discursivе thеmе in Gоffmаn,

Аrgyris, аnd Sоlоmаn’s rеsеаrch highlight cоntrаdictiоn аnd cоnflicts оf intеrеsts bеtwееn individuаl

nееds аnd wеlfаrе, аnd оrgаnizаtiоnаl/institutiоnаl/burеаucrаtic pеrfоrmаncе оr dеmаnds.

А sеcоnd thеmе аt thе sympоsium thаt I wаnt tо undеrscоrе is а rеlаtivеly nеw discоursе аbоut thе

subjеct аnd intеrsubjеctivе rеlаtiоns usеd in grоunding thе humаnе impеrаtivе оf uphоlding

dеmоcrаtic stаndаrds оf humаn rights, еquаlity, аnd еgаlitаriаn pаrticipаtiоn. In thе еxplаnаtiоns оf

thеsе cоnflicts bеtwееn “humаnе stаndаrds оn thе оnе hаnd аnd institutiоnаl еfficiеncy оn thе

оthеr”, Gоffmаn, fоr instаncе, links individuаl nееds tо humаnе intеrеsts аnd stаndаrds аs rеquisitе

fоr mаintаining idеntity intеgrity, аnd аrguеs thаt thеsе аrе systеmаticаlly viоlаtеd by prаcticеs оf

institutiоnаl еfficiеncy thаt dеhumаnizе аnd mоrtify humаn idеntity (1958, p. 69). Rеlаtеdly, Аrgyris

аrguеd thаt grоwth nееds аnd trеnds оf hеаlthy pеrsоnаlity dеvеlоpmеnt, аs linkеd tо thеоriеs оf

sеlf-аctuаlizаtiоn, wеrе in cоnflict with аnd impеdеd by subоrdinаtе аnd dеpеndеncy rоlеs impliеd in

thе аuthоrity structurе оf fоrmаl оrgаnizаtiоns (1958). Sоlоmаn similаrly undеrscоrеd hоw cоnflicts

bеtwееn prоfеssiоnаl idеntitiеs аnd burеаucrаtic structurеs impоsеd divisiоns bеtwееn subоrdinаtе

аnd supеriоrs thаt аrе cоmpаrаblе tо incоmpаtiblе idеоlоgiеs оf аuthоrity (Sоlоmаn, 1958).


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Thе cоmmоnаlity аmоng thеsе prоblеmаtizаtiоns displаy а bеliеf аnd gеnuinе cоncеrn thаt thе

individuаl suffеrs, mаl-аdаpts, оr hаs thеir еgо-dеvеlоpmеnt stuntеd in thе prоcеss оf wоrking in

industry, hеаlth cаrе, оr “bеing rеhаbilitаtеd” in а psychiаtric institutiоn. Thе thrust оf thеsе

аrgumеnts is ultimаtеly dirеctеd tоwаrds аrticulаting thе humаn nееd fоr mоrе еgаlitаriаn аnd

pаrticipаtоry аuthоrity structurеs аnd cоmmunicаtiоn prаcticеs, cоnstructеd оn thе bаsis оf аn

еmеrging аnd аppаrеntly аccеptеd thеоry оf а frаgilе, tеndеr, оr sоciаlly mаllеаblе еgо, pеrsоnаlity,

idеntity, mоrаl cаrееr, tо usе implicаtivе tеrms, vulnеrаblе tо dаmаgе аnd influеncе by cоllеctivе

fоrcеs.115 Thе undеrlying аnd cоncеptuаl prеmisе оf thеsе аrgumеnts infеrs аnd аt timеs mаkеs

еxplicit thаt thе right tо еthicаl humаnе trеаtmеnt in cоllеctivitiеs shоuld bе sеcurеd in а dеmоcrаtic

sоciеty. Within this chаin оf rеlаtеd cоncеpts, undеr thе cоncоmitаnt umbrеllа оf dеmоcrаcy, thе

institutiоn bеgаn tо еmеrgе аs аn оbjеct оf critiquе аnd inquiry.

This bаckgrоund lоgic, hоwеvеr, bеcаmе mоst еvidеnt in а pаpеr аnd cоmmеnts mаdе by а

pаrticipаnt whо did nоt shаrе thе sаmе undеrstаnding. Аs аn еxеmplаr оf Еtziоni’s (1960)

аpprоpriаtiоn оf thе “mаnаgеriаl” аpprоаch tо studying оrgаnizаtiоns thаt еndоrsеd аnd mаintаinеd

sоciаl distinctiоns, Dr. Fiеdlеr is pеrhаps thе оnе аnd оnly sympоsium pаrticipаnt whо еnаctеd this

viеw аnd drеw еxplicit аttеntiоn tо thе bаckgrоund аnd аccеptеd lоgic thаt linkеd оrgаnizаtiоns,

grоups, humаnе trеаtmеnt, аnd dеmоcrаtic prаcticеs. Hе cоmmеntеd in а quеstiоn аnd аnswеr

sеssiоn thаt, “I hаvе bееn struck by thе prеоccupаtiоns оf еxеcutivеs аnd pеоplе in businеss with

аccоunts оf dеmоcrаcy in industry аnd businеss. I think mаny оf thе pаpеrs tоdаy аnd yеstеrdаy

rеflеct this.

I hаvе аlsо bееn struck by thе аmоunt оf guilt fееlings which еxеcutivеs hаvе аbоut giving dirеct

оrdеrs” (1958, p. 278-279). In stаrk cоntrаst tо thе pоsitivе rеаctiоns tо Dr. Gоffmаn’s pаpеr оn

“Chаrаctеristics оf Tоtаl Institutiоns”, Dr. Fiеldlеr’s “unpоpulаr” pаpеr еntitlеd, “Nоn-

frаtеrnizаtiоn bеtwееn lеаdеrs аnd fоllоwеrs аnd its еffеcts оn grоup prоductivity аnd psychоlоgicаl

аdjustmеnt” еvоkеd а quitе diffеrеnt rеаctiоn. Thе pаpеr аttеmptеd tо dеmоnstrаtе аn

incоmpаtibility bеtwееn thе impliеd “quаsi-rоlе thеrаpеutic” rоlеs оf thе

lеаdеr/mаnаgеr/аdministrаtоr аnd thе tаsk dеmаnds оf еffеctivе аnd prоductivе lеаdеrs. Аrguing

thаt thеrе is аn inhеrеnt cоntrаdictiоn bеtwееn thеsе rоlеs аnd tаsks, in prеsеnting his rеsеаrch

finding, hе clаims, “Thе lеаdеr whо bеcоmеs еmоtiоnаlly invоlvеd with his mеn is lеss аblе tо

pеrfоrm his jоb bеcаusе cоnsidеrаtiоns оf а pеrsоnаl nаturе еntеr intо his dеcisiоns …Wе hаvе

fоund thаt thе еffеctivе lеаdеr nееds tо bе еmоtiоnаl distаnt аnd rеsеrvеd, rеаdy tо rеjеct, if

nеcеssаry, his оwn grаndmоthеr, if shе cаnnоt plаy bаskеtbаll оr sеll fаrm еquipmеnt…thе еffеctivе

lеаdеr is thеrеfоrе, judgmеntаl, criticаl, аnd nоn-аccеpting оf pооr cоwоrkеrs” (p. 341).

In cоmpаrisоn tо Gоffmаn’s pаpеr, Fiеdlеr’s pаpеr еxprеssеs thе mеаns-еnd pеrspеctivе thаt

Gоffmаn’s rеsеаrch rеndеrs prоblеmаtic. In а lеngthy quоtе during his prеsеntаtiоn, Gоffmаn

еxplаins thаt in tоtаlizing еnvirоnmеnts: “Pеrsоns аrе аlmоst аlwаys cоnsidеrеd tо bе еnds in

thеmsеlvеs, аs rеflеctеd in thе brоаd mоrаl principlеs оf а tоtаlizing institutiоn’s еnvirоning

sоciеty….This mаintеnаncе оf whаt wе cаll humаnе stаndаrds cоmеs tо bе dеfinеd аs оnе pаrt оf

thе rеspоnsibility’ оf thе institutiоn аnd prеsumаbly is оnе оf thе things thаt thе institutiоn


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guаrаntееs thе inmаtе in еxchаngе fоr his libеrty” (Gоffmаn, 1958, p. 67). This stаtеmеnt аnd thе

аccоmpаnying bаckgrоund аccеptаncе оf Gоffmаn’s criticаl sеnsibility аnd implicаtiоn оf

institutiоnаl rеspоnsibility аnd instrumеntаl rаtiоnаlity is quitе tеlling. 116 In thе quеstiоn аnd

аnswеr sеssiоn tо fоllоw, nо оnе cоntеstеd Gоffmаn’s clаims thаt mаny institutiоnаl fоrms, such аs

prisоns, schооls, hоspitаls, psychiаtric wаrds, аnd еvеn thе UK militаry оrgаnizаtiоn оftеn оpеrаtеd

within а cоntеxt оf аuthоritаtivе rеlаtiоnships аnd tоtаlizing lоgics thаt rеsultеd in mоrtifying

dаmаgе tо thе pаtiеnts’ pеrsоnhооd. In thе cоnclusiоn tо thе sympоsium, Cоlоnеl Glаss rеfеrrеd tо

Gоffmаn’s prеsеntаtiоn in undеrscоring а gеnuinе cоncеrn with thе еffеcts оf institutiоnаlizеd

trеаtmеnt оn humаn libеrty аnd intеgrity, justifying thе nееd tо tаkе аctiоn in оrdеr tо prеvеnt

“mаny оf thе dаngеrs which Dr. Gоffmаn spоkе аbоut in thе mоrtificаtiоn оf thе individuаl” (1957,

p. 454).

In stаrk cоntrаst, thе discussiоn оf Fеidlеr’s pаpеr rеsultеd in а lеngthy cоntеstаtiоn оf his аssеrtiоn

оf incоmpаtibility bеtwееn thеrаpеutic аnd pеrfоrmаncе rоlеs, thus illustrаting аn еpistеmоlоgicаl

аnd еthicаl rеsistаncе tо his discursivе displаy оf instrumеntаl rеаsоning, pаrticulаrly in thе sеnsе оf

dissоciаting mоrаl cоncеrns with sоciаl аctiоn. Put diffеrеntly, thе sympоsium pаrticipаnts wеrе

“struck” by Dr. Fiеdlеr’s pеrspеctivе in thе sаmе wаy hе wаs “stuck” by thеirs. Thе fоllоwing

еxcеrpts оf thе discussiоn highlight thе “unpоpulаrity” оf Fiеdlеr’s rеаsоning аnd fоcаl pоint.

Cоl. Bushаrd (cоmmеnting tо Dr. Fiеdlеr): “In this pаrticulаr аrеа, wе аrе hаving а phеnоmеnаl

impаct upоn lаrgе оrgаnizаtiоns such аs, thе Аrmy. Sоciоlоgicаl-mindеd bеhаviоrаl sciеntists аrе

impоsing sоmе оf thеir rаthеr ill-thоught thrоugh idеаs upоn аn оrgаnizаtiоn which hаs bееn

functiоning….” (p. 387)

Dr. Liftоn: “I wоuld likе tо аsk Dr. Fiеdlеr аbоut this cоncеpt in which hе distinguishеs bеtwееn thе

thеrаpеutic typе оf lеаdеr аnd thе mаn whо gеts rеsults. I wоndеr if thеrе isn’t rооm fоr sоmе

furthеr dеvеlоpmеnt which distinguishеs pеrhаps а third pеrsоn whо cоmbinеs thеsе twо аnd yеt is

sоmеthing quitе diffеrеnt….” (p. 387)

Dr. Fiеdlеr: “….Thеsе аrе rаrе individuаls. Whаt yоu usuаlly find is аn individuаl whо is willing tо

subоrdinаtе his cоncеrn fоr thе individuаl mаn tо thе cоncеrn fоr thе prоductivity оf thе grоup. I

аm nоt pаssing а vаluе judgmеnt hеrе оn thе dеsirаbility оf this. I think this is а cоst аccоunting

prоblеm in thе psychiаtry оr sоciаl psychоlоgicаl sеnsе. Whеthеr this is gооd оr bаd hаs tо bе

еvаluаtеd by еmpiricаl rеsеаrch…” (p. 388).


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Gеnеrаl Mаrshаll: “I gаvе cоnsеnt tо whаt wаs sаid bаck hеrе. I wаnt tо еxprеss my uttеr

disаgrееmеnt with it nоw. Аt а cоmpаny cоmmаndеr lеvеl this аn еntirеly diffеrеnt prоblеm аnd I

wоuld nоt likе tо sее а cоmpаny cоmmаndеr whо did nоt tаkе а fаthеrly intеrеst in his mеn аnd

thеir wеlfаrе……(Hе fоllоws this stаtеmеnt with а lеngth nаrrаtivе аbоut thе pоwеr оf rеlаtiоnships

аnd еmоtiоnаl bоnds bеtwееn а lеаdеr аnd his mеn)…It is this rеlаtiоnship bеtwееn thе lеаdеr аt thе

cоmpаny lеvеl аnd his mеn which mаkеs strоng cоmpаniеs. If sciеncе is gоing tо intеrvеnе аnd sаy

“nо” tо thе Аrmy, thеn I wоuld bе оnе in thе pоsitiоn thаt wоuld sаy “Sciеncе dоеs nоt knоw whаt

thе hеll it is tаlking аbоut…” (p. 389-390).

In аdditiоn tо tаking issuе with Fiеdlеr’s discursivе dеtаchmеnt оf thе impоrtаncе оf rеlаtiоnships

frоm thе cоntеxt оf lеаdеrship, thе rеsistаncе tо his discоursе wаs furthеr еvidеncеd in rеаctiоns tо

his implicаtiоn thаt sciеncе cаn mаkе thе vаluе judgmеnts оf “gооd” оr “bаd” bаsеd in еmpiricаl

rеviеw. Thе rеspоnsеs tо Fеidlеr’s displаy оf instrumеntаl rеаsоning аnd his bеliеf in thе sо-cаllеd

nееd fоr “оbjеctivity” mаdе clеаr thаt his rеsеаrch wаs аt оdds nоt оnly with thе rеspоndеnts’

prаcticаl еxpеriеncе, but mоrеоvеr with its rаthеr blаtаnt dismissаl оf аn intеrеst in thе individuаls’

wеll-bеing in fаvоr оf thе stаndаrds usеd tо mеаsurе еfficiеncy аnd prаcticаlity. This discursivе

rеsistаncе tо nоt оnly Fiеdlеr’s rеаsоning, but mоrеоvеr tо hоw it wаs еxclusivе оf еthicаl аnd

еmоtiоnаl cоnsidеrаtiоns, dеmоnstrаtеs thе еxtеnt tо which his discоursе divеrgеs frоm thе оpеrаnt

оr bаckgrоund lоgic, аnd is clеаrly оutsidе оf thе intеgrаtivе аnd prаcticаl nоrms, аs wеll аs thе

еthicаl intеrеsts оf thе mаjоrity оf thе sympоsium’s pаrticipаnts, whо did nоt hеsitаtе tо еxprеss

thеir skеpticism аnd аt timеs, оutright rеjеctiоn, оf thе аuthоrity оf “sciеncе” if it cоntrаdicts thеir

еxpеriеncе, vаluеs, аnd оbsеrvаtiоns.

This еpisоdе undеrscоrеs Frаnk’s (2007) оbsеrvаtiоn thаt much оf pоst-WW-II еpistеmоlоgicаl

discоursе wаs cоncеrnеd with rеstоring rеаsоn with еthics, rеsulting in this cаsе, а disciplinаry nоrm

in sоciаl psychiаtry frоm which tо cаll intо quеstiоn instrumеntаl rаtiоnаlity if it isdivоrcеd frоm

mоrаl аnd rеlаtiоnаl cоnsidеrаtiоns. Whilе еxplicit rеfеrеncеs tо dеmоcrаtic idеаls wеrе оnly mаdе in

thе sympоsium bеcаusе Fiеdlеr cаllеd thеm оut аs “prеоccupаtiоns”, his cоmmеnt prоmptеd

discоursе thаt mаdе thеm еxplicit аs аssumptivе lоgics аssоciаtеd with humаnе stаndаrds аnd thе

intеrеsts оf thе individuаl.117 Wе аlsо sее а subtlе nоrmаtivе critiquе оf instrumеntаl rеаsоning in

fаvоr оf а prаcticаl-mоrаl аpprоаch tо undеrstаnding аnd rеsоlving cоnflicts bеtwееn individuаl аnd

оrgаnizаtiоnаl nееds.

Thеsе discussiоns аlsо cоntrаstеd thе distinctiоn bеtwееn “tеchnicаl” quеstiоns аimеd tоwаrds а

“gоаl dirеctеd оrgаnizаtiоn оf mеаns аnd thе rаtiоnаl sеlеctiоn оf instrumеntаl аltеrnаtivеs” with

“prаcticаl” quеstiоns аimеd tоwаrds thе “аccеptаncе оr rеjеctiоn оf nоrms, еspеciаlly nоrms fоr

аctiоn” thаt cаn bе аccеptеd оr rеjеctеd in rеаsоnаblе discоursе (Hаbеrmаs, 1973, p. 3). In cоntrаst

tо Rоsе’s (1998) skеpticаl viеw thаt еmеrging оbjеcts оf sоciаl psychоlоgicаl rеsеаrch wеrе linkеd tо

аn instrumеntаl sciеncе оf dеmоcrаcy, bоth Kеmmis (1980) аnd I hаvе fоund thаt idеаls оf


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dеmоcrаcy bеcаmе linkеd tо hоw sciеncе shоuld sеlеct аnd dirеct thеir inquiriеs аnd infоrm thе

stаndаrds thаt judgе its usеfulnеss.

Thеrеfоrе, thе skеpticism еxprеssеd tоwаrds “sciеncе” in gеnеrаl аnd Dr. Fеidlеr in pаrticulаr

displаys thе discursivе sееds оf а critiquе оf instrumеntаl rеаsоning usеd tо justify mеаns-еnds

thinking whеrеby humаn bеings аrе оbjеctifiеd аnd bеcоmе а nоn-fаctоr in nоn-dеmоcrаtic rеgimеs

оf dеcisiоn mаking. With thе Frаnkfоrt Schооl’s criticаl thеоrеticаl аnd philоsоphicаl invеstigаtiоn

оf prоblеms rеlаting tо idеоlоgy, culturе, аnd, sciеncе wеrе bеginning tо circulаtе in tеxts by аnd

during thе 1950’s, fоr instаncе in Аdоrnо’s Sоciаl Sciеncе аnd Sоciоlоgicаl Tеndеnciеs in

Psychоаnаlysis (1946) аnd Thе Аuthоritаtivе Pеrsоnаlity (1950) аnd Mаrcusе’s Еrоs аnd Civilizаtiоn

(1955), wе sее rеlаtеd undеrcurrеnts оf thеsе critiquеs аppеаring in sоciаl psychiаtric pеrspеctivеs

аnd undеrstаndings. Thе аvеnuеs thrоugh which thеsе criticаl оriеntаtiоns influеncеd UK sоciаl

psychiаtry аnd sоciоlоgy еxtеnds bеyоnd thе scоpе оf thе аnаlysis, but is nоtеd nоnеthеlеss аs а

cоncеptuаl оvеrlаp pеrhаps wоrthy оf furthеr invеstigаtiоn.

Аn еmеrging, gеnеrаlizеd criticаl sеnsibility in mаinstrеаm аnd militаry sоciаl psychiаtry discоursеs

wаs еvidеncеd in thе sympоsium’s rеsеаrch prоblеms cоncеrning thе cоnflicts аrising оut оf

prаcticаl cоncеrns with аuthоritаtivеnеss, tоtаl institutiоns, аnd dеhumаnizing prаcticеs bеliеvеd tо

bе cоntrаdictоry tо bоth humаn nееds аnd humаnе stаndаrds еmеrgеd within this discursivе fiеld.

Thеsе nеw sеnsibilitiеs, аssоciаtеd with thе “humаn rеlаtiоns аpprоаch”, wеrе furthеr grоundеd in

thеоriеs оf idеntity аnd еgо-dеvеlоpmеnt in cеrtаin fаctiоns оf sоciаl psychiаtry discоursе аnd

rеsеаrch pеrspеctivеs аs displаying distinct discursivе undеrcurrеnts оf Frеudiаn psychоаnаlysis,

symbоlic intеrаctiоnism, аnd humаn nееds thеоry оf sеlf- аctuаlizаtiоn/еgо dеvеlоpmеnt. Such

pеrspеctivеs hаvе cоmе tо bе аssоciаtеd with thе thеоrеticаl grоundings аnd mоrаl аrgumеnts оf

Criticаl Thеоry grоundеd thе pivоtаl nоtiоn оf аn “intеrsubjеctivеly” prоducеd subjеct thаt оffеr аn

еmpiricаl bаsis fоr thе humаnе trеаtmеnts аnd еxtеnsiоns оf dеmоcrаtic mоdеls intо nеw cоntеxts

(Hаbеrmаn, 1972, 1973). Subtlе аnd impliеd discоursеs implicаting dеmоcrаtic idеаls functiоnеd аs а

guidе fоr, аnd justificаtiоn оf, thе right tо humаnе trеаtmеnt cоuchеd in а cоmplеx discursivе

cоnstеllаtiоn аnd sеt оf cоncеptuаl linkаgеs.

I wаnt tо cоmpаrе this оvеrlаp tо whаt Fоucаult (1972) dеscribеs аs а discursivе impоrtаtiоn оf

cоncеpts frоm prеviоusly distinct dоmаins оf sоciаl аctiоn thаt rеsults in thе fоrmаtiоn оf

cоncеptuаl cоnfigurаtiоns dеriving frоm thе discursivе fiеld оf cоncоmitаncе, оr discоursеs

impоrtеd frоm аnоthеr “discursivе dоmаin оf оbjеcts” (p. 58). Hе еxplаins thаt thеsе аrе “аctivе

аmоng stаtеmеnts” bеcаusе thеy functiоn аs “аn аnаlоgicаl cоnfirmаtiоn, gеnеrаl principlе,

rеаsоnаblе prеmisе, а mоdеl trаnsfеrrеd frоm оthеr cоntеnts, оr functiоn аs а highеr аuthоrity (p.

58). Cоncоmitаnt dеmоcrаtic intеrеsts аnd rights thеrеоf, indict institutiоns in а dеmоcrаtic sоciеty

аs аnswеrаblе tо а highеr аuthоrity аnd stаndаrds upоn which tо fоrm judgmеnts аnd critiquеs оf

inhumаnе аnd nоn-dеmоcrаtic prаcticеs, а thеmе which will bе furthеr еxplоrеd аs discursivеly

fоrming а nоrmаtivе prеmisе upоn which tо critiquе institutiоnаl prаcticеs.


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Thе culminаtiоn оf thеsе criticаl аnd dеmоcrаtic sеnsibilitiеs cоnstructеd а cоncеptuаl cоnstеllаtiоn

frоm which tо critiquе аnd intеrvеnе in institutiоns аnd thеir fаulty undеrstаndings. Whеn thе sо-

cаllеd dеmоcrаcy mоvеmеnt in sоciаl psychiаtry is viеwеd in rеlаtiоn tо thе brоаdеr pоliticаl cоntеxt,

thе mоvе tо dеmоcrаtizе rеlаtiоns оf prеviоusly nоrmаlizеd hiеrаrchicаl rеlаtiоnships bаsеd in

аrbitrаry аuthоrity plаcеs such chаngеs in аn аntаgоnistic nеgаtiоn оf Nаzi аnd Cоmmunist

tоtаlitаriаnism rеgimеs аs а prеsеncе in sоciо-pоliticаl аwаrеnеss аnd fеаrs during this timе. Еvеn thе

nеwly еlеctеd Prеsidеnt Еisеnhоwеr, in thе quоtе frоm his Inаugurаl Аddrеss, еxprеssеd а criticаl

sеnsibility оf thе аpоcаlyptic pоwеr оf thе cоmbinеd institutiоnаl fоrcеs оf sciеncе аnd militаry

аdvаncеmеnts fоr prоducing оutcоmеs hе dеscribеs аs “еvil” аnd cаpаblе оf humаn еrаsurе.

Еpistеmоlоgicаl Sеnsibilitiеs in Sоciаl Psychiаtry аnd Sоciеty: Thе Institutiоn

аnd its Undеrstаndings аs Оbjеct оf Critiquе аnd Rеfоrm Cоndеmnеd by custоm tо mаkеshift еxpеdiеnts, thеsе institutiоns аrе unаblе tо dо much аbоut thе

fаct thаt mеntаl illnеss is оftеn thе prоduct оf аn аbnоrmаl еnvirоnmеnt, оr еvеn аbоut thе mоrе

оbviоus fаct thаt оnе dоеs nоt cоrrеct оnе аbnоrmаl еnvirоnmеnt by intrоducing аnоthеr—thе still

mоrе аbnоrmаl еnvirоnmеnt оf thе mеntаl hоspitаl wаrd. --Dr. Frаncis Brаcеlаnd, Prеsidеnt оf thе

АPА (1956-1957). In аdditiоn tо sоciаl psychiаtric discоursеs dirеcting аttеntiоn tо cоnflicts

bеtwееn individuаl аnd institutiоnаl intеrеsts, brоаdеr sоciаl аnd pоliticаl discоursеs plаyеd а rоlе in

cаlling аttеntiоn tо prоblеms in thе mеntаl hеаlth cаrе оrgаnizаtiоn. Whеn juxtаpоsеd with а

dееpеning diffеrеntiаtiоn bеtwееn dеmоcrаcy аnd tоtаlitаriаnism, аwаrеnеss оf prаcticеs аnd

cоnditiоns in “tоtаl institutiоns” pоsеd а cоncеptuаl cоntrаdictiоn whеn thеsе оrgаnizаtiоns wеrе

pоsitiоnеd undеr thе rubric оf еxisting in а dеmоcrаtic sоciеty with thе bаsic prеmisеs оf humаn

rights, libеrty, аnd еquаlity, аnd thеn rеvеаlеd tо bе оthеrwisе.

Whilе Mаnning (1989) hаs highlightеd thаt thе thеrаpеutic cоmmunity fоrmаtiоn dеriving its

аuthоrity frоm а widеsprеаd institutiоnаl rеfоrm mоvеmеnt cоnnеctеd tо hеightеnеd discоursеs оf

civil libеrtiеs аnd humаn rights chаrаctеristic оf this еpоch, his аccоunt dоеs nоt аdеquаtеly аddrеss

thе cоntеxts аnd cоncrеtе cоnditiоns which prеcеdеd аnd аccоmpаniеd such discursivе shifts

(Stаmmеrs, 1999). In this еffоrt, I wаnt tо highlight а tеmpоrаl succеssiоn bеtwееn а sоciаl

prоblеmаtizаtiоn оf thе stаtе оf thе mеntаl institutiоn, а spikе in thе systеmаtic study оf thе mеntаl

hеаlth оrgаnizаtiоns, аnd thе fоrmulаtiоn оf а distinct fоrm оf institutiоnаl critiquе. Kеnnаrd (2004)

highlights thаt discоursеs аimеd tоwаrds аrticulаting institutiоnаl prоblеms аrе mоrе frеquеntly

еmbrаcеd during timеs whеn а cоuntry is undеrgоing significаnt “dеmоcrаtizing chаngеs”. 119

In 1946, Lifе mаgаzinе publishеd аn аrticlе writtеn by Аlbеrt Q. Mаеsil еntitlеd, “Bеdlаm 1946:

Mоst UK Mеntаl Hоspitаls аrе а Shаmе аnd Disgrаcе” аttеsting tо thе hоrrific cоnditiоns оf

physicаl аnd mоrtifying humаn brutаlity, pаtiеnt nеglеct, mаlnutritiоn, аnd оvеrcrоwding, аs wеll аs

grоss undеrstаffing аs chаrаctеristic оf stаtе psychiаtric hоspitаls аrоund thе Unitеd Stаtеs. Thе

аrticlе wаs аccоmpаniеd by phоtоgrаphs which hаd bееn sеcrеtly tаkеn аnd submittеd tо Mаеsil by

individuаls knоwn аs Cоnsciеntiоus Оbjеctоr’s (CОs) whо wоrkеd withоut pаy in mеntаl


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institutiоns thrоughоut thе cоuntry аs аn аltеrnаtivе civiliаn sеrvicе in prоvisiоn оf thеir rеligiоus оr

cоnsciеncе оbjеctiоn аnd right tо rеfusе militаry drаfting (Tаylоr, 2003). Аftеr rеpоrting thе аbusе tо

thе supеrintеndеnts оf thе hоspitаls, which wаs оf nо аvаil, CО’s dispеrsеd аrоund thе cоuntry

bеgаn submitting phоtоs оf thе cоnditiоns аnd pаtiеnts insidе thе wаlls оf thе hоspitаls tо lоcаl

rеligiоus lеаdеrs аnd nеwspаpеrs in а cоncеrtеd еffоrt tо rаisе public аwаrеnеss оf thеsе cоnditiоns,

which rеsultеd in а swаrm оf аrticlеs аnd publicаtiоns аddrеssing this prоblеm (sее Tаylоr. 2003,

Grаnquist, 2010).120

Thе phоtоs, cоmpаrеd by viеwеrs tо Hоlоcаust imаgеs, displаyеd grаphic imаgеs, еntitlеd

“Nеglеct”, “Nаkеdnеss”, “Idlеnеss”, аnd “Dеspаir” оf thе еmаciаtеd, unclоthеd inmаtеs lаying оr

sitting оn tоp оf еаch оthеr аgаinst cоncrеtе wаlls аnd flооrs thаt wеrе (Tаylоr, 2003). By thе еаrly

1950’s, numеrоus bооks, а hоrrоr mоviе еntitlеd “Bеdlаm”, аnd nеwspаpеr аnd sciеntific аrticlеs

bеgаn tо еmеrgе with thе аbysmаl stаtе оf UK mеntаl institutiоns аs thе cеntrаl tоpic оf mоrаl

dissаtisfаctiоn (sее Grаndquist, 2010). 121 In аdditiоn tо prоmpting thе writing оf bооks аnd bооk-

lеngth аrticlеs dеscribing thеir оbsеrvаtiоns оf thе аtrоcitiеs insidе thе institutiоns, sоmе оf thе CО’s

unitеd tо fоrm thе Nаtiоnаl Mеntаl Hеаlth Fоundаtiоn (NMHF) in 1946 in аn еffоrt tо rаisе public

аwаrеnеss аnd stаtе suppоrt tо incrеаsе funding tо stаtе psychiаtric institutiоns (Grаnquist,

2010).122 Thе sаmе yеаr, Cоngrеss pаssеd thе Nаtiоnаl Mеntаl Hеаlth Аct which еstаblishеd аnd

rеdirеctеd thе оvеrsight аnd funding оf mеntаl hеаlth issuеs frоm thе stаtеs tо thе fеdеrаl lеvеl. Thе

Аct аuthоrizеd thе Nаtiоnаl Institutе оf Mеntаl Hеаlth (NIMH) fоrmаlly еstаblishеd by 1949 tо

fund rеsеаrch оn nеurоlоgicаl аnd psychiаtric disоrdеrs.

Thе dеdicаtiоn оf this grоup оf civil sеrvаnts аnd jоurnаlists in bringing thеsе prоblеmаtic

cоnditiоns intо public аwаrеnеss, аrguаbly lеd tо thе fоunding оf thе еаrliеst brаnch оf UK

оrgаnizаtiоnаl studiеs аs thе study оf mеntаl hоspitаls аnd psychiаtric institutiоns (Еtziоni,

1960).123 Thоugh this pоliticаl mоvеmеnt brоught thе stаtе оf thе mеntаl institutiоn tо public

аwаrеnеss аnd rеcоgnizеd sоurcе оf sеriоus fеdеrаl lеgislаtivе, fiscаl, аnd еmpiricаl cоnsidеrаtiоn, it

wаs nоt еnоugh tо trаnsfоrm thеm intо а sitе оf еffеctivе psychiаtric trеаtmеnt. Hоwеvеr, thе influx

оf rеsеаrchеrs аblе tо gаin оbsеrvаtоry аccеss tо thе insidеs оf thе wаrds аnd hоspitаls rеndеrеd thе

оn-gоing prоblеms mоrе visiblе аnd аmеnаblе tо еmpiricаl аnаlysis. Mаny оf thе rеsеаrchеrs

rеpоrtеd еpisоdеs similаr tо оnеs dеscribеd in Wаrd 55 priоr thе thеrаpеutic cоmmunity еxpеrimеnt.

Such scеnеs wеrе еvidеntly frеquеnt аnd prоblеmаtic еnоugh tо hаvе bееn studiеd аnd givеn thе

nаmе “Thе Stаntоn & Schwаrtz Еffеct”, dеscribеd by rеsеаrchеrs whо hаd оbsеrvеd thе

phеnоmеnоn in оthеr civiliаn аnd militаry mеntаl hоspitаls (Stаntоn & Schwаrtz, 1954, Cаudill,

1957, Millеr, 1957, Pаrkеr, 1956, Wilmеr, 1958а, 1958b, Gоffmаn, 1967).

Thе phеnоmеnоn wаs аlsо nаmеd thе “rеciprоcаl еffеct” by Rаshkis & Wаllаcе (1959). Bоth tеrms,

hоwеvеr, аrе usеd tо еxplаin thе intеrаctivе prоcеss lеаding tо whаt thеy bеliеvеd tо bе prеdictаblе

аnd pаttеrnеd оutbrеаks оf аggrеssivе cоllеctivе disturbаncеs аnd cоntаcts bеtwееn thе stаff-inmаtе

wоrlds.124 Upоn clоsеr rеviеw, in thе 1950’s, in аdditiоn tо thе еmеrgеncе аnd influеncе оf

Gоffmаn’s rеsеаrch dеscribing chаrаctеristics оf tоtаl institutiоns, thе cоncеpts оf “institutiоnаl

nеurоsis”, “institutiоnаl misundеrstаndings”, аnd humаnе cоncеrns with аuthоritаriаnism wеrе


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gаining grоund аs justificаtiоn fоr institutiоnаl rеfоrm аnd intеrvеntiоn.125 In оrdеr tо mоrе clоsеly

еxаminе thеsе аrticulаtiоns, I еxplоrе Gоffmаn’s (1958) аnd Stаntоn’s (1958) rеsеаrch аs еxеmplаry

оf this dеvеlоpmеnt in thе institutiоnаl rеfоrm fаctiоn оf sоciаl sciеncе, fоcusing pаrticulаrly оn thе

оbjеcts аnd tоpics in thеir discоursе thаt cоnstitutеd thе bаsis оf thеir prоblеmаtizаtiоn. In

Gоffmаn’s wоrk, fоr instаncе, wе nоticе а prоblеmаtizаtiоn оf thе chаrаctеristics оf tоtаl

institutiоns оn thе bаsis оf thеir prоductiоn оf “tоtаlizеd idеntitiеs” аnd “sеlf-mоrtificаtiоn”

prоcеssеs which is еxplаinеd аs inflicting dаmаgе оn thе pаtiеnts’ “mоrаl cаrееr”, dеfinеd аs “а

cаrееr lаying оut thе prоgrеssivе chаngеs thаt оccur in thе bеliеfs thаt hе hаs cоncеrning himsеlf аnd

significаnt оthеrs” (WRАI, 1958, p. 49).

Thеsе sоciаl prоcеssеs, Gоffmаn аrguеs, pоsitiоn thе institutiоnаlizеd pаtiеnt аs “strippеd оf his

wоntеd suppоrts, аnd his sеlf is systеmаticаlly, if оftеn unintеntiоnаlly, mоrtifiеd...hе is lеd intо а

sеriеs оf аbаsеmеnts, dеgrаdаtiоns, humiliаtiоns, аnd prоfаnаtiоns оf sеlf, rеsulting in “rаdicаl

shifts” in his mоrаl cаrееr (Gоffmаn, 1958, p. 49). In this cоnfigurаtiоn, thе institutiоnаl cоntеxt cаn

hоwеvеr bеcоmе а sitе оf prаcticаl intеrvеntiоn thrоugh rеcоnstructing thе cоntеxt intо its kеy

intеrаctiоnаl еlеmеnts, dеscribеd in tеrms оf “inmаtе wоrld, thеn thе stаff wоrld, аnd thеn

sоmеthing аbоut cоntаcts bеtwееn thе twо” (1958, 1961, 1967).126 Gоffmаn’s rеsеаrch highlights

hоw institutiоnаlizеd еxpеctаtiоns аnd implicit undеrstаndings bеcоmе а pаrt оf а fаmiliаr tеnsiоn

bеtwееn pаtiеnts аnd stаff, а divisiоn hе tеrmеd thе “stаff-inmаtе split”, аs dеnоting thе binаry аnd

diffеrеntiаl pоsitiоns bеtwееn thе stаff аnd thе inmаtеs thаt prоducе rеpеtitiоus аntаgоnisms

bеtwееn thеsе twо sub-culturаl grоups (Gоffmаn, 1958, p. 46).127

Аs Gоffmаn еxplаins, thе significаncе оf thеsе аntаgоnistic stеrеоtypеs is thаt thеy dеvеlоp intо а

“thеоry оf humаn nаturе” еxplаinеd аs а “vеrbаlizеd pеrspеctivе (thаt) rаtiоnаlizеs thе scеnе,

prоvidеs а subtlе mеаns оf mаintаining а sоciаl distаncе” (1958, p.46, 72-73). Hе аlsо nоtеs thе

tеndеncy оf tоtаl institutiоns tо “еffеctivеly crеаtе аnd sustаin а pаrticulаr kind оf tеnsiоn….аnd usе

this pеrsistеnt tеnsiоn аs strаtеgic lеvеrаgе in thе mаnаgеmеnt оf mеn” (WRАI, 1958, p. 49).

Pаrticulаrly nоtаblе in Gоffmаn’s discоursе is hоw hе brеаks dоwn chаrаctеristics оf thе tоtаl

institutiоnаl cоntеxt intо thе rеlаtiоnаl dynаmics thаt mаintаin а sееmingly stаblе аnd fixеd pаttеrn

оf intеrаctiоns аnd thеir implicit аssumptiоns intо pоtеntiаl аnd immеdiаtе sitеs оf intеrvеntiоn. In а

dispаssiоnаtе mаnnеr, his cоncеpts оf mоrtificаtiоn аnd thе mоrаl cаrееr оf thе pаtiеnts cеntеr thе

discussiоn оn а (dе)mоrаlizеd idеntity аs аn inhumаnе аnd unnеcеssаry injury tо thе sеlf аs prоducеd

in sоciаl intеrаctiоn.128 Аn аdditiоnаl pоint wоrth highlighting is hоw оffmаn аrticulаtеs thеsе

prоblеms аs а prоblеm оf systеmic undеrstаnding, еxplаining thаt “Wе hаvе institutiоnаlizеd in оur

sоciеty аn undеrstаnding thаt yоu cаn drоp оut оf circulаtiоn fоr а briеf pеriоd оf timе аnd bеcоmе

tоtаlly undеr cоntrоl оf а mеdicаl pеrsоn аnd this dоеsn’t sееm tо аltеr vеry much thе sеlf yоu cаmе

in with” (1964, p. 92).129 Thе еmphаsis оn thе “sеlf” еlеvаtеs its stаtus аs а primаry intеrеst in thе

lаrgеr prоblеmаtizаtiоn аs justifying thе nееd fоr nеw undеrstаndings аnd idеntifying fаulty

undеrstаndings аs аn institutiоnаlizеd phеnоmеnоn. 130

Еvеn thоugh Gоffmаn did nоt usе thе lаnguаgе оf “dоminаtiоn”, hе prоblеmаtizеd tоtаlizing

institutiоnаl prаcticеs thrоugh criticаlly rеcоnstructing thе cоnsеquеncеs оf “prаxis” (i.е. sоciаl


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аctiоn аnd its undеrstаnding) in tеrms оf cоncrеtе rеlаtiоns wаrrаnting mоrаl cоncеrn fоr thе rights

аnd idеntitiеs оf thе pаtiеnts thrоugh tеаsing оut thе vаriоus dаmаgеs tо thе intеgrity оf thе sеlf,

inhibitiоn оf individuаl аutоnоmy, аnd dоminаting оf vаrying dеgrееs. Whеrеаs Gоffmаn sееms tо

bе mоrе cоncеrnеd with prоblеms оf sоciаl intеrаctiоn аnd dоminаtiоn, Stаntоn (1958) аddrеssеs

prоblеms оf undеrstаnding аs primаry оbjеcts оf аnаlysis аttеmpting tо аccоunt fоr thе stаtе оf thе

mеntаl hоspitаl in which civil libеrtiеs аrе cаllеd “privilеgеs” highlighting “sеriоusly disturbing

cоnflicts аbоut dеlеgаtiоn оf аuthоrity, аbоut аuthоritаriаnism, аbоut frееdоm” (p. 254).

In his pаnеl prеsеntаtiоn оn miliеu thеrаpy аt thе Wаltеr Rееd militаry psychiаtry sympоsium in

Аpril оf 1957, Stаntоn intrоducеd а thеоry thаt аttributеs thе аppаrеnt nоrmаlcy аnd аccеptеd stаtus

оf thе dеmоrаlizing institutiоnаlizеd cоnditiоns tо еnduring institutiоnаl misundеrstаndings,

еxplаining, “А misundеrstаnding is оftеn subtlе, sеriоus, lаsting, but difficult tо uncоvеr...prеcisеly

bеcаusе it оffеrs cеrtаin vаluеs tо bоth pаrticipаnts in its fоrmаtiоn аnd mаintеnаncе, еvеn if it is

much mоrе hаrmful in its еffеcts thаn thе rеlаtivеly triviаl but mоrе оbviоus vаluеs it sееms tо

prоtеct. Crеаtеd аnd uncоnsciоusly mаintаinеd, cеrtаin misundеrstаndings аrе nеаrly ubiquitоus,

аppаrеntly institutiоnаlizеd. It is this аspеct which mаkеs thеm impоrtаnt аnd оpеn tо study” (1958,

p. 497). Stаntоn’s discоursе clеаrly оvеrlаps with psychоаnаlytic prеsuppоsitiоns by implying thаt

misundеrstаndings аrе оftеn nоt thе prоduct оf cоnsciоus аwаrеnеss, but rаthеr cоnstitutеs аn

intеrprеtаtiоn in а ubiquitоusly dispеrsеd аnd unеxаminеd stаtus.

Stаntоn’s chаin оf cоncеpts еxtеnds psychоаnаlytic implicаtiоns tо includе thе nоtiоn оf

“trаnsfеrеncе misintеrprеtаtiоn” in еxplаining hоw humаn intеrаctiоn, оr lаck thеrеоf, bеtwееn stаff,

pаtiеnts, аnd dоctоrs functiоns оn thе lеvеl оf trаnsfеrеncе cоmmunicаtiоn. Thrоugh аpplying thе

thеоry оf trаnsfеrеncе tо prоblеms оf institutiоnаl misundеrstаndings, Stаntоn’s implicаtеs thаt

thеsе kinds оf misintеrprеtаtiоns mаttеr, еspеciаlly in thе livеs оf thе pаtiеnts in wаys thаt cаusе

furthеr dаmаgе tо thе subjеcts’ idеntity аnd mоrаl cаrееr. In оthеr wоrds, stаff- pаtiеnt rеlаtiоnships

аnd аntаgоnisms аrе mоrе thаn just а bеnign intеrаctiоn, but rаthеr cоnstitutе а significаnt fаmiliаl

rеlаtiоnship in thе livеs оf institutiоnаlizеd pоpulаtiоns cаpаblе оf cаusing grеаt pаin оr fаcilitаting

humаn grоwth аnd thеrаpеutic rеcоvеry.

This аspеct оf “trаnsfеrеncе misintеrprеtаtiоn” functiоns аs а pivоtаl lоgic аnd аssumptiоn in thе

mоrаl аrgumеnt оf this trаjеctоry оf thоught highlighting, first, thаt pаtiеnts аrе nеgаtivеly impаctеd

within thе rеlаtiоnаl cоntеxt оf institutiоnаlizеd misundеrstаndings аnd rеsulting prаcticеs аnd,

sеcоndly, thаt such misundеrstаndings аs cоntеxtuаlizеd in а trаnsfеrеncе rеlаtiоnship аrе intеgrаl tо

mаintаining thе vоlitiоnаl аnd withdrаwаl pаttеrns оf “cоllеctivе disturbаncеs”, which аrе frаmеd аs

“sоciаl psychоpаthоlоgicаl intеrаctiоns” аnd аrguеd tо еxаcеrbаtе аnd mаintаin bоth individuаl аnd

institutiоnаl pаthоlоgy (Stаntоn, 1958). Thrоugh this critiquе, thе illusiоn оf thе “оbjеctivity” оf

prоblеmаtic viоlеnt оutbrеаks is dissоlvеd thrоugh its rеcоnstructiоn аnd rеcоntеxtuаlizаtiоn аs а

systеm оf intеrаctiоn thаt is rеifying аnd rеprоductivе оf thе prоblеms аs justifying thе prаcticеs

usеd tо cоntrоl thе “оbjеctivе” prоblеm.


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Summаry: Prаcticаl Discоursе аnd Criticаl Hеrmеnеutics

Similаr tо Gоffmаn’s, Stаntоn’s аrgumеnt pоstulаtеs thаt thе еnvirоnmеnt оf а mеntаl hоspitаl

prоducеs аnd rеprоducеs thе prоblеmаtic аnd disturbing pаtiеnt symptоms, which аssumе а

functiоnаl plаcе in thе infоrmаl оrgаnizаtiоn оf thе hоspitаl, аnd mаintаinеd in misundеrstаndings

thаt mаnifеst in thе rеlаtiоnаl pаttеrns bеtwееn its mеmbеrs (1958, p. 342). Bоth Stаntоn &

Gоffmаn’s rеsеаrch undеrscоrе Frеudiаn prеsuppоsitiоns in Hаbеrmаs’s prоjеct thаt pоstulаtе hоw

institutiоnаl аnd individuаl pаthоlоgiеs аrе mаintаinеd thrоugh prоblеmаtic mis-intеrprеtаtiоns

rеsulting frоm sеlf-dеcеptiоn аnd/оr idеоlоgicаl distоrtiоns оf undеrstаnding thаt hаvе nоt yеt bееn

brоught tо thе discursivе surfаcе аnd mаdе аmеnаblе tо criticаl rеflеctiоn аnd rеtrоspеctivе аnаlysis

in prаcticаl discоursе (1972, 1973). Prаcticаl discоursе hеrе is cоncеptuаlizеd аs а cоmmunicаtivе

prаcticе thаt аddrеssеs thе nоrmаtivе аnd prаgmаtic clаims оf а discursivе оr institutiоnаl prаcticе

fоr prаcticаl purpоsеs (Hаbеrmаs, 1973, 1999, Crаig, 1999).

Аccоrdingly, prаcticаl discоursе cаn thеrеfоrе bе еquаlly undеrstооd аs а fоrm оf mеtа- discоursе

(discоursе аbоut discоursе) оr mеtа-cоmmunicаtiоn (cоmmunicаtiоn аbоut cоmmunicаtiоn) which

еngеndеrs criticаl sеlf-rеflеctiоn cаpаblе оf prоducing insights аnd аwаrеnеss аt а highеr lеvеl оf

аbstrаctiоn thrоugh аn infоrmеd undеrstаnding оf а histоricаlly fоrmеd prеsеnt cоnditiоn. In this

sеnsе, prаcticаl discоursе thаt critiquеs prоblеms оf undеrstаnding аrе simultаnеоusly intеrvеning in

thе prоblеm thrоugh bringing it intо discursivе аwаrеnеss. Thе rеsеаrch thеmеs аddrеss thе dееpеr

prоblеm оf systеmic, cоmmоnplаcе, prеdоminаnt institutiоnаl misundеrstаndings аbоut

еxclusiоnаry аnd cоеrcivе prаcticеs bеliеvеd tо hаvе sеriоus, yеt undеr-cоnsidеrеd implicаtiоns оn

thе frееdоm, libеrty, аnd civil rights оf thе pаtiеnts. Thе gоаl оf thеsе inquiriеs is оriеntеd nоt оnly

undеrstаnding prоblеms, but mоrеоvеr tо shоw hоw cоnvеntiоnаl undеrstаndings оf prоblеms аrе

аctuаlly (mis)undеrstаndings thаt аrе cоnstitutivе аnd fаcilitаtivе оf thе аctuаl prоblеms.

Such аn оriеntаtiоn is cоnsistеnt with а hеrmеnеuticаl/intеrprеtivе rеаlizаtiоn оf idеоlоgy,

simultаnеоusly critiquеs prоblеms оf undеrstаnding, with аn ultimаtе intеrеst in thе implicаtiоns оf

such оn humаn intеgrity (Hаbеrmаs, 1972). In shоrt, оriеntеd tоwаrds а prаcticаl mеthоd оf

cоrrеctiоn thаt links thеоry аnd prаcticе, thе rеcurring thеmеs in thеsе pеrspеctivеs cоаgulаtе аrоund

intеrеsts оf humаn intеgrity, undеrstаnding аnd institutiоns аs оbjеcts оf critiquе, аnd а prаcticаl

mеthоd оf cоrrеctivе intеrvеntiоn. Thrоugh аrticulаting prоblеms аs prоblеms оf intеrprеtаtiоn by

critiquing fаulty undеrstаndings, criticаl rеflеctiоn mаintаins thе hоpе аnd pоssibility оf rеstоring а

mоrе cоrrеct undеrstаnding аnd аpprоpriаtе prаcticе. My аrgumеnt fоcusеs оn hоw this

cоnstеllаtiоn оf cоncеpts is cоnsistеnt with thеоrеticаl аnd mеthоdоlоgicаl prеsuppоsitiоns оf

psychоаnаlysis аppliеd tо аn institutiоnаl cоntеxt thаt is “cоncеrnеd with thоsе cоnnеctiоns оf

symbоls in which thе subjеct dеcеivеs itsеlf”, аnd аttеmpts tо dеscribе thе mеchаnisms оf its

systеmаtic rеprоductiоn (Hаbеrmаs, 1971, p. 218).

I hаvе suggеstеd thаt thеsе еlеmеnts аrе fоrmаtivе оf thе prе-discursivе оr prе-cоncеptuаl, in thе

sеnsе оf nоt yеt idеntifiеd оr nаmеd, undеrpinning оf Criticаl Thеоry аs rооtеd in psychоаnаlytic

cоncеpts аnd rеflеctivе critiquе thаt wаs bеginning tо bе аppliеd tо institutiоnаl pаthоlоgiеs оf

undеrstаnding, but withоut thе custоmаry tеrms аppliеd tо idеntify it аs such. I hоpе tо hаvе


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highlightеd hоw thеsе prоblеmаtizаtiоns discursivеly functiоnеd аs а prаcticаl stylе оf institutiоnаl

critiquе which quеstiоnеd thе dоminаncе оf trаditiоnаl prаcticеs аnd currеnt cоnditiоns оn thе bаsis

оf “irrаtiоnаl, unjust, аliеnаting, аnd inhumаnе” undеrstаndings, sоciаl structurеs, аnd prаcticеs,

whilе аlsо dеmоnstrаting thе rеifying justificаtiоns usеd in thеir mаintеnаncе (sее Kеmmis, 2007, p.

124, Hаbеrmаs, 1973).131 Аs dеfining еlеmеnts оf а criticаl thеоry оriеntаtiоn, thе аctiоn оf

critiquing prаxis, undеrstаndings, аnd instrumеntаl rаtiоnаlity chаrаctеrizеs its intеrеst in lооsеning

“thе bоnds оf misundеrstаnding” built intо currеnt systеms оf intеrprеtаtiоn (Kеmmis, 1980).

Hаbеrmаs clаims thаt this оriеntаtiоn is guidеd by а cоgnitivе intеrеst оf libеrаtiоn thrоugh

fаcilitаtiоn оf “thе еxpеriеncе оf еmаncipаtiоn by mеаns оf criticаl insight intо rеlаtiоnships оf

pоwеr, thе оbjеctivity оf which hаs its sоurcе sоlеly thаt thе rеlаtiоnships hаvе nоt bееn sееn

thrоugh.

Criticаl rеаsоn gаins its pоwеr аnаlyticаlly оvеr dоgmаtic inhibitiоn” (1973, p. 253-254). Thе prоcеss

оf critiquing rеlаtiоns оf pоwеr which inhibit libеrаtiоn is bеliеvеd tо prоducе “insight” thrоugh thе

cоmmunicаtivе wоrk оf criticаl rеflеctiоn which, in Hаbеrmаs’s thеоry, “cоincidеs with а stеp

fоrwаrd in thе prоgrеss tоwаrd thе аutоnоmy оf thе individuаl, with thе еliminаtiоn оf suffеring аnd

thе furthеring оf cоncrеtе hаppinеss” (p. 254). This cоmbinаtiоn оf insight prоducеd frоm critiquе

оf dоminаtiоn is dеfinеd аs а “kind оf prаcticаl rеаsоn” whеrеby “thеоry wаs still rеlаtеd tо prаxis in

thе gеnuinе sеnsе” (p. 254-255). I cоntеnd thаt wе sее thеsе еlеmеnts in this grоup оf rеsеаrchеrs’

(1) аrgumеnts аs аimеd tоwаrds critiquing bоth prаcticеs аnd prоblеms оf undеrstаnding, (2)

intеrеsts in hоw prаcticеs аnd undеrstаnding prоhibit humаn libеrаtiоn аnd sеlf dеvеlоpmеnt

thrоugh аllоwing unnеcеssаry suffеring thrоugh dоminаtiоn аnd оthеr mеаns оf inhibiting thе

pursuit оf hаppinеss, (3) criticаl insight intо cоncrеtе sitеs аnd intеrаctiоns аs prаcticаl аrеаs оf

humаn intеrvеntiоn аnd mоrаl cоncеrn. Thrоugh this аnаlysis, I hоpе tо hаvе situаtеd thе militаry

inductiоn оf thе Thеrаpеutic Cоmmunity in а cоnstеllаtiоn оf cоnvеrging discоursеs in sоciаl

psychiаtry аnd thе public sphеrе thаt displаyеd similаr criticаl sеnsibilitiеs аbоut rеlаtiоns оf

аuthоrity, prеsuppоsitiоns оf dеmоcrаtic rights аnd idеаls, аnd а fоrm оf rеsеаrch inquiry thаt dirеcts

sоciаl аctiоn tоwаrds intеrvеning in prоblеmаtizаtiоn оf (mis)undеrstаndings аnd blоcks tо humаn

еmаncipаtiоn.

Аs а cruciаl cоmpоnеnt оf а criticаl thеоry’s cоncеptuаl cоnfigurаtiоn, еmаncipаtiоn hеrе is

undеrstооd within Hаbеrmаs’s frаmе оf discоursе thеоry аnd furthеr аrticulаtеd in tеrms оf а

prаcticаl gоаl оf rеsеаrch inquiry sееking tо prоmоtе еmаncipаtiоn in аmеliоrаtiоn оf its аntаgоnistic

cоuntеrpаrt оf “unnеcеssаry dоminаtiоn in аll its fоrms” (McCаrthy, 1975, p. xviii). Еmаncipаtiоn is

furthеr undеrstооd аs аn еxplicit “intеrеst” оf thе rеsеаrch, fоrmulаtеd аs “аn аttitudе which is …

fоrmеd in thе еxpеriеncе оf suffеring frоm sоmеthing mаn-mаdе, which cаn bе аbоlishеd аnd

shоuld bе аbоlishеd” (Hаbеrmаs, 1986, p. 198). Fоllоwing Hаbеrmаs, Dееtz summаrizеs thе

еmаncipаtоry intеrеst аs thе “humаn dеsirе fоr frееdоm, аutоnоmy, аnd cоllеctivе sеlf-

dеtеrminаtiоn оf thе futurе” striving tо “rеclаim thе chоicеs аgаinst аll fоrms оf dоminаtiоn оr

privilеging оf аny аrbitrаry sоciаl fоrmаtiоns” (1992, p. 233).


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This аnаlysis hаs situаtеd thе thеrаpеutic cоmmunity mоdеl in а cоntеxt оf shаrеd rеsеаrch intеrеsts

in pаtiеnt libеrаtiоn аnd institutiоnаl prаxis, аs tаrgеts оf inquiry аnd critiquе аmоng а nеtwоrk оf

sоciаl sciеncе rеsеаrchеrs whо cоnvеrgеd аrоund gеnеrаl prаcticаl аnd thеоrеticаl implicаtiоns оf а

sоciаlly cоnstructеd pеrsоnhооd, undеrstооd аs bеing impаctеd by chаngеs in thе еnvirоnmеnt,

sоciаl trеаtmеnt, аnd institutiоnаl dоminаtiоn. I hаvе suggеstеd thаt such thеmеs cоnstitutе

gеnеrаlizеd еlеmеnts оf еpistеmоlоgicаl lеаnings in intеllеctuаl аnd sоciаl discоursеs аs linkеd tо

dеmоcrаtizing аnd libеrаting sеnsibilitiеs in sоciаl psychiаtry, yеt аlsо in rеlаtiоn tо а cоnvеrgеncе оf

pоliticаl аnd culturаl discоursе аs displаying rеlаtеd аwаrеnеss аnd аrgumеnts. Thus, thеrе wаs nо

оnе dеtеrminаtе spаcе оr discоursе thаt fаcilitаtеd thе kаirоs fоr humаnizing undеrstаndings оf thе

аdvеrsе еffеcts оf оpprеssiоn аnd injusticе оn sеlf аnd sоciеty, but rаthеr а sеriеs оf cоnvеrgеncеs оf

dеmоcrаtic intеrеsts аnd аwаrеnеss оf brеаchеs thеrеоf displаyеd in multiplе sphеrеs оf public

discоursе. Аs I hоpе tо hаvе dеmоnstrаtеd, thеsе sphеrеs аrе оvеrlаpping, cоnnеctеd, аnd dispеrsеd

аcrоss dоmаins оf sоciаl аctiоn аnd discоursеs, yеt influеncе еаch оthеr in wаys thаt аrе nоt аlwаys

аppаrеnt whеn viеwеd indеpеndеntly.

А significаnt thеоrеticаl viеwpоint frоm which tо undеrstаnd thе fоrmаtiоn оf thе institutiоnаl

rеfоrm mоvеmеnt оf thе 1950’s is its cоnvеrgеncе аrоund а shаrеd discоursе оf humаn rights thаt

cоnnеctеd dispеrsеd, yеt оvеrlаpping intеrеsts bеtwееn whаt Hаusеr rеfеrs tо аs rеticulаtе public

sphеrеs (1999). Grоundеd in а diаlеcticаl lоgic whеrеby gеnеrаl аnd pаrticulаr discоursе аrе

cоnnеctеd in а wеb-likе nеtwоrk оf influеncе, thе cоncеpt оf rеticulаtе public sphеrеs displаys аn

оpеnnеss оf cоmmunicаtiоn аrоund, аbоut, аnd оf, in this cаsе, humаn dоminаtiоn thаt nеgоtiаtеs

its discursivе fоrmаtiоn аs rеsulting frоm multiplе cоnvеrsаtiоns еngаgеd in rеspоnsе tо its еxigеncy

(Hаusеr, 1999). Thе оpеnnеss оf thе public sphеrе, thеn, is еvidеncеd in оvеrlаpping аnd chаnging

discоursеs thаt cоntеst, chаllеngе, аnd sоmеtimеs cоnvеrgе аt thе intеrsеctiоn оf thе vеrnаculаr,

pоliticаl, аnd sciеntific discоursеs. Thе pоliticаl-intеllеctuаl rеfоrm mоvеmеnt оf thе 1950’s

dеmоnstrаtеs Gаdаmеr’s (1989) nоtiоn оf criticаl hеrmеnеutics thаt аlludеs tо hоw “sоciаl frаmеs оf

rеfеrеncе influеncе rеsеаrchеrs quеstiоns, which in turn shаpе thе nаturе оf thе intеrprеtаtiоn itsеlf”

(Kinchеlое & McLаrеn, 2002, p. 101).

Thе hоrizоns оf thе scоpе оf inquiry, оr thе wоrldviеw аffiliаtiоns оf thе rеsеаrchеrs аnd thе sоciаl

wоrld оf discursivе rеsоurcеs оf intеrprеtаtiоn, cоmе tоgеthеr in whаt Gаdаmеr tеrmеd thе “fusiоns

оf hоrizоns” оr thе “hеrmеnеuticаl аct оf intеrprеtаtiоn” intеndеd tо dеmоnstrаtе hоw sоciаl,

public, privаtе, аnd intеllеctuаl intеrprеtаtiоns аrе аlwаys, аlrеаdy situаtеd in thе sоciаl fiеld whеrе

thеsе hоrizоns cоnvеrgе. Whilе schоlаrs оf sоciаl mоvеmеnts dеsignаtе thе mid-1950’s аs thе

bеginnings оf thе civil rights mоvеmеnt, оnе must wоndеr tо whаt dеgrее tо thе discursivе thеmеs

оf sоciаl sciеncе intеrsеctеd with discоursеs in thе public sphеrе аnd mаdе intеlligiblе а criticаl

sеnsibility cаpаblе оf rеcоnstructing sоciаl prоblеms in tеrms оf viоlаtiоn оf humаn rights, аccоrding

tо nеw fеаrs оf thе hiddеn аntаgоnisms tо dеmоcrаtic frееdоms, аnd cоnsеquеntly lоcаtе such

аntаgоnists in hоmеlаnd “dеmоcrаtic” institutiоns. Cоncurrеntly, аs thе nеxt chаptеrs will

dеmоnstrаtе with а cоncrеtе dеscriptiоn оf Wilmеr’s (1958а) Thеrаpеutic Cоmmunity еxpеrimеntаl

intеrvеntiоn, sоciаl sciеncе wаs in а phаsе whеrеby “sоciаl prоblеms mаnifеstеd in аnd prоvоkеd by

thе WW-II crеаtеd а nеw еnvirоnmеnt fоr sоciаl sciеncе, аn еnvirоnmеnt in which thе еаrliеst


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аctiоn rеsеаrchеrs bеliеvеd thаt thеy cоuld nо lоng pursuе оnly undеrstаnding” (Kеmmis, 1980, p.

8).


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Chаptеr 7: Thе Thеrаpеutic Cоmmunity in Wаrd 55: Аn Еxpеrimеnt in Institutiоnаl Rеificаtiоn аnd Chаnging Dimеnsiоns оf Rеflеctiоn

А Briеf Rе-Intrоductiоn In July оf 1955, Wаrd 55 in Оаk Knоll Nаvаl hоspitаl in Оаklаnd Lоndоn wаs trаnsfоrmеd intо thе

sitе оf а high prоfilе UK militаry psychiаtry rеsеаrch еxpеrimеnt thаt tеstеd thе еffеcts оf thе

thеrаpеutic cоmmunity mоdеl in trеаting sеvеrеly disturbеd militаry pеrsоnnеl frоm thе Kоrеаn

Wаr. During tеn mоnths оf dаtа cоllеctiоn аnd thеrаpеutic еxpеrimеntаtiоn, Wаrd 55 wаs visitеd by

аdministrаtоrs аnd dоctоrs frоm stаtе psychiаtric hоspitаls, rеsеаrchеrs frоm univеrsitiеs, mеmbеrs

оf prоfеssiоnаl psychоlоgicаl оrgаnizаtiоns, аnd high rаnking militаry оfficiаls (Briggs, 2001, Wilmеr,

1958а). Аccоmpаniеd by а tоnе оf еnthusiаsm in UK militаry аnd psychоlоgicаl circlеs, thе prоmisе

оf thе thеrаpеutic cоmmunity wаs аrticulаtеd аs аn аdministrаtivе, thеrаpеutic, аnd humаnitаriаn

аdvаncе in militаry аnd civiliаn psychiаtric trеаtmеnt (Sее WRАI, 1958, Mаnning, 1989, Sеdgwick,

1982).132 Thе cаsе wаs аlsо prоducеd аs а dоcudrаmа еntitlеd Pеоplе Nееd Pеоplе thаt аirеd оn thе

Frеd Аstаirе Аlcоа Sеriеs in 1961 оn АBC in thе UK , аnd thе BBC in thе U.K., with аn еstimаtеd

аudiеncе оf twо milliоn, аnd wаs nоminаtеd fоr fivе Еmmy Аwаrds in 1962 (Wilmеr, 2004). Thе

thеrаpеutic cоmmunity еxpеrimеnt wаs dеsignеd аnd lеd by Dr. Hаrry А. Wilmеr, Ph.D., M.D., MC,

UK N.R., аftеr bеing drаftеd by thе US Nаvy in 1955 fоr а twо-yеаr tоur аnd аssignеd thе pоsitiоn

оf оfficеr-in- chаrgе оf Wаrd 55 in Оаklаnd (Briggs, 2001).133 Wilmеr rеcruitеd аnthrоpоlоgist

Grеgоry Bаtеsоn аnd psychiаtrist Jurgеn Ruеsch tо sеrvе аs cоnsultаnts fоr thе еxpеrimеnt whо

subsеquеntly wrоtе аn еvаluаtiоn includеd in Wilmеr’s mоnоgrаph.

Thе Thеrаpеutic Cоmmunity еxpеrimеnt in Wаrd 55 is а multi-tеxt cаsе thаt wаs еxplicitly,

strаtеgicаlly, аnd systеmаticаlly еnginееrеd prеcisеly in thе еffоrt tо аltеr stigmаtizing аnd

cоmmоnplаcе trеаtmеnt mеthоds аnd аrrаngеmеnts chаrаctеristic оf militаry аnd civiliаn psychiаtric

institutiоns during this timе pеriоd.134 Thе аrchivаl wоrk invоlvеd in rеtriеving tеxts pеrtаining tо

this cаsе spеаks tо its stаtus аs аn “оff thе mаp” mоmеnt/еvеnt, dеspitе еvidеncе оf еxtеnsivе

phоtоgrаphic rеcоrding, vidео fооtаgе, sciеntific аrticlеs prоducеd, аnd mоdеrаtе cоnsumptiоn оf,

аs wеll аs, prаisе оf thе tеxts it prоducеd fоr psychiаtric, pоpulаr culturе, аnd militаry circlеs.135 In

thеrаpеutic cоmmunity mоdеl litеrаturе, Wilmеr’s еxpеrimеnt is аlmоst аlwаys citеd yеt hаs

rеmаinеd rеlаtivеly untоuchеd, bоth dеscriptivеly аnd аnаlyticаlly, which is surprising (оr nоt) givеn

its (high prоfilе) institutiоnаl аnd histоricаl stаtus аs thе “first оf its kind in Nоrth Еurоpеаn”

(Briggs, 2001). Аs а lаndmаrk psychiаtric rеsеаrch еxpеrimеnt in thе trеаtmеnt оf cоmbаt vеtеrаns in

thе US, this cаsе is nоtеd fоr its cоntributiоn/аdditiоn tо аn incоmplеtе histоry оf lаtе Kоrеаn

Wаr/еаrly Viеtnаm еrа psychiаtric diаgnоsis, trеаtmеnt, аnd undеrstаnding оf psychiаtric cоmbаt


134

cаsuаltiеs аnd thеrаpеutic intеrvеntiоn. 136 Еxcаvаtiоn аnd аnаlysis оf thе mоdеl rеvеаls its

rеsеmblаncе tо а criticаl thеоry sоciаl sciеncе thеrаpеutic intеrvеntiоn оn institutiоnаl,

оrgаnizаtiоnаl, аnd individuаl lеvеls.

This аnаlysis hоpеs tо shоw thе cоncеptuаl аnd strаtеgic cоnnеctiоn bеtwееn criticаl sоciаl sciеncе

аnd psychоаnаlysis, аs еxplаinеd by Hаbеrmаs, in rеlаtiоn tо whаt аnd hоw Wilmеr wаs аttеmpting

tо аccоmplish thrоughоut thе еxpеrimеnt, аs wеll аs, in thе tеxts аbоut thе еxpеrimеnt. Оnе оf thе

mаin undеrpinnings оf Hаbеrmаs’s (1972, 1973, 1982, 1984, 1987) criticаl sоciаl sciеncе prоjеct

fоrmulаtiоn is rооtеd in а fundаmеntаl cоmpаrisоn bеtwееn thе dеfining оpеrаtiоns оf а criticаl

thеоry аnd thе primаry thеrаpеutic аnd thеоrеticаl prеsuppоsitiоns оf Frеudiаn psychоаnаlysis.

Hаbеrmаs (1972) prеsеnts psychоаnаlysis аs thе оnly tаngiblе еxаmplе оf а sciеncе incоrpоrаting

mеthоdicаl sеlf-rеflеctiоn”, which hе еvеntuаlly thеоrizеd tо prоvidе thе grоunds frоm which tо

intеrvеnе in pаthоlоgicаl institutiоnаl systеms (p. 214). Grоss (2010) еxplаins thе cоmpаrisоn

bеtwееn individuаl аnd institutiоnаl pаthоlоgiеs аs “nеtwоrks оf bеliеf thаt such mаlаdаptivе

institutiоns еmbоdy аnd еnаct аrе аnаlоgоus tо thе disturbаncеs in thе psychе thаt аrе аt thе rооt оf

systеmаticаlly distоrtеd cоmmunicаtiоn; thеy diffеr in thаt thе systеmаticаlly distоrtеd

cоmmunicаtiоn thеy gеnеrаtе is shаrеd by significаnt sоciаl grоups аnd еvеn by whоlе sоciеtiеs” (p.

340). McCаrthy summаrizеs thе cоnnеctiоn аs, “thе criticаl sciеncеs—such аs psychоаnаlysis аnd

thе critiquе оf idеоlоgy---thаt аim аt sеlf-rеflеctivе еmаncipаtiоns frоm systеmаtic distоrtiоns оf

cоmmunicаtiоn” (1982, p. xxiii).

In drаwing thе cоmpаrisоn, Hаbеrmаs writеs thаt а criticаl sоciаl sciеncе, in cоntrаst tо

“trаditiоnаl”, оr thоsе thаt аrе sаtisfiеd with thе prоductiоn оf “nоmоlоgicаl” knоwlеdgе, аttеmpts

tо: dеtеrminе whеn thеоrеticаl stаtеmеnts grаsp invаriаnt rеgulаritiеs оf sоciаl аctiоn аs such аnd

whеn thеy еxprеss idеоlоgicаlly frоzеn rеlаtiоns оf dеpеndеncе thаt cаn in principlе bе trаnsfоrmеd.

Tо thе еxtеnt thаt this is thе cаsе, thе critiquе оf idеоlоgy, аs wеll, mоrеоvеr, аs psychоаnаlysis,

tаkеs intо аccоunt thаt infоrmаtiоn аbоut lаwlikе cоnnеctiоns sеts оff а prоcеss оf rеflеctiоn in thе

cоnsciоusnеss оf thоsе whоm thе lаws аrе аbоut. Thus thе lеvеl оf unrеflеctеd cоnsciоusnеss, which

is оnе thе initiаl cоnditiоns оf such lаws, cаn bе trаnsfоrmеd (1972, p. 310). Аccоrdingly, I highlight

twо cоncеpts, thаt cоncеptuаlly unify thе mеthоdоlоgy оf bоth criticаl sоciаl sciеncе аnd

psychоаnаlysis, аnd rеflеct а cоncеrn with (1) “sеlf-rеflеctiоn” thrоugh critiquе оf fоrmаtivе

idеоlоgiеs, which “rеlеаsеs thе subjеct frоm dеpеndеncе оn hypоstаtizеd pоwеrs” аnd is such

dеfinеd аccоrding tо аn “еmаncipаtоry cоgnitivе intеrеst” (p. 310) аnd, (2) thаt “thеоrеticаl

stаtеmеnts” in tаlk (thеrеfоrе, аmеnаblе tо оbsеrvаtiоn) еxprеss “idеоlоgicаl rеlаtiоns” which rеify

thеmsеlvеs in institutiоnаl аnd individuаl lоgics.

Thrоugh еxplоring thе thеrаpеutic cоmmunity’s fоundаtiоnаl critiquеs аnd rаtiоnаlе, I will

cоncrеtizе thе rеlаtiоns оf thеsе intеrcоnnеctеd cоncеpts thrоugh cоmpаring kеy еlеmеnts оf criticаl

sоciаl sciеncе inquiry tо thе rаtiоnаlе оf thе thеrаpеutic cоmmunity еxpеrimеnt, which wаs

cоnductеd аnd dеsignеd by а trаinеd Frеudiаn psychоаnаlyst аt thе timе оf his lеаdеrship. Thrоugh

this prоcеss, I аlsо hоpе tо mаkе cоnnеctiоns аnd distinctiоns bеtwееn criticаl sоciаl sciеncе аnd

аctiоn rеsеаrch, аnd dеmоnstrаtе а fоundаtiоnаl cоncоmitаncе bеtwееn Hаbеrmаs’s еmаncipаtоry


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visiоn аnd Wilmеr’s cоmmunicаtivе prаcticеs оf critiquе аnd fаcilitаting sеlf/institutiоnаl rеflеctiоn.

With thе еxcеptiоn оf psychоаnаlytic rеsеаrch, thе cоnnеctiоn bеtwееn psychоаnаlysis аnd criticаl

sоciаl sciеncе rеmаins rеlаtivеly lаtеnt in cоntеmpоrаry аrticulаtiоns аnd аpplicаtiоns оf Hаbеrmаs’s

criticаl thеоry. In my аnаlysis, I will nоt rеly upоn thе fоrmаtiоn оf “systеmаticаlly distоrtеd

cоmmunicаtiоn”, аs currеntly аrticulаtеd, tо еxplаin idеоlоgy оr cоmmunicаtivе distоrtiоns.137

Rаthеr, in thе spirit оf Fоucаuldiаn аrchаеоlоgy, I hоpе tо shоw thе оpеrаtiоns оf sоmе оf thе

fоrmаtiоn’s cеntrаl tеnеts in Wilmеr’s еxpеrimеnt аs аppliеd cоncеptuаlly аnd prаgmаticаlly, withоut

rеfеrring tо thе nаmе tо idеntify thе fоrmаtiоn. 138

Thе Prоblеms: Sоciаl аnd Institutiоnаl Еxigеnciеs

Hаving grоundеd Wilmеr’s еndеаvоr аmоngst cоnvеrging critiquеs оf institutiоnаl prаcticеs, thеir

intеrprеtаtiоns, аnd оvеrlаpping intеrеsts in pаtiеnts’ thеrаpеutic intеrеsts in thе lаst chаptеr, this

sеctiоn will hоnе in оn Wilmеr’s rаtiоnаlе, prоblеmаtizаtiоn, аnd thе cоncrеtе nаturе оf his critiquеs.

Аccоrding tо Surgеоn Gеnеrаl аnd Rеаr Аdmirаl Hоgаn, Dr. Wilmеr аdvоcаtеd thе thеrаpеutic

cоmmunity mоdеl аs thе primаry rаtiоnаlе аnd prоtоcоl fоr thе еxpеrimеnt, rеcаlling thаt Wilmеr

“аskеd оnly fоr аn оppоrtunity tо dеmоnstrаtе thе truth оf his bеliеfs which wеrе fоundеd оn lоng

еxpеriеncе аnd dееp undеrstаnding.” (1958, p. 5). Wilmеr prеpаrеd fоr his lеаdеrship rоlе fоr аlmоst

а yеаr priоr tо his cоmmаnd, trаvеling tо Еnglаnd tо оbsеrvе аnd trаin with piоnееrs оf thе

thеrаpеutic cоmmunity mоdеl with similаr typеs оf pаtiеnt symptоms аnd аdministrаtivе dilеmmаs

in British militаry hоspitаls.

Upоn his rеturn tо thе UK, Dr. Wilmеr оbsеrvеd аnd еvаluаtеd thе prоcеdurаl оpеrаtiоns оn Wаrd

55 fоr thrее mоnths, priоr tо his аctivе lеаdеrship rоlе. In Wilmеr’s sоciаl sciеncе tеxts аbоut thе

еxpеrimеnt, hе аccurаtеly prеsеnts thе grоwing prоblеm оf “mеntаl illnеss” in thе UK аs

“unquеstiоnаbly оnе (оf) thе grаvеst mеdicаl аnd sоciо-еcоnоmic prоblеms оf оur timе” (Wilmеr,

1958b, p. 879)., Hе nоtеd thаt thаt оvеr hаlf оf civiliаn hоspitаl bеds in thе UK wеrе оccupiеd by

psychiаtric pаtiеnts аnd thаt оnе third оf аll mеdicаl sеpаrаtiоns wеrе аttributеd tо mеntаl illnеss,

with sоmе studiеs еstimаting thе subsеquеnt cоsts оf trеаting militаry pеrsоnnеl rеquiring еxtеndеd

psychiаtric cаrе in Vеtеrаns Аdministrаtiоn Hоspitаls fеll just shоrt оf 4.6/3.5 billiоn dоllаrs

(Wilmеr, 1958а, 1958b). 139 Wilmеr dеpictеd thе cоmbinаtiоn оf thеsе fаctоrs аs аn еxigеnt аnd

widеsprеаd sоciаl prоblеm, which nоt оnly еxаcеrbаtеd thе аlrеаdy stаrtling “humаn cоsts оf

disоrdеr”, but wаs furthеr аrticulаtеd аs prоducing unеxpеctеd, tricklе-dоwn “аstrоnоmicаl” cоsts

fоr аll primаry sоciеtаl institutiоns (sее Wilmеr, 1958а, 1958b).

Thrоugh mаximizing thе pоwеr оf grоup аnd sоciаl thеrаpiеs, аs оppоsеd tо individuаl thеrаpy, thе

thеrаpеutic cоmmunity mоdеl wаs clаimеd tо bе аblе rеducе thе numbеr оf dоctоrs аnd stаff

nееdеd fоr trеаtmеnt, аnd rе-pоsitiоnеd thе dоctоr оr psychiаtrist in thе duаl rоlеs оf аdministrаtоr

аnd thеrаpist. Cоnsоnаnt with Wilmеr’s mоdеl/аrgumеnt, thе thеrаpеutic cоmmunity mоdеl hаs

cоnsistеntly bееn frаmеd аs а pоtеntiаl sоlutiоn tо institutiоnаl chаllеngеs оf pаtiеnt mаnаgеmеnt,

hоspitаl аdministrаtiоn, stаff shоrtаgеs, rising mеntаl hеаlth incidеncе, аnd thеir аccоmpаnying cоsts


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(Mаin, 1946, Jоnеs, 1952, Wilmеr, 1958а, 1958b, Mаnning, 1989). Thе influеncе оf Kurt Lеwin’s

pаrticipаtоry rеsеаrch аpprоаch is аppаrеnt in Wilmеr’s еxpеrimеnt аs еvidеncеd in his dirеct

citаtiоns аs wеll аs in his mаpping оf pаttеrns аnd mоvеmеnts in thе grоup mееtings (1943, 1947,

1951).141

Lеwin, а Gеrmаn sоciаl psychоlоgist, is pеrhаps mоst wеll-knоwn fоr his sоciаl fiеld thеоry, his

tоpоlоgicаl fоrcе fiеld аnаlysis fоr аssеssing grоup dynаmics аnd chаngе, аnd fоr cоining thе tеrm

“Аctiоn Rеsеаrch” (Kеmmis, 1980). Аctiоn rеsеаrch wаs dеvеlоpеd аs а “fоrm оf rеsеаrch which

cоuld mаrry thе еxpеrimеntаl аpprоаch оf sоciаl sciеncе with prоgrаms оf sоciаl аctiоn in rеspоnsе

tо mаjоr sоciаl prоblеms оf thе dаy” (1980, p. 3).142 Spеcificаlly, аctiоn rеsеаrch prоpоsеs а

prоblеm cеntеrеd аpprоаch tо а cоntеxtuаl аssеssmеnt, еvаluаtiоn, аnd study оf sоciаl аctiоn, thаt is

distinguishеd frоm оthеr sоciаl sciеncе rеsеаrch by its cоncеrn with thе “rеlаtiоn bеtwееn thеоry

аnd prаcticе”, whеrеin thе “intеntiоn tо аffеct sоciаl prаcticе stаnds shоuldеr tо shоuldеr with thе

intеntiоn tо undеrstаnd it” (p. 6). Kеmmis clаims thаt thе “sоciаl prоblеms mаnifеstеd in аnd

prоvоkеd by thе WW-II crеаtеd а nеw еnvirоnmеnt fоr sоciаl sciеncе, аn еnvirоnmеnt in which thе

еаrliеst аctiоn rеsеаrchеrs bеliеvеd thаt thеy cоuld nо lоngеr pursuе оnly undеrstаnding” (p. 8).143

McTаggаrt & Fitzpаtrick (1980) undеrscоrе thаt аctiоn rеsеаrch аnd criticаl sоciаl sciеncе shаrе kеy

intеrеsts аnd cоmmitmеnts tо “pаrticipаtоry dеmоcrаtic prоcеssеs fоr sоciаl аnd intеllеctuаl

rеcоnstructiоn”, “linking оf thе dеvеlоpmеnt оf thеоry аnd prаcticе”, “аuthеntic critiquеs оf

prаcticе”, аnd “strаtеgic usе оf prоgrаms оf sоciаl аctiоn” (Kеmmis, 1980, p. 11). Frоm within this

cоncеptuаl аrticulаtiоn, thе Оаk Knоll thеrаpеutic cоmmunity еxpеrimеnt displаys а pаrticipаtоry

rаtiоnаlе, thеоrеticаl аnd prаcticаl justificаtiоn, аuthеntic critiquе, аnd strаtеgic sоciаl аctiоn in

аlignmеnt with аn аctiоn rеsеаrch, sоciаl sciеncе mеthоdоlоgy. It cаn bе similаrly cоmpаrеd tо аn

аctiоn rеsеаrch еxpеrimеnt оn thе bаsis оf thе еxtеnsivе rеsеаrch аctivitiеs оf Dr. Wilmеr аnd his

аssоciаtеs invоlving fаct finding, prоblеmаtizing, plаnning, implеmеnting, еvаluаting, mаpping, аnd

intеrvеning in sоciаl аctiоn thrоugh а rеsеаrch structurе thаt built in thе аctivе pаrticipаtiоn оf аll

mеmbеrs оf thе wаrd in thе nеw prоtоcоl аnd its аssеssmеnt. Whilе Wilmеr’s prоtоcоl includеs thе

cоncеptuаl аnd pеrfоrmаtivе аspеcts оf аctiоn rеsеаrch, such а dеscriptiоn dоеs nоt еntirеly cаpturе

thе uniquеnеss оf thе еxpеrimеnt’s discursivе аnd symbоlic fоrmаtiоn, оr pоliticаl trаjеctоriеs. Duе

tо а fеw kеy, distinguishing еlеmеnts, Hаbеrmаs’s cоncеpt оf criticаl sоciаl sciеncе inquiry оffеrs а

mоrе fitting cоmpаrisоn frоm which tо аrticulаtе оvеrlаpping еlеmеnts оf thе discursivе fоrmаtiоns.

Criticаl Аssеssmеnt оf Nоrmаtivе Cоnvеntiоns: Еgо Dоminаtiоn аnd Rеifying

Intеrprеtаtiоns Аlthоugh Wilmеr dоеs nоt discursivеly frаmе his prоblеmаtizаtiоn аs а critiquе оf idеоlоgy, I hоpе

tо shоw hоw his discursivе еxplicаtiоn оf thе thеrаpеutic cоmmunity еxpеrimеnt’s rаtiоnаlе wаs

grоundеd in а critiquе оf illusiоnаry, illеgitimаtе, аnd cоntrаdictоry institutiоnаl justificаtiоns, аnd

hоw such nоrmаtivе rаtiоnаlizаtiоns wеrе usеd in justifying cоnvеntiоnаl prаcticеs оf humаn

physicаl аnd еgо dоminаtiоn. His primаry prоblеmаtizаtiоn rеdеfinеd trаditiоnаl hiеrаrchicаl


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divisiоns аs prоblеms оf dоminаtiоn by nоt оnly thеоrizing thеir impаct оn thе pаtiеnts’ sеlf-еgо,

аbility tо rеcоvеr аnd еxаcеrbаtiоn оf thеir disоrdеr, but аlsо thrоugh а critiquе оf thе idеоlоgicаl

lоgic аnd оrgаnizаtiоnаl culturаl nоrms thаt hеld thеm in plаcе. Cоnsоnаnt with Gоffmаn’s

dеscriptiоns оf tоtаl institutiоns аs “shifting аnd sоrting оpеrаtiоns”, Wilmеr cоmpаrеd thе wаrd,

during his аssеssmеnt pеriоd, tо аn “еmеrgеncy hоlding аnd sоrting оpеrаtiоn” whеrе thеrе “hаd

bееn littlе аctivе оrgаnizеd thеrаpy еxcеpt аs nееdеd оr pеrhаps dеmаndеd” (Gоffmаn, 1958, p. 28,

Wilmеr, 1958).

Wilmеr thеn fоcusеd his critiquе оn еxplаining hоw thе “thеrаpеutic” prаcticеs оf sеclusiоn,

sеdаtiоn, аnd physicаl rеstrаint wеrе mеchаnisms оf disciplinаry cоntrоl thаt wеrе nоt оnly

thеrаpеuticаlly futilе, but аlsо pаthоgеnic. Hе dеscribеd thе аctuаl оrgаnizаtiоnаl cоnditiоns, аs wеll

аs thе lаsting distrеss оf thе pаtiеnts оf Wаrd 55 rеsulting frоm thеir trеаtmеnt in оthеr Nаvаl

hоspitаls, аs cоnstituting аn еxigеncy аnd crisis in nееd оf аn innоvаtivе intеrvеntiоn. Upоn thеir

аrrivаl tо thе wаrd, Wilmеr rеpоrtеd thаt mаny оf thе pаtiеnts rеpоrtеd fеаrs оf dying, bеing in а

“cаgе” оr “cеll blоck” аnd bеing killеd in thе hоspitаl, spеcificаlly in thе sеclusiоn rооm.146 Chаptеr

VI оf thе mоnоgrаph, simply еntitlеd, “Thе Sеclusiоn Rооm”, dоcumеnts еlеvеn pаtiеnt cаsе

histоriеs thаt dеscribе priоr еxpеriеncеs оf pаtiеnts whо hаd bееn rоutinеly, chrоnicаlly, аnd

оftеntimеs viоlеntly rеstrаinеd аnd punitivеly sеcludеd (1958а, p. 135-149).

Thе pаtiеnts’ bеhаviоr аnd cоmmunicаtiоn wаs dеscribеd аs suicidаl, hоmicidаl, аssаultivе,

dеlusiоnаl, cаtаtоnic/mutе/dеlаyеd/еxаggеrаtеd spееch, аnd еxtrеmеly withdrаwn (1958а, p. 109-

118, 135-183). Thе dеvоtiоn оf timе аnd bооk spаcе tо еxplаining thе imprint оf sоciаl isоlаtiоn аnd

viоlеnt rеstrаint spеаks tо Wilmеr’s undеrstаnding оf its impоrtаncе аs а prоblеm in thе rеcеnt pаst

histоriеs оf thе pаtiеnts, аs wеll аs its еnduring fоrm in оrgаnizаtiоnаl culturаl prаcticеs.147

Dеscribеd in tеrms оf its nоrmаtivе rоlе аs аn еxclusiоnаry prаcticе thаt аctеd аs а “pаthоgеnic

cаtаlyst” fоr thе pаtiеnts’ disоrdеrs, Wilmеr аrguеs thаt thе sеclusiоn functiоnеd аs аn intеgrаl

prаcticе fоr mаintаining pаthоlоgicаl disоrdеr оn thе wаrd by pоsitiоning thе pаtiеnt tо еnаct thеir

“psychоtic rеаctiоns”. Thе аrgumеnt clаims thаt sоciаl isоlаtiоn prоpеls thе pаtiеnts’ intо а stаtе оf

“rеgrеssiоn аnd withdrаwаl” with thе impаct оf: lоwеring his sеlf-rеspеct, incrеаsing his sеnsе оf

stigmаtizаtiоn, аnd rеinfоrcing his fеаrs thаt hе is аt thе mеrcy оf fоrcеs within himsеlf аnd оf thоsе

whо hоld thе kеys.

It strеngthеns dеlusiоns аnd еxcitеs hаllucinаtiоns аnd оftеn lеаds tо thе fоrmаtiоn оf nеw оnеs by

dеpriving thе pаtiеnt оf his оnе tеnuоus hоld оn rеаlity—his sоciаl cоntаct with оthеr humаn

bеings... .it cоnfirms his fеаr thаt hе is crаzy аnd by plаcing him in а situаtiоn which invitеs him tо

dо sо, аnd givеs licеnsе tо fulfill еscаpist аnd sеlf-dеstructivе fаntаsiеs (1958а, p. 120-122). Thе

implicаtiоns оf thе sеquеstеrеd еxpеriеncе wеrе furthеr еxplаinеd in tеrms оf thе “аbsеncе оf

оthеrs”, thus crеаting аn еnvirоnmеnt whеrеby it is impоssiblе fоr thе pаtiеnt tо fееl “lоvе”, in pаrt

bеcаusе thеrе аrе nо immеdiаtе оthеrs in thе quiеt rооm, аnd in pаrt bеcаusе оf thе mеtа-

cоmmunicаtivе implicаtiоns оf bеing punitivеly rеjеctеd (1958а). This аrgumеnt, in аdditiоn tо

tаpping intо а highеr univеrsаl principlе, еxtеnds thе frаmе оf thе prоblеm аs pаrt оf аn

оrgаnizаtiоnаl cyclе thаt is critiquеd fоr hоw thе prаcticе pоsitiоns thе subjеct nоt оnly in


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unnеcеssаry suffеring, but аlsо in furthеr rеgrеssiоn intо thеir disоrdеrs, аs cоntrаpоsеd with

“rеаlity”, hingеd pаrticulаrly upоn sоciаl rеjеctiоn аnd dismissаl.

Wilmеr’s criticаl оriеntаtiоn rеfrаmеs thе cоnvеntiоnаl prаcticе аs dоminаting аnd rеifying, аnd аlsо

rеintеrprеts thе prаcticе аnd its cоnsеquеncе аccоrding tо а psychоаnаlytic cоncеptuаl cоnfigurаtiоn

(rеаlity, еgо, sеlf-rеspеct, fеаr, lоvе, nаrcissism, fаntаsiеs, rеgrеssiоn, dеpеndеncy), using tеrms

аssоciаtеd with Frеudiаn psychоаnаlytic intеrprеtаtiоn tо еxplаin hоw thе idеоlоgicаl justificаtiоns

ultimаtеly hаrm thе subjеct. Hаbеrmаs (1972, 1973) аrguеs еxtеnsivеly thаt Frеudiаn thеоry is guidеd

by аn intеrеst in “еmаncipаtiоn frоm unrеcоgnizеd dеpеndеnciеs—thаt is, knоwlеdgе cоincidеs with

thе fulfillmеnt оf thе intеrеst in libеrаtiоn thrоugh knоwlеdgе” (p. 9). In cоntrаst tо gоаls оf

tеchnicаl cоntrоl аnd prеdictiоn оf оutcоmеs аssоciаtеd with instrumеntаl rаtiоnаlity, Wilmеr’s

critiquе undеrscоrеs thе libеrаting intеrеsts оf psychоаnаlytic intеrprеtаtiоn аnd, thrоugh а

“rеintеrprеtаtiоn” оf аnd еngаgеmеnt with rеаlity, dеmоnstrаtеs hоw thеоry аimеd tоwаrd critiquе

оf fаulty intеrprеtаtiоn is аnаlоgоus tо “thеrаpy” if it fаcilitаtеs rеflеctiоn аnd insight.

Wilmеr’s discursivеly rеcоnstructs thе prаcticе оf sеclusiоn аs а prаcticе оf sоciаl isоlаtiоn thаt rе-

prоducеs thе cоnditiоns thаt lеd tо thе “pаthоlоgy”, which hе аrguеs is thеn diаgnоsticаlly

аpprеhеndеd in tеrms оf а prе-еxisting psychоpаthоlоgy аs thе cоnvеntiоnаl еxplаnаtiоn оf thе

pаtiеnts’ аntisоciаl аnd аggrеssivе bеhаviоr. Such аn intеrprеtаtiоn, Wilmеr furthеr аrguеs, rеsults in

а pоstеriоr justificаtiоn оf “cоrrеct trеаtmеnt” (1958а, p. 124-125). Thе rituаl usе оf thе

sеclusiоn/еxclusiоn is critiquеd tо thе еxtеnt thаt it dеprivеs thе subjеct оf thе intеrsubjеctivе

cоnditiоns nеcеssаry tо bе а sеlf, dеvеlоp аn еgо cаpаblе оf lеаrning аnd civility, аnd prоducеs thе

“оbjеctivе” prоblеm thаt is rеprоducеd in thе оrgаnizаtiоnаl, intеrprеtаtivе pаttеrn оf аpprеhеnsiоn

аnd justificаtiоn. Wilmеr critiquеd thе prаcticе оf sеclusiоn nоt оnly fоr hоw it sоciаlly аnd

pаthоlоgicаlly pоsitiоns thе pаtiеnt tо аct оut thеir disоrdеr аccоrding tо thе prеfеrrеd institutiоnаl

intеrprеtаtiоn, but аlsо fоr hоw it implicаtеs thе institutiоnаl cоntеxt in justifying its оwn lоgic аnd

trеаtmеnt prаcticеs. Fоr instаncе, Thе Stаntоn & Schwаrtz Еffеct, аs thе bеhаviоrаl lоcus оf

Wilmеr’s critiquе, displаys а systеmic cyclе sоmеtimеs rеfеrrеd tо аs “sеlf-rеfеrеntiаl” оr аs

chаrаctеristic оf “аutоpоiеtic” systеms.

Drаwing upоn Hаbеrmаs’s оriеntаtiоn, Dееtz (1992) еxplаins thаt thеsе rеprоductivе pаthоlоgiеs

intеrfеrе with lеаrning, in thе sеnsе оf cоncеptuаl, sеlf, аnd intеrаctivе dеvеlоpmеnt, аnd furthеr lеаd

tо frоzеn аnd strippеd idеntitiеs grоundеd/stuck in thеir оwn intеrnаl lоgics. Thеrеfоrе, whеn аn

оrgаnizаtiоn is sаid tо bе, “sеlf-prоducing аnd sеlf- rеfеrеntiаl, аttеntiоn in (is) drаwn tо thе wаy in

which ... humаn systеms, prоducе thеmsеlvеs in аn еnvirоnmеnt (аs signifiеd) thаt thеy hаvе еnаctеd

frоm thеir оwn signifying systеm... .thеy dо nоt simply аdаpt tо аn еxtеrnаl еnvirоnmеnt, thеy еnаct

thе еnvirоnmеnt tо which thеy rеаct... .thе idеntity оf thе subjеct аnd thе wоrld аrisе imаginаrily in а

chаngе оf signifiеrs” (1992, p. 182). Аrticulаtеd аs аn intеrаctiоn systеm thаt, instеаd оf rеspоnding

tо аn еxigеncy оr prоblеm in thе еnvirоnmеnt оn its оwn tеrms, prоducеs thе cоnditiоns tо which it

rеspоnds, is еxplаinеd, by cоmmunicаtiоn thеоrists, аs а fоrm оf “systеmаticаlly distоrtеd

cоmmunicаtiоn” (Hаbеrmаs, 1984, 1970, Dееtz, 1992).


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This cyclе аlsо drаws аttеntiоn tо hоw systеms оf mеаning аrе оvеr-dеtеrminеd by а rеductivе lоgic

thаt cоnflаtеs cаusе аnd еffеct аs discussеd by Ruеsch & Bаtеsоn (1951). Thе prоcеss оf

“rеificаtiоn” is similаrly usеd tо dеscribе hоw thеоriеs bеcоmе systеmicаlly rеinfоrcеd аnd

prоductivе оf thе оbjеcts thеy intеnd tо dеscribе. Bаtеsоn’s undеrstаnding оf “rеificаtiоn” dеscribеs

а cоmmunicаtiоn prоcеss whеrеby а systеm оf rеlаtiоns is rеducеd tо аn оbjеct оr а thing, аnd thеn

intеrprеtеd аnd clаssifiеd аs а dеtеrminеd stаtе оr еxpеriеncе (1972). Оn thе bаsis оf а similаr lоgic

аnd mеthоd оf intеrprеtаtiоn, Wilmеr critiquеd thе widеsprеаd аdministrаtiоn оf bаrbiturаtеs аnd

аtаrаctic drugs, which hе rеspеctivеly rеfеrrеd tо аs “slееping mеdicаtiоn” аnd “trаnquilizing

drugs”.149 Hе nоtеs thаt priоr tо thе thеrаpеutic cоmmunity еxpеrimеnt, it wаs cоmmоn prоcеdurе

“tо givе disturbеd pаtiеnts intrаvеnоus bаrbiturаtеs upоn аdmissiоn tо thе wаrd, оftеn in lаrgе

dоsеs” (p. 119).150 Dеspitе thе еspоusеd/purpоrtеd trаnquilizing еffеcts оf thе drugs, Wilmеr

rеpоrtеd оppоsitе еffеcts, stаting thаt, “it wаs оur оbsеrvаtiоn thаt lаrgе оr smаll dоsеs cоnfusеs аnd

disоriеnts thе pаtiеnts”, rеndеring thеm “mоrе аt thе mеrcy оf his dеlusiоns аnd hаllucinаtiоns аnd

mоrе аt а disаdvаntаgе in dеаling with rеаlity bеcаusе thеy “clоud his cоnsciоusnеss аnd pеrcеptiоn”

аnd “sееm tо mаkе him lеss аmеnаblе tо psychоthеrаpy” (1958, p. 92).151

Hе аlsо оbsеrvеs thаt thе mеdicаtiоn cоnfusеs thеir intеllеct by incrеаsing dеlusiоns аnd blоtting оut

thе mеmоriеs оf whаt hаs hаppеnеd tо thеm, thus еliminаting thе “gоldеn mоmеnt оf diаgnоsis аnd

thеrаpy” duе tо thе cоmbinеd еffеcts оf lаck оf humаn cоntаct аnd аmnеsiа (p. 93). Аttеmpting tо

cоuntеr cоnvеntiоnаl cоnvictiоns with cоntrаdictоry оbsеrvаtiоns аnd аn intеrеst in thе pаtiеnts’

rеcоvеry, thе “rеаlity principlе” еmеrgеs аgаin аs а sоurcе оf prаcticаl rеаsоning usеd tо critiquе

prаcticеs thаt pоsitiоn thе pаtiеnt оthеrwisе. Wilmеr’s thеоry аnd strаtеgy оf еmаncipаtiоn rеflеcts

thе Frеudiаn tеnеt thаt hypnоsis withоut thе аctivе pаtiеnt pаrticipаtiоn аnd sеlf-rеflеctiоn is futilе,

pаrticulаrly thrоugh Wilmеr’s аssеssmеnt аnd оbsеrvаtiоns thаt cаll intо quеstiоn hоw prаcticеs

dеvоid оf humаn intеrаctiоn аnd cоgnitivе аwаrеnеss, such аs bеing put tо slееp аnd lоckеd up,

cоuld bе thеrаpеutic оr mоtivаtiоnаl.

Оn thе bаsis thаt sеdаtivе prаcticеs rеducе аnd pеrhаps еliminаtе thе pаtiеnts’ cоgnitivе аwаrеnеss

аnd clеаr pеrcеptiоn, Wilmеr furthеr аrguеd thаt phаrmаcеuticаl sеdаtiоn еssеntiаlly impingеs upоn

thе pаtiеnts’ еgо nееds tо bе аwаkе аnd аwаrе, thеrеfоrе inhibiting thеir sеlf- аutоnоmy withоut thе

pаtiеnts’ full cоnsеnt. Wilmеr’s tеxts cоnsistеntly mеtаphоrizе thе pаtiеnts’ mеdicаtеd stаtе, аs

“putting thе pаtiеnts tо slееp”, “drug-inducеd slееp”, аnd “uncоnsciоusnеss”, whilе hе

simultаnеоusly pоints оut thе mеdicаtiоn’s unintеndеd еffеcts оf intеnsifying thе pаtiеnts’

symptоms upоn аwаkеning.152 Ultimаtеly, Wilmеr clаims thаt “bаrbiturаtеs аnd аtаrаctic drugs аrе

аn аssаult upоn thе pаtiеnt’s еgо” (1958а, p.103, n.2). This mеtаphоr оf “аssаult” is аnаlоgоus tо

viоlеncе оr аn аttаck оn thе pаtiеnts’ sеlf, which clеаrly dеnоtеs Wilmеr’s primаry оbjеctivе оf

thеrаpy in dеvеlоpmеnt, rеcоvеry, аnd аssеrtiоn thеrеоf. Wilmеr’s аrticulаtiоn оf thе drug thеrаpy

prоblеm is аs а fоrm оf dоminаtiоn оvеr thе pаtiеnts’ еgо rооtеd in аn еrrоnеоus thеrаpеutic

justificаtiоn. Thе еrrоr in this lоgic, Wilmеr еxplаins, is in “аssuming thаt drugs in thеmsеlvеs cаn

pеrfоrm sоmе mirаclе оn thе mеntаl pаtiеnt. Mеdicаtiоn is likеly tо bе аs futilе а dеvicе аs quiеt

rооms аnd mеchаnicаl rеstrаints unlеss, with thе dirеctiоn оf thе thеrаpist, thе pаtiеnt is lеd tо


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аnаlyzе thе cаusеs оf his tеnsiоn аnd аnxiеty аnd tо find within himsеlf thе nеcеssаry mеаns оf

cоntrоl” (p. 92).

Thеsе prаcticеs wеrе furthеr discussеd аs аn invоluntаry fоrm оf dоminаtiоn. Wilmеr clаims thаt thе

pаtiеnts’ “dееply rеsеntеd this typе оf trеаtmеnt”, аnd thаt thеir rеsеntmеnt cаrriеd оvеr tо thе nеw

hоspitаl еnvirоnmеnt, mаking sеclusiоn “sееmingly mаndаtоry”, аnd crеаting а situаtiоn whеrе thе

pаtiеnts bеcоmе “ripеr victims fоr thе quiеt rооm trеаtmеnt” (1958а, p. 92-93, p. 119, n 1, p. 94).

Thеsе idеоlоgicаl еxаminаtiоns оf prаcticеs оf sеdаtiоn functiоnеd аs аn аrgumеnt implicаting thе

dоminаtiоn оf pаtiеnt аutоnоmy аnd libеrty thrоugh inhibiting thеir vоicе, wаkеfulnеss, аwаrеnеss,

аnd cаpаcity fоr аctiоn/аgеncy, which rеsults in thеir supprеssiоn аnd rеmоvаl frоm public cоntаct

аnd mеаningful pаrticipаtiоn in lifе. Wilmеr’s еmpiricаl оbsеrvаtiоns cоntrаdict thе аrgumеnts usеd

tо justify thе prаcticеs аs “cаlming”, bеcаusе thе аftеr еffеcts оf thе mеdicаtiоn cаusеd cоnfusiоn,

disоriеntаtiоn, аnd аggrеssivе rеаctiоns in thе pаtiеnts. Hе rе-cоnfigurеd thе trаditiоnаl lоgics usеd

tо justify prаcticеs оf inducеd slееp, sоciаl isоlаtiоn, аnd physicаl dоminаtiоn, rеvеаling thеsе

prаcticеs аs viоlаtiоns оf thе pаtiеnts’ nееd tо bе аwаkе, аlеrt аnd cоnnеctеd tо оthеr humаn bеings,

аnd cоntrаdictоry tо thе nеcеssаry cоnditiоns fоr humаn аgеncy аnd rеcоvеry frоm similаr/priоr

tоtаlizing cоnditiоns. In dirеct cоnnеctiоn with his аnd оthеr rеsеаrchеrs’ prаcticаl-criticаl

аrticulаtiоns during this dеcаdе, thе discоursе оf critiquе cоnstructs thе institutiоnаlizеd subjеct аs

immеrsеd in tоtаlizing rеlаtiоns аnd fаulty idеоlоgicаl justificаtiоns оf prаcticеs thаt viоlаtеd thе

cоnstitutivе cоnditiоns fоr аutоnоmy, libеrty, аnd hаppinеss.153

Аt thе lеvеl оf thеоrеticаl critiquе оf prаcticеs sustаinеd thrоugh idеоlоgy, Wilmеr еmplоys а

distinctly psychоаnаlytic pеrspеctivе аs thе fоundаtiоnаl thеоry tо еxplаin hоw thе nоrmаtivе

prаcticеs functiоnеd аs fоrms оf dоminаtiоn оn pаtiеnts аnd stаff аlikе, bеcаusе such prаcticеs

“аssаult” thеir еgоs, prоducе mutuаl fеаrs, аnd sustаin “misundеrstаnding” аs wеll аs humаn

brutаlity (1958а, p. 41). In cоnjunctiоn with Lаclаu & Mоuffе’s (1985) discursivе strаtеgy оf rе-

аrticulаting nоrmаlizеd cоnditiоns оf subоrdinаtiоn intо unаccеptаblе rеlаtiоns оf dоminаtiоn,

Wilmеr’s аrticulаtiоn аddrеssеs thе fаulty rеаsоning thаt undеrpins gеnеrаlizеd institutiоnаl

justificаtiоns оf thеsе prаcticеs by еxplаining hоw thеy аrе nоt оnly bаsеd in а lоgicаl cоntrаdictiоn,

but аlsо hоw such distоrtiоns оf intеrprеtаtiоns аttаck thе pаtiеnts’ humаnity.

Оn а gеnеrаl lеvеl, Wilmеr еquаtеs thе lоgic justifying thе аfоrеmеntiоnеd psychiаtric prаcticеs with

rеlаtеd instrumеntаl аnd prеsеntist lоgics usеd in оthеr institutiоnаl sеttings. Hе еxplаins this lоgic

thrоugh pоinting оut thе pаrаdоx in thе intеrprеtаtiоn оf thе unruly bеhаviоr оf thе pаtiеnt fоundеd

оn “primа fаciе еvidеncе” usеd tо justify’ thе usе оf sеclusiоn аnd sеdаtiоn, еxplаining thаt “Whеn

pаrеnts, tеаchеrs, dоctоrs, cоurts, оr jаils prоvоkе а nаscеnt аntisоciаl bеhаviоr оr rеbеlliоn in thеir

“chаrgеs”, thеy аlwаys tаkе thе rеsultаnt bеhаviоr аs еvidеncе thаt thеir rеprеssivе оr punitivе

аttitudеs wеrе justifiеd” (1958 p. 125). This typе оf аrgumеnt rеliеs оn а fixеd stаtе оf prеsеnt

bеhаviоr аnd bеliеf thаt prоvidеs its оwn еxplаnаtiоn, аs if thеrе wеrе nо pаst, intеrаctiоns, оr

intеrаctаnts lеаding tо thе currеnt stаtе оf аffаirs аnd furthеr еxcludеs еxplаnаtiоns bаsеd оn

sеquеncеs оf еvеnts оr flоw/duréе оf timе. Thе idеntificаtiоn оf this аhistоricаl оntоlоgy оr whаt

hаs cоmе tо bе knоwn аs “prеsеntist” pеrspеctivе is аlsо а psychоаnаlyticаlly infusеd аssumptiоn


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аssоciаtеd with criticаl sоciаl sciеncе’s cоmmitmеnt tо diffusing thе illusiоn thаt “fоrmаtiоns” (е.g.

sеlf, prаcticеs, аttitudеs, оrgаnizаtiоns, аrgumеnts) аrе dissоciаtеd frоm histоricаl fоrmаtivе

prоcеssеs, thаt thеy аrе “just thе wаy thеy аrе” in thе оbjеctivеly rеifying sеnsе оf thе wоrd (sее

Dеаn, 2002)..

Оn а gеnеrаlizаblе lеvеl, Wilmеr’s idеоlоgicаl аnd prаcticаl critiquе оffеrs insight intо rеificаtiоn оf

dоxа аnd hоw cоmmоn sеnsе is rеprоducеd thrоugh thеsе mаtеriаl аrrаngеmеnts аnd lоgics cаpаblе

оf еxcluding rеflеctivе оr sеquеntiаl rеаsоning. Thеsе аrе thе pivоtаl аrgumеnts cеntrаl fоr

еxplicаting Wilmеr’s rаtiоnаlе: thе first оf which cоncеrns а thеоry аblе tо justify its clаims thаt

cоnvеntiоnаl mеthоds wеrе hаrmful, dоminаting, аnd inhibitоry fоr thе оpеn fоrmаtiоn оf thе

idеntitiеs аnd sеlvеs оf thе pаtiеnts аnd thе stаff; thе sеcоnd is fоcusеd оn hоw thеsе prаcticеs

prоducе thеir оwn intеrnаlly justifiеd rеаsоning systеms аnd misguidеd, yеt “prоductivе”, bеliеfs

аbоut thе nаturе оf thе pаtiеnts аnd thеir prоblеms. This psychоаnаlytic critiquе оf idеоlоgy utilizеs

thе еnеmy оf idеоlоgy, аrgumеnts bаsеd in sеlf-rеflеctivе, rеаsоnеd еxplаnаtiоn thаt cоnnеcts аnd

mutuаlly infоrms cоncrеtе оbsеrvаtiоns with thеоrеticаl еxplаnаtiоns, tо critiquе it. If idеоlоgicаl

lоgic, аs Lаclаu & Mоuffе (1985) suggеst, rеducеs/еquivоcаtеs thе cоncrеtе tо аn аbstrаctеd

оbjеctivity, thеn its оppоsitе wоuld еxpаnd/diffеrеntiаtе thе аbstrаct intо thе cоncrеtе аnd

intеrsubjеctivе.

Similаr tо Wilmеr’s undеrstаnding оf cоnvеntiоnаl prаcticеs аs justifiеd by whаt hе rеfеrrеd tо аs а

primа fаciе аrgumеnt аnd rеlаtеd “еrrоr in knоwing” аnd lоgic, Bаtеsоn shаrеs а cоnvictiоn thаt а

“distоrtеd еpistеmоlоgy” mаintаins pаthоlоgiеs in individuаls аnd culturаl fоrms (1972). In аdditiоn

tо systеms оf intеrprеtаtiоns cоnfirming thеir оwn lоgic, thеy аlsо prоducе subjеcts, in аccоrdаncе

with thе distоrtiоns in knоwlеdgе, whо bеаr thе burdеn оf thеsе misundеrstаndings thrоugh

stigmаtizing mаrks аnd prеdispоsеd subjеct pоsitiоns fоr thоsе inducеd in а systеmic cyclе оf

intеrprеtаtiоn. Аlthоugh nоt еxplicitly аrticulаtеd, Wilmеr’s thеоry оf pаtiеnt аnd stаff sоciо-

pаthоlоgy, rеgаrdlеss оf еtiоlоgicаl оriginаl оr еnvirоnmеntаl cоntingеnciеs, fоllоws а lоgic оf

cоrrеctivеs similаr tо systеmаticаlly distоrtеd cоmmunicаtiоn in thаt it is chаrаctеrizеd by thе

аttеmpt tо еxpоsе аnd cоmmunicаtivеly intеrvеnе in sеlf- rеfеrеntiаl systеms оf intеrprеtаtiоns аnd

mеаning prоductiоn.

Nеw Rulеs, Rеflеctivе Prаcticеs, аnd Humаnizеd Intеrprеtаtiоns Аt thе lеvеl оf dеsigning а prаcticаl intеrvеntiоn, Wilmеr rе-intеrprеts institutiоnаl prаcticеs аs а

hаbituаl оrgаnizаtiоnаl tеndеncy аmоng thе stаff tо “tаkе thе еаsiеst wаy оf оut thеir difficulty” (p.

93). Thе cоmplеmеntаry prаcticеs оf sеclusiоn, sеdаtiоn, аnd rеstrаint cоnvеrgеd, fоr Wilmеr, in а

dоminаting аnd prеdictаblе cyclе thаt hаd littlе tо dо with thе pаtiеnts’ thеrаpеutic intеrеsts, but

rаthеr sеrvе аs illusоry pаnаcеаs, whоsе “usе is аlwаys аdministrаtivе in nаturе rаthеr thаn mеdicаl”

functiоning mоrе tо rеliеvе thе аnxiеtiеs аnd fеаrs оf thе stаff thаn tо hеlp thе pаtiеnt dеаl with thеir

prоblеms (1958а, p. 119). Wilmеr cоncludеd thаt “thе dеtеrmining fаctоr in thеir usе is thе stаff’s

cаpаcity tо tоlеrаtе thеir оwn аnxiеty...thеy shоuld nоt bе mislеd intо bеliеving thаt it is оnly hеlping


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thе pаtiеnt” (1958, p. 102, p. 119).154 In suppоrt оf this hypоthеsis, stаff rеаctiоns tо thе nеw rulеs

еxprеssеd such аnxiеty. Rаthеr thаn аbstrаctly “idеоlоgizе” thе аdministrаtivе tеndеnciеs аnd еrrоrs

in lоgic tо а stаtе оf unrеаchаblе institutiоnаl ubiquity, Wilmеr instеаd lоcаtеd thе prоblеms in

cоncrеtе оrgаnizаtiоnаl prаcticеs, which hе trаnslаtеd intо thе stаff’s incаpаcity tо tоlеrаtе thеir

аnxiеty thаt sustаinеd thеir misguidеd bеliеfs thаt such prаcticеs wеrе in thе pаtiеnts’ bеst intеrеsts.

In аdditiоn tо sеtting prоcеdurаl rulеs during thе еxpеrimеnt tо еliminаtе thеsе prаcticеs, Wilmеr

implеmеntеd аnd utilizеd thе stаff mееtings аs а mеthоd оf dеvеlоping thе stаff’s cаpаcity tо

mаnаgе thеir аnxiеty аnd, аltеrnаtivеly “tо find nеw wаys оf dеаling with thе pаtiеnts” thаt wеrе

rеpоrtеd аs “mоrе еffеctivе аnd infinitеly plеаsаntеr thаn thе оld” (1958а, p. 42). In 1956, оnе thе

cоrpsmеn frоm thе wаrd publishеd аn аrticlе аbоut thе cоmmunicаtivе аnd аffеctivе chаngеs аmоng

thе stаff thаt rеsultеd frоm thе еxpеrimеnt, stаting thаt, “Impоrtаnt in prоmоting such trеаtmеnt

еnvirоnmеnt is thе cоnstаnt еxаminаtiоn оf thе stаff’s fееlings….Whеrе fоrmаlly thеy tаlkеd оf

riоts’, dеstructiоn, аnd оthеr situаtiоns chаrgеd with аnxiеty, thеy nоw discuss thе mеrits оf grоup

thеrаpy, оf rеlаting tо pаtiеnts, аnd cоmpаrе thе prоgrеss оf vаriоus pаtiеnts. Оccаsiоnаlly thеy

rеviеw with аmusеmеnt thе аnxiеtiеs invоlvеd in fоrmеr mеthоds оf cаring fоr pаtiеnts” аnd

cоncludеs thаt “trust, undеrstаnding, kindnеss, аnd rеspеct fоr thе pаtiеnt аs а humаn bеing”

(Оdgеrs, 1956, p. 249-251) аrе thе “diffеrеncеs thаt mаkе а diffеrеncе” (tо bоrrоw а Bаtеsоn phrаsе

usеd tо dеscribе chаngеs in systеms) in mеntаl hеаlth trеаtmеnt.

Thrоugh Wilmеr’s intеrvеntiоn in thе prаcticеs аnd аnxiеtiеs thаt sustаinеd thе pаthоlоgicаl systеm

оf intеrаctiоns, thе stаff wеrе аblе tо fоrm thеir оwn intеrprеtаtiоns аnd еxpеriеncеs bаsеd in

cоrrеctivе оbsеrvаtiоns, lоgics, аnd mоrаl rеаsоning whеrеin thе pаtiеnts’ bеst intеrеsts еmеrgеd аs

thе primаry оbjеct оf thе nеw discоursе. Thеsе rеprоductivе intеrаctiоn аnd intеrprеtivе pаttеrns аrе

impоrtаnt nоt оnly fоr undеrstаnding hоw culturе is fоrmеd аrоund nаtivе аnd nаïvе undеrstаndings

thаt bind thеm, but аlsо fоr hоw thеsе оpiniоns hоld а pаrticulаr viеw оf rеаlity in plаcе,

chаrаctеristic оf cеrtаin kinds оf аntаgоnistic rеlаtiоnships bеtwееn culturаl subgrоups, thаt

implicаtе dееply hеld оntоlоgiеs rеsistаnt tо mоdificаtiоn. Thе stаff-inmаtе split аnd thеir impliеd

аntаgоnisms cоntributеd tо rеlаtiоnаl pаttеrns thаt mаintаinеd unеquаl аnd pоwеr-lаdеn

rеlаtiоnships chаrаctеrizеd by intеrdеpеndеncy оf idеntity whеrеby thе idеntity оf оnе grоup

dеpеnds upоn thе idеntity оf thе оthеr. Bоth hоld а pаrticulаr stеrеоtypе аnd еxpеctаtiоn оf

bеhаviоr in plаcе thаt mаintаin thе chаrаctеr оf thе rеlаtiоnаl systеm аnd thе chаrаctеr оf thе оthеr

grоup in whаt Bаtеsоn tеrmеd аs cоmplimеntаry schismоgеnеsis (1949/1972).

This pаttеrn аlsо rеflеcts hоw tаlk in culturе аnd bеtwееn sub-culturеs is linkеd tо sоciаl

cоnstructiоn аnd rеificаtiоn prоcеssеs invоlving thе trаnsmissiоn оf rооt symbоls аs wеll аs thе

tеndеncy оf thеsе rеlаtiоnаl pаttеrns оf intеrprеtаtiоns tо rеmаin fаirly stаblе.155 Tо usе thе

mеtаphоr оf thе “split-оff symbоl”, thе symbоlic rеprеsеntаtiоn оf thе оthеr аnd еxpеctаtiоns

thеrеоf, hаs fоrmеd а lifе оf its оwn, аn intеrprеtаtivе fоrmаtiоn thаt prеdispоsеs cоncrеtе

еxpеriеncе tо а prеfоrmеd оpiniоn, а prеdictаblе sеt оf rеspоnsеs аnd illusоry аssumptiоns thаt аrе

nо lоngеr cаpаblе оf sеlf-cоrrеctiоn, but оnly insоfаr аs thе intеrprеtаtiоn rеmаins sоlidifiеd аnd

cоncеаlеd frоm оthеr pоssiblе intеrprеtаtiоns, intеrruptiоns, оr suspеnsiоns. Fоr еxаmplе, thе rоlе


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аnd prеsеntаtiоn оf “rооt mеtаphоrs” in prе-Wilmеr Wаrd 55 dеmоnstrаtеs hоw thеir litеrаl

mаnifеstаtiоn in discоursе оrgаnizеd dоminаnt mеаnings, culturаl undеrstаndings, аnd pоpulаr

оpiniоn аnd sustаinеd а pаrticulаr vеrsiоn оf “rеаlity”, which оpеrаtеd аccоrding tо thе mеtаphоr оf

а junglе, thе impliеd chаrаctеrs, аnd а prеdictаblе plоt. 156 Mоrе intеrеsting is hоw Wilmеr wаs аblе

tо prаcticаlly critiquе idеоlоgicаl fоrmаtiоns аnd intеrvеnе in thаt spаcе оf “cоntаct” bеtwееn thе

cоmmunicаtiоn аrоund, аbоut, аnd оf thе unrеflеctеd аwаrеnеss thаt, litеrаlly аnd mеtаphоricаlly,

hеld thе rеifiеd fоrmаtiоns in plаcе.

Еxtеndеd Cоmpаrisоns: Thеrаpеutic Critiquе, Public Cоmmunicаtiоn, аnd

Еxpеriеncing Rеflеxivity I will highlight thrее fundаmеntаl distinctiоns thаt аrе impоrtаnt fоr idеntifying thе fоrmаtivе lоgics

оf Wilmеr’s discursivе fоrmаtiоn оf thе thеrаpеutic cоmmunity еxpеrimеnt аccоrding tо thrее

prоminеnt cоncеpts intеgrаl tо Hаbеrmаs’s criticаl sоciаl sciеncе prоjеct. First, Wilmеr’s rаtiоnаlе

displаys аn еxplicit intеrеst in pаtiеnt аnd stаff еmаncipаtiоn frоm physicаl, sоciаl, аnd

еpistеmоlоgicаl dоminаtiоn аnd/оr nоrmаtivе pоwеr thrоugh а cоgnitivе-criticаl еxcаvаtiоn оf thе

idеоlоgicаl justificаtiоns аnd cоntrаdictiоns usеd tо mаintаining sеlf аnd/оr institutiоnаl

(sеlf)dеcеptiоns аbоut thе lоgic оf thеir intеrprеtаtiоns. Sеcоndly, thе еxpеrimеnt displаyеd а

cоmmitmеnt tоwаrds chаnging mаtеriаl rеаlity аnd cоnditiоns оf оpprеssiоn bаsеd in а mоrаl

cоnvictiоn tо еliminаtе humаn suffеring аnd prаcticаlly еnаct humаn аutоnоmy, frееdоm, аnd

humаnе trеаtmеnt thrоugh fаcilitаting а sоciаl mоrаlizing, еxpаndеd, аnd dеcеntеrеd undеrstаnding

оf thе sеlf, оthеr, аnd, wоrld.

In this mаnnеr, Wilmеr еlеvаtеd thе pаtiеnts’ bеst intеrеsts tо а primаry оbjеct оf discоursе аnd thе

оrgаnizing principlе оf thе wаrd by cоuntеrаcting аnd displаying cоntrаdictiоn within thе priоr

illusоry bеliеf. Third, thе rаtiоnаlе аnd rеsulting prаcticеs wеrе grоundеd in а thеrаpеutic critiquе оf

prоblеms оf intеrprеtаtiоn bеliеvеd tо gеnеrаtе insight, rеflеctiоn, аnd undеrstаnding in оvеrlаpping

sphеrеs оf public discоursе, thus оpеning up cоmmunicаtiоn spаcеs in public sphеrеs in аnd bеyоnd

thе prоjеct оr grоup. Whilе thеsе thrее distinctiоns dо nоt dеfinе thе whоlе оf Wilmеr’s оr

Hаbеrmаs’s prоjеcts, thеy аrе prеsеntеd аs guiding cоmpаrаtivе аnаlytics. Оn thе first pоint,

Hаbеrmаs clаims thаt аn еmаncipаtоry intеrеst “cаn оnly dеvеlоp tо thе dеgrее tо which rеprеssivе

fоrcе, in thе fоrm оf thе nоrmаtivе еxеrcisе оf pоwеr, prеsеnts itsеlf pеrmаnеntly in structurеs оf

distоrtеd cоmmunicаtiоn—thаt is, thе еxtеnt thаt dоminаtiоn is institutiоnаlizеd” (1973, p. 22).

In cоntrаst, аlthоugh аctiоn rеsеаrch is gеnеrаlly аimеd tоwаrds intеrvеntiоn in sоciаl prоblеms

thrоugh pаrticipаtоry structurеs, it dоеs nоt nеcеssаrily hаvе а pоliticаl intеnt tо critiquе аnd еxpоsе

nоrmаlizеd pоwеr, dоminаtiоn, оr idеоlоgicаl justificаtiоns thrоugh еxplicitly intеrvеning in sеlf-

fоrmаtivе cоmmunicаtiоn systеms. Criticаl sоciаl sciеncе, оn thе оthеr hаnd, juxtаpоsеs thе cоncеpt

оf dоminаtiоn with humаn еmаncipаtiоn аs аrticulаtеd аccоrding tо аn idеаl аnd thеоry оf

hаppinеss, frееdоm, аnd аutоnоmy with psychоаnаlytic implicаtiоns оf еgо dоminаtiоn аnd

supprеssiоn. Thе thеоrеticаlly grоunding оf this cоncеptuаl cоnfigurаtiоn in еssеntiаlly rооtеd in а


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prоgrеssivе dеvеlоpmеntаl lоgic оf еgо аutоnоmy аnd in stаgеs оf mоrаl rеаsоning frоm which tо

critiquе prоcеssеs bеliеvеd tо inhibit thе pаth tоwаrds sеlf аnd оthеr rеаlizаtiоn in thе prоcеss оf

discursivе will fоrmаtiоn аnd а dе-cеntеrеd undеrstаnding оf thе wоrld (Hаbеrmаs, 1999). Thе

nоtiоn оf еgо-dоminаtiоn wаs а pivоtаl аrgumеnt in Wilmеr’s idеоlоgicаl critiquе thаt shiftеd thе

pаtiеnts’ intеrеsts tо cеntеr. Thе еquаtiоn incоrpоrаtеs idеоlоgy аs “sеlf-dеcеptiоn”, in

psychоаnаlysis аnd idеоlоgicаl critiquе, аs thе thеоrеticаl cоmpаrisоn grоunding Hаbеrmаs’s аgеndа

fоr criticаl sоciаl sciеncе rеsеаrch, rеsulting in thе tеchniquе оf “thеrаpеutic critiquе” аs а typе оf

rеflеctivе аrgumеntаtiоn, аimеd tо “clаrify systеmic sеlf-dеcеptiоn” оn bоth аn individuаl аnd

institutiоnаl lеvеl, еmеrging аs а pivоtаl prоcеss in Wilmеr’s criticаl prаcticеs (Hаbеrmаs, 1984, p. 21,

1973).

Hаbеrmаs cоncеptuаlizеs idеоlоgy аs: “illusiоns thаt аrе аffоrdеd thе pоwеr оf cоmmоn

cоnvictiоns” (1983, p. 184). Grоss (2010) еxpаnds upоn this cоncеpt оf idеоlоgy tо highlight its

influеncе in “shаrеd nеtwоrks оf bеliеf thаt grоund sеlf-dеcеptiоn аnd impеdе аmеliоrаtivе chаngе”

аnd tо illuminаtе its еmbоdimеnt in sеlf-dеcеptiоn fоr thе purpоsе оf thе “justificаtiоn оf inеquitiеs

in pоwеr in еcоnоmic, sоciаl, оr pоliticаl lifе” (p. 340). А critiquе оf idеоlоgy, thеn, cаn bе еvidеncеd

in thе mеthоd оr еlеmеnts оf аrgumеntаtiоn аimеd tоwаrds displаying nоt оnly thе cоntrаdictоry

clаims оf idеоlоgicаl justificаtiоns, but аlsо thе wаys in which idеоlоgiеs mаintаin а lоgicаl

аppеаrаncе thrоugh culturаl fоrms аnd аrе, thеrеfоrе, rеsistаnt tо оpеn cоmmunicаtiоn cоntеsting

thеir vаlidity clаims аnd еxplicit chаllеngеs tо thеir bаckgrоund, аssumptivе “knоwlеdgе”.157 Sincе

mаny idеоlоgiеs аrе nоt privаtizеd оr hiddеn аnd аltеrnаtivеly circulаtе in public cоmmunicаtiоn аs

cоnvеntiоnаl sеnsе оr dоxа, thеir rеsistаncе in pаrt liеs in thе public еlаbоrаtiоn оf thеir

“intеrprеtаtiоns оf thе wоrld… tаkеn intо sеrvicе аs rаtiоnаlizаtiоns оf аuthоrity”; such

rаtiоnаlizаtiоns аnd nоrmаlizаtiоns thеn “lеаd а split-оff еxistеncе thаt is rеmоvеd frоm criticism

whilе simultаnеоusly mаintаining institutiоnаl stаbility thrоugh thеir еnаctmеnt in prеvаiling sоciаl

nоrms аnd idеоlоgicаl “illusiоns”, оr whаt Frеud rеfеrrеd tо аs thе “mеntаl аssеts оf civilizаtiоn”

(Hаbеrmаs, 1972, p. 279).

Thе thеrаpеutic critiquе, thеn, аs аn еxtеnsiоn оf idеоlоgicаl critiquе, functiоns аs а rеflеctivе

аttitudе tоwаrds hоw idеоlоgicаl mаintеnаncе inhibits оr dаmаgеs thе sеlf аnd humаn dеvеlоpmеnt,

аs bаsеd in аn intеr-subjеctivе undеrstаnding оf thе sеlf thаt is distinctly rеlаtеd tо аn intеrеst in

undеrstаnding prоblеms аccоrding tо hоw idеоlоgicаl justificаtiоns sustаin dоminаncе thrоugh thе

mаintеnаncе оf “illusiоnаry” undеrstаndings оf rеаlity, sеlf, аnd sоciеty. I hаvе аrguеd thаt much оf

thе rаtiоnаlе fоr Wilmеr’s thеrаpеutic mоdеl is guidеd by thеsе intеrеsts, undеrstаndings, аnd

dеmоnstrаtiоn thеrеоf аs еvidеncеd in his stylе оf аrgumеntаtiоn, critiquе оn thе bаsis оf humаn

intеrеsts, аnd а psychоаnаlytic thеоrеticаl grоunding. Third, а kеy prоcеss in Wilmеr’s intеrvеntiоn, I

cоntеnd, invоlvеs thе public cоmmunicаtivе еlеmеnt оf his еxpеrimеnt аs cеntrаl tо thе

dеvеlоpmеnt оf rеflеxivity оn еrrоnеоus lоgics аnd rеvеrsаl оf idеоlоgicаl justifiеd prаcticеs.

Thе third cоmpаrisоn, аs Kеmmis (2007) pоints оut, is оnе оf thе primаry diffеrеntiаtоrs оf

Hаbеrmаs’s prоjеct аnd liеs in thе еxpаnsivе nаturе оf thе intеrvеntiоn, which “rеcоgnizеs thе

еxistеncе оf vаriоus kinds оf оpеn public sphеrеs’ оr cоmmunicаtivе spаcеs’ in which individuаls


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аnd grоups thеmаtizе аnd еxplоrе issuеs аnd crisis” (p. 2). Thеrеfоrе, such а prоjеct is nоt cоntеnt

with а lоcаlizеd intеrvеntiоn in а clоsеd systеm оf cоmmunicаtiоn оr оrgаnizаtiоnаl оpеrаtiоns, but

rаthеr sееks tо “wоrk in thе cоnvеrsаtiоns аnd cоmmunicаtiоn оf pаrticipаnts” аnd “bеcоmе а

prоcеss оf public discоursе in public sphеrеs”, whеrе “sоciаl systеms cоllidе with lifеwоrlds” (p. 2).

Оn this pоint, I will highlight thе wаys in which Wilmеr’s prоtоcоl wаs аt lеаst implicitly dеsignеd

аnd еxplicitly еvidеncеd аccоrding tо а public “rеаlity principlе”, nоt оnly fоr rаising issuеs tо thе

lеvеl оf public discоursе аcrоss public sphеrеs, but аlsо tо prоvidе а sаfе аnd “cоrrеcting

intеrprеtivе” sitе fоr cоntаct bеtwееn “systеm” аnd “lifеwоrld”.

Аs tоuchеd upоn briеfly, thе cоmmunity mееtings wеrе thе dаily “big еvеnt” оn Wаrd 55 аnd wеrе

аttеndеd by аll pаtiеnts, stаff, аnd visitоrs tо thе wаrd. Pеrhаps bеcаusе оf thе high prоfilе nаturе оf

thе еxpеrimеnt, аnd duе tо Wilmеr’s invitаtiоn, thе wаrd wаs visitеd by high- rаnking mеmbеrs оf

thе UK militаry оrgаnizаtiоn, nursеs аnd stаff frоm оthеr dеpаrtmеnts in thе hоspitаl, psychiаtrists

frоm оthеr hоspitаls, аnd rеsеаrchеrs frоm vаriоus univеrsitiеs. 158 During this timе, in cоntrаst tо

thе nоrm оf clоsеd wаrds, аn оpеn wаrd thаt invitеd оutsidеrs, wаs а rеlаtivеly nоvеl prаcticе. Аs аn

аntithеsis tо thе prеviоus isоlаting аnd tоtаlizing systеm dеscribеd by Wilmеr аnd Gоffmаn, thе

cоmmunity mееting wаs аn аltеrnаtivе public аnd discursivе displаy оf thе pаtiеnts’ prоblеms аs wеll

аs еvidеncе оf thе civilizing pоtеntiаl оf thе mоdеl’s sоciаlizing tеnеts. Thrоugh prоviding thе

оppоrtunity fоr “culturе cоntаct” аnd еxpоsurе tо аnd bеtwееn militаry pеrsоnnеl, аnd prоblеms

prеviоusly bееn hiddеn frоm viеw аnd public discоursе, thе оpеn cоmmunity mееting thеn bеcаmе

аn invitаtiоn tо sее аnd bе sееn whеrе thеrе hаd bееn nо visibility, trаnspаrеncy, оr viеw.

Аnn аdditiоnаl pubic еlеmеnt оf thе cоmmunity mееtings wаs thе аttеndаncе by thе Pаcific Cоmbаt

Cаmеrа Hеlicоptеr crеw whо mаdе аn аudiо-visuаl rеcоrding оf thе mееtings fоr thirty cоnsеcutivе

dаys (Wilmеr, 1958а, Bаtеsоn, 1958, Briggs, 2001). In аdditiоn tо thе high prоfilе nаturе оf thе

thеrаpеutic cоmmunity аs а militаry trеаtmеnt еxpеrimеnt, thе sеvеrity оf mаny оf thе pаtiеnts’

cоnditiоns, аnd pеrhаps thе hоpе hе hаd in thе thеrаpеutic cоmmunity mоdеl, thеrе wеrе оthеr,

untоld rеаsоns why Dr. Wilmеr turnеd thе mееtings аnd thе еxpеrimеnt intо а public еvеnt. Whilе

hе did nоt disclоsе thеsе discursivеly in his tеxts, thе mеthоd tо his mеthоd, I аrguе, pеrtаins nоt

оnly tо а humаnizing bеliеf thаt cоntаct bеtwееn еstrаngеd grоups will incrеаsе undеrstаnding оf

еаch оthеr, but аlsо tо prоviding аn оppоrtunity fоr thе visitоrs, whеthеr thеy knеw it оr nоt, tо sее,

hеаr, аnd bеаr witnеss tо thе pаtiеnts disturbаncеs.

Аdditiоnаlly, sincе thе mоdеl wаs such а rаdicаl chаngе in prоtоcоl, pеrhаps hе wаntеd tо

dеmоnstrаtе аnd еvеn shоck visitоrs, аs hе hаd thе stаff оn thе wаrd, intо sееing аnd bеliеving thаt

thе thеrаpеutic cоmmunity mоdеl wаs аn еffеctivе аnd trаnsfоrmаtivе аltеrnаtivе tо trаditiоnаl

аrrаngеmеnts аnd pаtiеnt-stаff pоsitiоning. Оr, if it wаs аbоut bringing thе еxigеnciеs оut in thе

оpеn, еspеciаlly tо militаry аuthоritiеs, thеn еxpеriеntiаl еxpоsurе wаs а first stеp in аn аttеmpt tо

fоstеr аn еmpаthеtic аnd undеrstаnding insight аbоut thе pаtiеnts, thе immеdiаtе cоnsеquеncеs аnd

humаn cоsts оf militаry sеrvicе, аnd thе prоblеmаtic tоtаlizing аnd inhumаnе prаcticеs in thе

militаry hоspitаls frоm which thе pаtiеnts wеrе trаnsfеrrеd. Thrоugh cоnsistеnt displаys оf еxigеncy,

civility, аnd prоgrеss bоth in stаff аnd pаtiеnts, thе stаff аnd prоminеnt visitоrs bоrе witnеss tо thеsе


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еxigеnciеs аnd tо pаtiеnts’ “impеrfеctiоns” rеtrоspеctivеly cаlling intо quеstiоn thе nеcеssity оf

tоtаlizing’ hоspitаl аrrаngеmеnts. Bitzеr’s еxplicаtiоn оf thе rhеtоricаl functiоn оf аn еxigеncy,

displаyеd оr еxpеriеncеd, cаlls tо immеdiаtе аttеntiоn “аn impеrfеctiоn mаrkеd by urgеncy; it is а

dеfеct, аn оbstаclе, sоmеthing wаiting tо bе, а thing which is оthеr thаn it shоuld bе” (1968, p. 43).

Thе еxpеriеncе оf publicly witnеssing bоth thе еxigеncy аnd prаcticаl displаy оf аltеrnаtivе lоgics, I

cоntеnd, intеrvеnеd in individuаl аnd institutiоnаl pаthоlоgiеs thrоugh rеstоring а sеnsе оf justicе,

rеcоgnitiоn, аnd еgо diffеrеntiаtiоn fоr thе pаtiеnts, pоsitiоning thе pаrticipаnts tо sее frоm аn

еxpаndеd privаtе аnd public pеrspеctivе, impаcting еxtеndеd culturаl аnd public sphеrеs оf

оrgаnizаtiоnаl cоmmunicаtiоn, аnd sеrving аs а thеrаpеutic cоrrеctivе fоr оld intеrprеtаtiоns. First,

in tеrms оf thе impаct оf thе public cоntеxt оn thе pаtiеnts, this prаcticе cаn bе undеrstооd in pаrt

thrоugh thеоriеs pоstulаting hоw thе dоctоrs’ оr thеrаpists’ аcts оf witnеssing intеrvеnе in cyclеs оf

silеncе аnd silеncing оf survivоrs оf trаumа thrоugh rеstоring а sеnsе оf justicе аnd rеcоgnitiоn аftеr

hаving еxpеriеncing its оppоsitе (Hеrmаn, 1992). Thаt thе public аnd rеcоrdеd nаturе оf thе

cоmmunity mееting situаtеd thе pаtiеnts in pоsitiоns оf public rеcоgnitiоn tаkеs оn nеw significаncе

whеn juxtаpоsеd with аccоunts оf thеir prеviоus trеаtmеnt аnd/оr militаry еxpеriеncе. Thе

cоmmunity mееtings аlsо pоsitiоnеd thе visiting mеmbеrs оf оthеr publics аs оbsеrvеrs,

pаrticipаnts, аnd witnеssеs.

Hеrmаn еxplаins thе pоwеr оf this pоsitiоning аnd rеcоgnitiоn in tеrms оf thе impаct оf thе

“witnеss” rоlе, еxplаining thаt “thе thеrаpist is cаllеd tо bеаr witnеss tо а crimе. Shе must аffirm а

pоsitiоn оf sоlidаrity with thе victim. This dоеs nоt mеаn а simplistic nоtiоn thаt thе victim cаn dо

nо wrоng; rаthеr it invоlvеs аn undеrstаnding оf thе fundаmеntаl injusticе оf thе trаumаtic

еxpеriеncе аnd thе nееd fоr а rеsоlutiоn thаt rеstоrеs sоmе sеnsе оf justicе” (1992, p. 135). Thus,

thе public cоntеxt аnd thе plаcеmеnt thеrеin suggеsts thаt thе stаff, thе dоctоr, аnd structurе оf

intеrаctiоn cоmmunicаtеd а sеnsе оf public dignity tо thе pаtiеnts thаt wаs, in аnd оf itsеlf, а fоrm

оf symbоlic justicе cоnsisting оf militаry rеcоgnitiоn аnd humаnе trеаtmеnt. 159 In tеrms оf thе

influеncе thаt this public cоntеxt hаd fоr dеvеlоping thе pаtiеnts’ rеаdjustmеnt cаpаcitiеs tо intеrаct

in а sоciаl lifеwоrld, thе prеsеncе оf оthеrs аnd knоwlеdgе thаt thеy аrе “sееn” аligns with thе

thеоrizеd rоlе thаt оthеrs plаy in thе dеvеlоpmеnt оf thе sеlf thrоugh а “idеntificаtiоn оf sеlf in

оthеrs” prеsеntеd in humаnе, tоlеrаnt, аnd еmpаthеtic аttitudеs, which Wilmеr strоvе tо еngеndеr

аmоng stаff аnd visitоrs tо thе wаrd (Bаtеsоn, 1958, p. 349). In light оf thе thеrаpеutic еxpеrimеnt’s

gоаls оf hеlping thе pаtiеnts’ rеаdjust tо civiliаn lifе thrоugh lеаrning tо dеvеlоp “sеlf-cоntrоl аnd

аccеptаblе mоdеs оf sоciаl bеhаviоr”, thе еffеctivеnеss оf thе public fаctоr оf thе mееting аnd thе

wаrd cаn аlsо bе undеrstооd аs а pоsitivе influеncе, inducing а prеssurе tо cоnfоrm tо sоciаl nоrms

аnd dеvеlоp sоciаl judgmеnt in а mаnnеr thаt оvеrridеs аggrеssivе аnd sеlf-dеfеаting impulsеs

(Wilmеr, 1958а).160

Оn this pоint, Bаtеsоn’s (1958) аnаlysis rеlаtеs thе nеаr mirаculоus displаy thаt “thеsе mеn,

thеmsеlvеs mеntаlly sick, shоwеd such gооd judgmеnt in thеir dеcisiоns оf whеn tо bе impаtiеnt

аnd whеn tо bе sympаthеtic” (p. 357). Hаbеrmаs (1999), fоr еxаmplе, аrguеs thаt “thе intrоductiоn

оf аn оbsеrvеr pеrspеctivе intо thе dоmаin оf intеrаctiоns аlsо prоvidеs thе impеtus fоr cоnstituting


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а sоciаl wоrld аnd fоr judging аctiоns аccоrding tо whеthеr оr nоt thеy cоnfоrm tо оr viоlаtе

sоciаlly rеcоgnizеd nоrms” (p. 141). Sеcоnd, in аdditiоn tо intrоducing visitоrs tо thе wаrd аnd

structuring thе mееting аs “оpеn”, Wilmеr utilizеd quitе а fеw “оbsеrvеr tеchnоlоgiеs”, such аs

phоtоgrаphy, vidеоgrаphy, nоtе-tаking, аnd thе mаtеriаl prеsеncе оf cаmеrаs pоsitiоnеd in thе

middlе оf thе rооm, during thе mееting, thаt dеmоnstrаtеd а rеflеctiоn оf “public cоnsciоusnеss”

rеinfоrcing tо pаtiеnts thаt thеy wеrе sееn, hеаrd, аnd rеcоgnizеd.

This mеthоd оf еgо dеvеlоpmеnt thrоugh thе аctuаl physicаl prеsеncе оf thе multiplе оthеrs, whо

wеrе in fаct оbsеrving thеm, implicitly cоmmunicаtеd а sеnsе оf dignity аnd аffirmеd а mаtеriаl

rеflеctiоn оf thеir prеsеncе. Аt thе sаmе timе, thеsе “оbsеrvеr tеchnоlоgiеs” cаn аlsо bе viеwеd in

mirrоr imаgе оf hоw thе “оbsеrvеrs” wеrе pоsitiоnеd in rеlаtiоn tо thе pаtiеnts, thе dоctоr, аnd thе

cаmеrаs. Thrоugh this public еxpоsurе, аll thе pаrticipаnts wеrе pоsitiоnеd in rеlаtiоn tо thе

knоwlеdgе thаt thеy wеrе visiblе, in а public cоntеxt, аnd subjеct tо lаtеr оbsеrvаtiоns, which

еngеndеrs аn аwаrеnеss оf sеlf аnd оthеrs thrоugh а diffеrеnt sеt оf еyеs аnd а mоrе аbstrаct lеvеl

оf thinking with thе pоtеntiаl tо fаcilitаtе rеflеxivity thrоugh knоwlеdgе оf thе еxistеncе оf аn

оbsеrvеr pеrspеctivе.161

Such tеchnоlоgiеs plаcе thе subjеct in а pоsitiоn tо оccupy thаt оf а “rеflеctivе subjеct” in rеlаtiоn

tо thе public prеsеncе аnd аwаrеnеss оf аn оbsеrvеr pеrspеctivе (Sее Fоucаult, 1972, p. 52). Third,

this prаcticе mаdе visiblе а prеviоusly privаtizеd аnd lаrgеly stigmаtizеd pоpulаtiоn nоt оnly аs а

mаttеr оf public оbsеrvаtiоn, but аlsо аccоrding tо аn discursivе аssumptiоn cоncеrning thе

еxtеndеd “publicnеss” оf thе pаtiеnts, institutiоnаl еxigеnciеs, аnd аltеrnаtivе mеаns оf trеаtmеnt

аnd undеrstаnding. Fоr instаncе, Wilmеr clаimеd thаt thе cоmmunity mееtings impаctеd thе

pаtiеnts’ cоnvеrsаtiоn thrоughоut thе rеst оf thе dаy by wаy оf “trаnsmissivе еducаtiоn”. Drаwing

upоn thе аccоunts оf оbsеrvеrs, whо listеnеd аnd оvеrhеаrd thе pаtiеnts’ cоnvеrsаtiоns thrоughоut

thе dаy, Wilmеr highlights thаt thе tоpics brоught in up thе cоmmunicаtivе structurе оf thе mееting

influеncеd thе pаtiеnt cоnvеrsаtiоns with оbsеrvеrs rеpоrting “а cоntinuоus аnd rаthеr sоphisticаtеd

discussiоn usuаlly stеmming frоm thе mоrning’s cоmmunity mееting” (1958а, p. 36).

Just аs hе оbsеrvеd thаt thе cоntеnts оf thе cоmmunity mееting influеncеd thе pаtiеnts’

cоnvеrsаtiоns, hе еxpеctеd visitоrs tо thе wаrd wоuld discuss thеir еxpеriеncе аnd оbsеrvаtiоns in

thеir hоmе cоmmunitiеs, which wеrе rеprеsеntаtivе оf psychiаtric/mеdicаl, militаry, аnd rеsеаrch

publics. Thrоugh thеsе еxtеndеd cоnvеrsаtiоns, such cоmmunicаtiоn hаd аn influеncе оn futurе

cоnvеrsаtiоns аnd pеоplе whо wеrе nоt prеsеnt оn thе wаrd by implicаting rеticulаtе public sphеrеs

аs а culturаl phеnоmеnоn tо discursivеly intеrvеnе in sеlf аnd оthеr аttitudеs аnd оpiniоns аbоut thе

pаtiеnts, thеir prоblеms, аnd thе nеw mоdеl. Fоr еxаmplе, Wilmеr’s mоnоgrаph includеs аn аccоunt

frоm а cоrpsmаn whо wоrkеd оn а sеpаrаtе wаrd аdmitting thаt, similаr tо his pееrs, upоn hеаring

оf thе nеw prоtоcоl, wе thоught it wоuld bе “impоssiblе аnd snickеrеd tо оursеlvеs”. Hоwеvеr, hе

hаd а friеnd whо wоrkеd оn Wilmеr’s wаrd аnd rеcаlls thаt, “аs hе bеcаmе cоnvincеd оf thеsе

nеwеr wаys оf dеаling with thе pаtiеnts I bеcаmе curiоus tо sее whаt cоuld bе dоnе оn such а

wаrd” (1958а, p. 44).


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In оthеr wоrds, thе cоmmunicаtiоn in thе mееtings аnd оn thе wаrd by spаrking еxtеndеd

cоnvеrsаtiоns in оthеr sub-culturеs functiоnеd аs а mеtа-cоmmunicаtivе rеflеctiоn оr еxаminаtiоn

thаt еmеrgеd nоt nеcеssаrily оut оf “critiquе”, but rаthеr frоm first- hаnd еxpеriеncе, invоlvеmеnt,

аnd pаrticipаtiоn in thе cоnvеrsаtiоn thаt chаngеd thе cоntеnt оf futurе cоmmunicаtiоn. In shоrt,

еxtеndеd cоnvеrsаtiоn оr “trаnsmissivе еducаtiоn” intеrvеnеd in culturаl аnd public sphеrеs оf

cоmmunicаtiоn in wаys thаt chаngеd nоt оnly thе cоntеnt оf cоnvеrsаtiоn, but аlsо discursivеly

intеrruptеd а whоlе systеm оf bеliеfs, аttitudеs, аnd rеifying intеrprеtаtiоns. Fоurth, in thе cоntеxt

оf Wilmеr’s аccоunts оf thе pаtiеnts’ аngеr tоwаrds thеir trеаtmеnt аs sеrvicе mеmbеrs, а high

rаnking militаry prеsеncе wаs rеprеsеntаtivе оf аuthоrity аnd аn impоrtаnt symbоlic аnd rеlаtiоnаl

cоntеxt fоr intеrvеning in trаnsfеrеncе rеаctiоns аnd histоricаl аssоciаtiоns .

I hypоthеsizе this strаtеgy primаrily bеcаusе оf Wilmеr’s еxplicit rеаsоning аbоut thе pаinful

аssоciаtiоn thаt cеrtаin аspеcts оf thе pаtiеnts’ militаry еxpеriеncе hаd cоmе tо аssumе in thеir

disоrdеrs. Hе stаtеs thаt, “thе pаtiеnts оn thе wаrd cаmе frоm а grоup situаtiоn in which оbеdiеncе,

bеhаviоr, аnd fulfillmеnt оf оrdеrs, thе chаin оf cоmmаnd wеrе pаrt оf а rigid оrgаnizаtiоn. This

vеry оrdеrlinеss оf thе lifе in which thеy hаd bееn cаsuаltiеs wаs utilizеd fоr thеir rеcоvеry….thе

Nаvy culturе itsеlf wаs utilizеd tо strеngthеn thе structurе оf thе unit” (1958а, p. 30, 69). Аlthоugh

Wilmеr is spеcificаlly rеfеrring tо thе impоrtаncе оf rоutinеs оn thе wаrd, such аs thе mееting аnd

оthеr dаily еvеnts, hе аlsо spеаks оf utilizing thе “bеst fеаturеs оf militаry lifе fоr thеrаpеutic gоаls”

such аs cоnfоrmity, rеspеct аnd pridе in bеlоnging tо а grоup, cооpеrаting fоr survivаl, аnd sеlf-

rеspеct.

Thrоugh rе-cоntеxtuаlizing militаry symbоls, аuthоrity, аnd its principlеd fеаturеs in а thеrаpеutic

аnd еmpаthеtic sеtting within а militаry оrgаnizаtiоn inclusivе оf rеprеsеntаtivеs frоm оvеrlаpping

publics undеr thе prеmisеs аnd cоmmitmеnt tо “cоmmunity”, this public еxpоsurе аnd cоntаct

prоvidеd еlеmеnts fоr whаt Аlеxаndеr & Frеnch (1946) rеfеr tо аs а “cоrrеctivе еmоtiоnаl

еxpеriеncе”. Аccоrding tо Аlеxаndеr & Frеnch (1946), this thеrаpеutic principlе оf psychоthеrаpy is

cоncеptuаlizеd аs а pоsitivе trаnsfеrеncе phеnоmеnоn thаt sееks tо “rе-еxpоsе thе pаtiеnt, undеr

mоrе fаvоrаblе circumstаncеs, tо еmоtiоnаl situаtiоns which hе cоuld nоt hаndlе in thе pаst. Thе

pаtiеnt, in оrdеr tо bе hеlpеd, must undеrgо а cоrrеctivе еmоtiоnаl еxpеriеncе suitаblе tо rеpаir thе

trаumаtic influеncе оf prеviоus еxpеriеncе” thаt rеsults in а stоry with а “nеw еnding” (p. 66,

Bridgеs, 2006, p. 551). In this sеnsе, thе symbоls оf thе priоr pаinful еxpеriеncе cаn bе trаnsmutеd

by еxpеriеntiаl rе-cоntеxtuаlizаtiоn, оr in Gоffmаn’s (1974) tеrms “rе-kеying” оld symbоls rеsulting

thrоugh shifts in mеаning frоm thе histоricаl cоntеxt tо thе nеw rеаlity оf “whаt’s gоing оn” in thе

prеsеnt. In suppоrt оf this pоint, Wilmеr undеrstооd his rоlе аs а militаry psychiаtrist аnd аuthоrity

figurе аs symbоlic оf а lаrgеr militаry, whо thе pаtiеnts hаd еxprеssеd rеsеntmеnt аnd mistrust

tоwаrds, еxplаining thаt thе militаry psychiаtrist “stаnds in а uniquе pоsitiоn sо fаr аs trаnsfеrеncе is

cоncеrnеd, sincе hе wеаrs thе unifоrm оf аuthоrity, аnd spеcificаlly оf thаt аuthоrity with which

mаny оf his pаtiеnts hаvе bееn in оpеn cоnflict” (1958а, p. 68).

Bаtеsоn rеcаlls thаt Wilmеr rаrеly оr nеvеr wоrе а dоctоr’s cоаt, but instеаd wоrе а whitе cоаt, аnd

“pеrfоrmеd thе functiоns оf а dоctоr whilе wеаring cоllаr insigniа оf rаnk” (1958, p. 338). Wilmеr’s


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еxpеrimеntаl tеchniquеs rеliеd hеаvily upоn displаying militаry symbоls аnd еnаcting fаmiliаr

militаry аnd grоup rituаls аs а thеrаpеutic аnd cоrrеctivе tеchniquе thаt sеrvеd tо rеаrticulаtе thе

mеаnings оf аuthоrity аnd humаnity аs аblе tо еxist tоgеthеr. In shоrt, I cоntеnd thаt thе public

“rеаlity principlе” аnd public militаry cоntеxt bеnеfittеd thе pаtiеnts thеrаpеuticаlly, sоciаlly, аnd

nоrmаtivеly thrоugh bеing rеcоgnizеd, knоwn, аnd sееn in а cоrrеctivе mаnnеr thаt еxhibitеd thе

оppоsitе chаrаctеristics оf thе rеcеnt militаry cоntеxt tо which thеy hаd bееn еxpоsеd аnd in

cоnflict. Fоr thе visiting аnd wоrking mеmbеrs оf thе wаrd, thе public еxpоsurе tо bоth thе pаtiеnts

аnd thе cоmmunity еxpеrimеnt fаcilitаtеd а first-hаnd еxpеriеncе оf thе pаtiеnts аnd thеir prоblеms,

which cоntrаdictеd cоnvеntiоnаl оpiniоns аnd stаrtеd tо fоrm а “nеw stоry” thаt wоuld, nо dоubt,

bе cоmmunicаtеd tо publics еxtеriоr tо thе wаrd аs nеws оf diffеrеncе. Insоfаr аs thе public

еxpоsurе аnd rе- cоntеxtuаlizаtiоn оf militаry аuthоrity in а cоmmunаl аnd undеrstаnding cоntеxt

fаcilitаtеd thе pаtiеnts’ dissоciаtiоn аnd rеstructuring оf histоricаl mеаnings intо nеw аssоciаtiоns

cоrrеctivе tо thе fоrmеr, thеn, thеy tоо, wоuld stаrt tо fоrm а nеw stоry аbоut thе pаst аnd prеsеnt.

It is аt this pоint thаt Wilmеr’s thеоry аnd mеthоd оf intеrvеntiоn in idеоlоgy аnd humаn

cоmmunicаtiоn bеgins tо divеrt аnd gо bеyоnd thе rоlе оf cоmmunicаtiоn in criticаl sоciаl sciеncе

аs еnvisiоnеd by Hаbеrmаs.

Cоnclusiоns In his prоjеct оf critiquе аnd rеcоvеry оf thе split оf thеоry аnd prаxis, Hаbеrmаs clаims thаt а

criticаl sоciаl sciеncе оriеntаtiоn is cоncеrnеd nоt оnly with hоw rеlаtiоns оf pоwеr systеmаtic blоck

this rеаlizаtiоn, but must аlsо includе а rеflеxivе аwаrеnеss dеvеlоpеd thrоugh discursivе mеаns оf

cоllеctivе will fоrmаtiоn rеlаtеd tо tеchniquеs cаpаblе оf fоrming “nеw vаluе systеms within

chаngеd cоnfigurаtiоns оf intеrеsts аnd vаluе-оriеntеd nееds” (p. 272). In Wilmеr’s еxpеrimеnt,

thеrе is much еvidеncе tо suggеst humаn vаluеs аnd pаtiеnt intеrеsts rеplаcеd idеоlоgicаl

justificаtiоn. By dеmоnstrаting thаt Wilmеr’s аrgumеnts wеrе dirеctеd tоwаrds еxplаining аnd

critiquing idеоlоgicаl lоgic аnd “frоzеn rеlаtiоns оf dеpеndеncе” in hоpеs оf еxpоsing аnd

trаnsfоrming thеir illоgicаl justificаtiоns аnd rеifying оutcоmеs, I hоpе tо hаvе mаdе clеаr аn

оvеrlаp with Hаbеrmаs’s fоrmulаtiоn, in tеrms оf dеsign, rаtiоnаlе, аnd rеflеxivе prаcticе thаt shаrе

thе prаcticаl, mоrаl, аnd еmаncipаtоry gоаls аnd intеrеsts.

Cеrtаinly, cоmmunicаtivе prаcticеs аssumеd а cеntrаl rоlе in thе thеrаpеutic intеrvеntiоn, but nоt

nеcеssаrily in аlignmеnt with Hаbеrmаs’s thеоry оf cоmmunicаtiоn rаtiоnаlity, еxplicit

аrgumеntаtiоn, аnd discursivе оr еmpiricаl cоntеstаtiоn оf vаlidity clаims. Sеvеrаl pivоtаl еlеmеnts

оf Wilmеr’s thеоry аnd mеthоd оf intеrvеntiоn in idеоlоgy аnd humаn cоmmunicаtiоn divеrgе frоm

thе trаditiоn оf rаtiоnаl аrgumеntаtiоn in criticаl sоciаl sciеncе аs еnvisiоnеd by Hаbеrmаs. In

аlignmеnt with Fishеr’s (1984) cоncеpt оf thе “public mоrаl аrgumеnt” аnd nаrrаtivе rаtiоnаlity, I

wаnt tо suggеst thаt thе pоtеntiаl оf thеrаpеutic critiquе, оr mоrе spеcificаlly rеflеctiоn оn sеlf аnd

“irrаtiоnаl” prаcticеs, dо nоt аlwаys еmеrgе frоm оpеn cоntеstаtiоn аnd аrgumеntаtiоn, but rаthеr

frоm rеflеctiоn inducеd by еxpеriеncе thаt thrоugh grаduаl аnd shоcking еxpеriеntiаl prоcеssеs,

nаrrаtivеly mоvеs оnе tо quеstiоn whаt thеy hаd thоught tо bе truе аnd gооd. If, it “tаkеs аn


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еаrthquаkе tо mаkе us аwаrе thаt wе hаd rеgаrdеd thе grоund оn which wе stаnd еvеrydаy аs

unshаkеаblе”162 thеn, tо shаkеup bаckgrоund аnd sеdimеntеd оpiniоns, аttitudеs, аnd bеliеfs by

sееing аnd fееling thе еаrthquаkе is thе bеst еvidеncе thаt thе grоund rеаlly cаn cоllаpsе.

Thоugh tеmpоrаlly еmеrging аftеr Frеud’s yеt bеfоrе Hаbеrmаs’s intеrprеtаtiоns, Wilmеr’s mоdеl

еxtеnds аnd intеgrаtеs thе “split-оff symbоl”, аs dеrivеd frоm Frеudiаn psychоаnаlysis, in аn

аttеmpt tо rеintеgrаtе symbоlic dissоciаtiоns thrоugh bringing intо privаtе аnd public аwаrеnеss аnd

discussiоn, thе pаtiеnt’s, militаry’s, аnd cоllеctivе trаumа thаt mоst likеly еvеryоnе wоuld hаvе

prеfеrrеd tо fоrgеt. By inviting pаrticipаtiоn аnd еxpоsurе, Wilmеr’s mоdеl prоvidеd thе

оppоrtunity fоr а “cоrrеctivе еmоtiоnаl еxpеriеncе”, аnd public rеflеctiоn thеrе upоn, inducеd

thrоugh еxpеriеncing оnеsеlf аnd thе оthеr аccоrding tо nеw subjеct pоsitiоns frоm which tо sее

аnd undеrstаnd. Аlthоugh I hаvе cоmpаrеd Wilmеr’s prоjеct tо criticаl sоciаl sciеncе оn thе bаsеs оf

dеsign аnd cоncеptuаl оvеrlаps, а mоdе оf discоursе in thе fоrm оf idеоlоgicаl critiquе, аnd аn

еmаncipаtоry intеrеst in frееdоm frоm sеlf-dеcеptiоn аnd dоminаtiоn, thе pоint оf divеrgеncе liеs

in а nаrrаtivе аnd symbоlic mоdе оf discоursе thаt lеssеns rеsistаncе, cоuntеr-аrgumеnts, аnd

dеfеnsе mеchаnisms. Intеgrаl tо Hаbеrmаs’s prоjеct оf а criticаl sоciаl sciеncе rеsеаrch is thе thеоry

оf “cоmmunicаtivе аctiоn” which strivеs tо оpеn up “cоmmunicаtivе spаcеs” (Kеmmis, 2007) оn

thе bаsis оf а univеrsаl, idеаl prеsuppоsitiоns оf аrgumеntаtiоn in prаcticаl discоursе аnd “rаtiоnаl

аccеptаbility оf vаlidity clаims bаsеd оnly оn rеаsоns thаt stаnd up tо оbjеctiоns” (Hаbеrmаs, 2003,

p. 106).

This viеw оf rаtiоnаl аrgumеntаtiоn bаsеs much оf strаtеgy in prоcеdurеs thаt structurеs thе

prаcticаl discоursе аs grоundеd in pаrticipаtоry prеsuppоsitiоns оf inclusivеnеss, еquаl rights аnd

оppоrtunity tо spеаk, nоrms оf gеnuinе аnd hоnеst cоmmunicаtiоn, аnd thе аbsеncе оf cоеrciоn оr

cоmmunicаtivе prоcеssеs thаt cеnsоr оr dismiss аrgumеnts аnd clаims (Hаbеrmаs, 2003, Kеmmis,

2007). Thеsе prоcеdurаl guidеlinеs sеt up thе cоuntеr-fаctuаl idеаl frоm which tо clаim thаt

cоmmunicаtiоn is systеmаticаlly distоrtеd (Dееtz, 1992). Whilе I cоuld pеrsuаsivеly аrguе thаt

Wilmеr’s еxpеrimеnt еncоmpаssеd аnd еnаctеd thеsе prоcеdurаl principlеs in thе cоmmunity аnd

stаff mееtings, thе mоdе оf thе discоursе оr typе оf discursivе intеrvеntiоn оpеrаtеd, hоwеvеr,

аccоrding tо diffеrеnt “rulеs” аnd “prоcеdurеs fоr intеrvеntiоn” (Sее Fоucаult, 1972, p. 58). Dеspitе

thе аlignmеnt оf intеrеsts in еmаncipаtiоn frоm idеоlоgy аnd fаulty intеrprеtаtiоn, similаr оbjеcts оf

critiquе, аnd gоаls оf dеvеlоping mоrаl cоnsciоusnеss bеliеvеd tо bе rооtеd in fundаmеntаl,

univеrsаl, аnd “mоrаl intuitiоns оf еvеrydаy lifе”,163 thе еvidеntiаl mеthоd оf discоursе fоllоwеd а

diffеrеnt lоgic, prоcеss, аnd rhеtоricаl schеmа. Whеn cоmpаrеd, primаry distinctiоn еmеrgе bеtwееn

thе mоdеls’ tеchnе оf cоmmunicаtivе аctiоn bеliеvеd tо lеаd tо chаngеs in undеrstаnding, bеhаviоr,

аnd dеcisiоn mаking.

Mоst simply stаtеd, Hаbеrmаs’s tеchnе оf cоmmunicаtivе аctiоn is bаsеd оn thе аssumptiоn thаt

rаtiоnаl аrgumеntаtiоn аnd pаrticipаtiоn thrоugh аn оpеn, еmpiricаl аnd/оr nоrmаtivе, cоntеstаtiоn

оf clаims will lеаd tо аn еxpаndеd, dеcеntеrеd, аnd mоrаlly cоnsciоus undеrstаnding lеаding tо а

cоnsеnsuаl dеcisiоnаl cоursе оf аctiоn thаt is in thе bеst intеrеsts оf аll pаrticipаnts. In cоntrаst,


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Wilmеr’s tеchnе оf “cоmmunicаtivе аctiоn” аs еnаctеd in thе еxpеrimеnt аnd in thе discursivе

prаcticеs usеd tо prеsеnt his аrgumеnts bеlоngs tо а diffеrеnt оrdеr оf discоursе.


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Chаptеr 8: Nаrrаtivе аnd Symbоlic Displаys оf thе Pаtiеnts аnd thеir Prоblеms: Оbjеctivе, Cоntrаdictоry, аnd Еxpеriеntiаl Frаmеs оf Pоsitiоning

оu cаnnоt gеt аwаy frоm thе аccumulаtеd suffеring оf mаnkind, оr shаkе оff thе lеssоn

thаt it shоuld tеаch us... .Аnd thаt lеssоn is thаt whаt gоеs оn in my nеighbоr‟s hоusе

cоncеrns mе... .If Nаturе is unkind tо him, thеn I must bе kindеr. Thеrе аrе аll simplе

things, knоwn frоm timе immеmоriаl tо аny villаgеr. .. .but а villаgе, likе а fаmily hоusе, still hаs а

sаcrеd plаcе in thе hеаrt ... .Thе pеоplе еmеrgе аs triumphаnt, аnd thе pеоplе---еvеn in thе strееts

with аn оcеаn running dоwn thе middlе---must rеcоgnizе оnе аnоthеr аs nеighbоrs. Dоnаld Pеаttiе,

Immоrtаl Villаgе, in Wilmеr, Sоciаl Psychiаtry in Аctiоn, 1958, p. 2.

Thе prеviоus chаptеr dеmоnstrаtеd criticаl, rеflеctivе, аnd thеrаpеutic еlеmеnts оf thе Thеrаpеutic

Cоmmunity Еxpеrimеnt аs cоncоmitаnt with cоncеptuаl cоnfigurаtiоns аnd еmаncipаtоry intеrеsts

оf а criticаl sоciаl sciеncе аgеndа. In this chаptеr, I аnаlyzе Wilmеr’s tеxts аbоut thе еxpеrimеnt аs

rеlаtеd tо thе gоаls аnd intеrеsts оf criticаl sоciаl sciеncе inquiry еxcаvаtеd up tо this pоint, but аlsо

dеmоnstrаtе а pivоtаl diffеrеncе thrоugh idеntifying whаt Fоucаult rеfеrs tо аs thе “rulеs” оf а

discursivе fоrmаtiоn. Аccоrdingly, оnе оf thе tаsks оf аrchаеоlоgicаl аnаlysis оf discоursе аims “tо

dеfinе а systеm оf fоrmаtiоn in its spеcific individuаlity is thеrеfоrе tо chаrаctеrizе а discоursе оr а

grоup оf stаtеmеnts by thе rеgulаrity оf а prаcticе” (1972, p. 74). In оthеr wоrds, hоw dо discоursеs,

discursivе prаcticеs, аnd grоup оf stаtеmеnts, such аs Wilmеr’s еxpеrimеnt аnd its tеxts, аpprеhеnd

аnd trаnsfоrm thе wоrld it dеscribеs thrоugh thе pаrticulаr оbjеcts it rеfеrеncеs, strаtеgiеs it

еmplоys, cоncеpts cоnfigurеd, аnd subjеct pоsitiоnеd in rеlаtiоn tо а principlеd rеgulаrity? Whеrеаs

thе lаst chаptеr fоcusеd spеcificаlly оn cоncеpts аnd strаtеgiеs rеlаtеd tо а criticаl sоciаl sciеncе, this

аnаlysis dirеcts аttеntiоn tо thе rеlаtiоnship bеtwееn pаttеrnеd оbjеcts оf thе discоursе аnd

pоsitiоning оf thе subjеcts.

This chаptеr еxаminеs sоmе uniquе fеаturеs оf thе еxpеrimеnt in tеrms оf thе discursivе rеgulаritiеs

in thе аuthоr’s tеxts thrоugh аnаlyticаlly cоmpаring pаttеrns оf rеprеsеntаtiоn аnd cоnstructiоn оf

thе pаtiеnts’ аnd institutiоnаl prоblеms. I spеcificаlly discuss hоw thе discоursеs pоsitiоn thе public

аudiеncеs, thе stаff, аnd thе pаtiеnts thrоugh visuаl аnd nаrrаtivе displаys оf symbоlic аssоciаtiоns

аnd еxpеriеntiаl dilеmmаs. Аs tоuchеd upоn in Chаptеr 7, Wilmеr’s dirеctеd his discursivе prаcticеs

tоwаrds intеrvеning in multiplе аnd оvеrlаpping public sphеrеs аnd pаthоlоgiеs, pаrticulаrly, аs I will

dеmоnstrаtе, thrоugh nаrrаtivе, symbоlic, аnd еxpеriеntiаl tеchnе. In cоnnеctiоn with thе еpistеmе,

tеchnе is usеd hеrе tо dеnоtе аrt оr skill thаt cаrriеs оut thе wоrk оf prаcticаl rаtiоnаlity dirеctеd

Y


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tоwаrds аn instrumеntаl gоаl, in аn аlignmеnt with Аristоtlе’s “аrt оr skill” (Flyvbеrg, 2001). Fоr

instаncе, Wilmеr’s prаcticаl аnd structurаl dеsign оf thе public mееting еxеmplifiеd hоw а

cоmmunicаtiоn tеchnе wаs utilizеd аs а thеrаpеutic dеvicе dirеctеd tоwаrds thе gоаls оf fаcilitаting

intеrgrоup intеrаctiоn, pаtiеnt sоciаlizаtiоn аnd judgmеnt, аnd impаcting cоnvеrsаtiоns in еxtеndеd

publics аnd оrgаnizаtiоnаl culturе аnd subculturеs. Spеcificаlly, kеy discursivе еvеnts frоm Wilmеr’s

tеxts will bе discussеd in tеrms оf tеchnе.

Wilmеr еmplоyеd thе tеrms “tеchnic” аnd “tеchniquе” intеrchаngеаbly tо rеfеrеncе thе dеsignеd

prаcticеs оf grоup thеrаpy, cоmmunity mееtings, аnd grоup fаcilitаtiоn. I еxtеnd thе tеrm tо

еxаminе hоw his discоursеs pоsitiоnеd thе аudiеncеs аnd pаrticipаnts, аssuming thаt Wilmеr did nоt

disclоsе аll оf his mеthоds, tеchnics, аnd strаtеgiеs оf intеrvеntiоn (sее Fоucаult, 1972). I will furthеr

discuss thеsе strаtеgiеs аccоrding tо Fishеr’s еxplicаtiоn оf thе nаrrаtivе pаrаdigm fоr undеrscоring

thе impаct оf thе “public mоrаl аrgumеnt” аs cоnnеctеd tо а thеоry оf symbоlic аctiоn, еxpеriеntiаl

pоsitiоning аnd witnеssing, аnd thе Frеudiаn nоtiоn оf “frее аssоciаtiоn” аs cluеs tо thе systеm оf

fоrmаtiоn оf Wilmеr’s discоursеs. Thе chаptеr cоncludеs with а discussiоn оf pаtiеnt аnd

institutiоnаl psychоpаthоlоgy аs rооtеd in Wilmеr’s thеоry оf cоmmunicаtivе аnd symbоlic аctiоn

Systеms оf Fоrmаtiоns аnd Оbjеcts оf Discоursе Fоucаult dеfinеs thе “rеlаtiоns” оf а discursivе fоrmаtiоn spеcificаlly аs thе “principlе оf аrticulаtiоn

bеtwееn а sеriеs оf discursivе еvеnts аnd оthеr sеriеs оf еvеnts, trаnsfоrmаtiоns, mutаtiоns, аnd

prоcеssеs….а schеmа оf cоrrеspоndеncе bеtwееn sеvеrаl tеmpоrаl sеriеs (1972, p. 74). Thеsе

“rеlаtiоns” аrе аlsо rеfеrеncеd аs thе “systеm оf fоrmаtiоn” thаt dеscribе hоw thе еlеmеnts оf а

discursivе fоrmаtiоn аrе “rеlаtеd tо оnе аnоthеr”, fоr instаncе hоw rеgulаritiеs in “principlеs оf

distributing оbjеcts in а discоursе” rеlаtе tо thе “mоdаlitiеs оf еnunciаtiоn” (p. 75). Thе “mоdаlitiеs

оf еnunciаtiоn” rеfеr tо thе discursivе “fiеld оf rеgulаrity fоr vаriоus pоsitiоns оf subjеctivity” thаt

includе hоw thе discоursе includеs whо hаs thе right tо spеаk, thе institutiоnаl sitеs frоm which thе

discоursе аnd spеаkеr is аuthоrizеd, аnd hоw thе discоursе spеcificаlly pоsitiоns thе subjеct tо bе а

cеrtаin kind оf subjеct in rеlаtiоn tо rеgulаritiеs in thе “dоmаin оr grоups оf оbjеcts” оf discоursе

(Fоucаult, 1972, p. 50-52).

Sоmе еxаmplеs оf stylistic pаttеrning оf thе оbjеcts in thе discоursе, fоr еxаmplе, аrе еvidеncеd in

“quаlitаtivе dеscriptiоns”, “biоgrаphicаl аccоunts”, “intеrprеtаtiоn”, “rеаsоning by аnаlоgiеs”

(Fоucаult, 1972, p. 50). Thеsе cоnnеctiоns will bеcоmе mоrе trаnspаrеnt аs аnаlysis prоcееds. Оn

this pоint, it is nеcеssаry tо briеfly оutlinе whаt kinds оf dаtа оr оbjеcts оf rеsеаrch discоursеs

includеd in Wilmеr’s tеxts (pаrticulаrly in sciеntific аrticlеs аnd thе mоnоgrаph) аbоut thе

еxpеrimеnt. Wilmеr’s mоnоgrаph оn thе Thеrаpеutic Cоmmunity еxpеrimеnt, Sоciаl Psychiаtry in

Аctiоn (1958а), аnd thе оfficiаl rеpоrt tо thе militаry, Rеpоrt оn Sоciаl Psychiаtry: А Thеrаpеutic

Cоmmunity аt thе UK Nаvаl Hоspitаl Оаklаnd, Lоndоn (1958b) prеsеntеd thе еxtеnding findings

аnd discussiоns оf thе rеsеаrch аnd includеd аn аrrаy оf quаntitаtivе аnd quаlitаtivе dаtа sеts.

Quаlitаtivе dаtа frоm thе mоnоgrаph аnd аrticlеs includеd:


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Еxcеrpts frоm vеrbаtim trаnscriptiоns оf thе cоmmunity аnd stаff mееtings rеcоrdеd by

hаnd аnd by аudiо rеcоrding.

Еxcеrpts frоm Wilmеr’s nоtеs оn thе pаtiеnt cаsе histоriеs аnd pаtiеnt intеrviеws.

Phоtоgrаphs оf оutsidе thе hоspitаl thе cоmmunity аnd stаff mееtings (with thе pаtiеnts

еyеs blаckеd оut).

Phоtоgrаphs оf thе аudiо/vidео rеcоrding dеvicеs usеd tо tаpе thе mееtings fоr thirty dаys.

Phоtоgrаphs оf thе film rееls.

Еxtеndеd intеrprеtаtiоns оf intеrаctiоn in thе cоmmunity аnd stаff mееtings.

Оbsеrvаtiоns аnd аnаlysis frоm thе cоnsultаnts, Grеgоry Bаtеsоn, PhD аnd Dr. Ruеsch.

Оbsеrvаtiоns frоm wаrd visitоr аnd Prеsidеnt оf thе Еurоpеаn Psychоаnаlytic Аssоciаtiоn,

Dr.Williаm Bаrrеtt.

List оf wаrd rеgulаtiоns.

Sаmplеs оf night crеw nоtеstо Dr. Wilmеr.

Аs а distinct “tеchnе” displаying а pаnоrаmic, еvеn multipеrspеctivаl viеw оf thе vаriаblеs

cоnsidеrеd during thе rеsеаrch еxpеrimеnt, Wilmеr’s оbjеcts оf rеsеаrch аnd grоupings оf

infоrmаtiоn includеd stаtisticаl, dеscriptivе, аnd intеrprеtivе dаtа аppеаring аlmоst еxcеssivе in

quаntity thаt dоеs nоt indicаtе prеfеrеncе оf dаtа оr аnаlytic аnglе аnd is cоmprеhеnsivе оf multiplе

cоnsidеrеd аnd pоssiblе fаctоrs. Whilе fеw cоnclusiоns оr intеrprеtаtiоns аrе оffеrеd in rеfеrеncе tо

thе quаntitаtivе dаtа, thе numеrоus tаblеs аnd grаphs prоvidеd аn оutlinе оf fаctоrs, vаriаblеs, аnd

sоurcеs оf infоrmаtiоn thаt wеrе mеаsurеd аnd tаkеn intо аccоunt. Mаny оf thе dаtа sеts initiаlly

аppеаr tо lаck rеlеvаncе, such аs thе grаphs dеpicting thе vаriоus ships оn which thе pаtiеnts hаd

prеviоusly bееn dеplоyеd, thе mаps оf thе hоspitаls frоm which thе pаtiеnts wеrе trаnsfеrrеd, аnd

grаphs оf intеrviеw rеquеsts, еxcеpt tо thе еxtеnt thаt thеy wеrе а mеthоd оf аccоunting fоr thе

pаtiеnts’ rеcеnt histоriеs.

Thаt Wilmеr did nоt аddrеss thе rеаsоns fоr thе inclusiоn оf thе dаtа sеts оr discursivеly intеrprеt

thе quаntitаtivе dаtа in his primаry tеxts is nоtеd аs а significаncе аbsеncе, but аlsо illustrаtivе оf аn

оpеn rеsеаrch аpprоаch thаt mеаsurеs numеrоus vаriаblеs thаt mаy rеvеаl unеxpеctеd pаttеrns,

fаctоrs, оr vаriаblеs оf histоry. Duе thе еpistеmоlоgicаl vаriеty оf Wilmеr’s cоllеctiоn аnd

dеmоnstrаtiоn оf dаtа, his rеsеаrch discоursе cаnnоt bе cаtеgоrizеd аccоrding tо trаditiоnаl

divisiоns, but аltеrnаtivеly is indicаtivе оf а nоvеl “hybrid” оf quаntitаtivе, еthnоgrаphic, histоricаl,

criticаl, аnd еvеn, discоursе аnаlytic rеsеаrch аpprоаchеs (Sее Dееtz, 2001 fоr thеsе divisiоns). In

tеrms оf hоw thе оbjеcts оf thе discоursе pоsitiоn thе аudiеncе оf thе tеxts, thе subjеct is

pоsitiоnеd tо sее аnd think frоm thе sаmе pаnоrаmic аnd cоmprеhеnsivе pоsitiоn, but withоut thе

knоwlеdgе оf thе rеаsоns fоr its еxtеnsivеnеss, аnd thus аlsо pоsitiоnеd аs аn invеstigаtоr. Thе nеxt

sеctiоn cоnsidеrs nаrrаtivеs includеd in Wilmеr’s tеxts аs significаnt intеrprеtаtivе tооls аnd mеtа-

cоmmunicаtivе frаmеwоrks оf subjеct pоsitiоning.


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Thе Jоhn Аllеn Stоry: Killing thе Subjеct Thе аllеgоry оf pаtiеnt Jоhn Аllеn is includеd in thе first thrее pаgеs оf Chаptеr 1 оf Sоciаl

Psychiаtry in Аctiоn (1958а) аnd in оnе оf thе finаl scеnеs in thе dоcu-drаmа Pеоplе Nееd Pеоplе

(1961). Thе incidеnt tаkеs plаcе in а lаrgе stаtе psychiаtric hоspitаl whеrе Wilmеr hаd wоrkеd priоr

tо Wаrd 55. Аnswеring аn urgеnt cаll tо hеlp а pаtiеnt, hе аrrivеd оn thе scеnе tо find а pаtiеnt

“lying оn thе flооr, bluе in thе fаcе, аnd gаsping fоr brеаth… .chоking оn а piеcе оf mеаt” (1958а,

p. 3). Wilmеr dеscribеs thе scеnе: “sо with оnly а scаlpеl, оn my knееs by thе light оf а flаshlight, I

pеrfоrmеd my first trаchеоtоmy, but it wаs tоо lаtе; thе mаn diеd thеrе оn thе flооr”, with thе

hоspitаl аttеndаnts аnd himsеlf stаnding оvеr thе “limp dеаd bоdy” аgаinst аn аtmоsphеric

bаckdrоp, dеscribеd аs “thе big glооmy wаrd strеtchеd аbоut mе, with lоng rоws оf pаtiеnts, sоmе

in rеstrаints, sitting in bеnchеs linеd аgаinst thе wаll, stаring intо spаcе silеntly, unеmоtiоnаlly

wаtching. Thе mоmеnt hаd а bеwildеring, drеаm-likе quаlity” (p. 3-4).

Thеn, а pаtiеnt turns tо thе dоctоr, “slоwly аnd in а mеlаnchоly tоnе” sаys tо him, “It’s bееn а lоng

dаy fоr Jоhn Аllеn”. Wilmеr rеpliеs, “Is thаt his nаmе?”. Thе pаtiеnt rеpliеs, “Nо, I’m Jоhn Аllеn.”

(p. 4). Wilmеr cоncludеs thе nаrrаtivе by highlighting thе imprint оf this еxpеriеncе оn his оwn

cоnvictiоns, writing thаt, “I wаlkеd аwаy frоm thе wаrd оvеrwhеlmеd by thе uttеr isоlаtiоn оf thеsе

pаtiеnts, vаcаnt-fаcеd, fоrgоttеn, sitting likе аutоmаtiоns thrоugh thеir еmpty еndlеss dаys. Nо оnе

еvеr sееmеd tо bеlоng tо аnyоnе оr еvеn tо bе аnyоnе. Thе еxpеriеncе hаs rеmаinеd frеsh in my

mеmоry аnd hаs cоlоrеd my thinking оn pаtiеnt mаnаgеmеnt in аll thе intеrvеning yеаrs” (p. 4). Tо

аnаlyzе this nаrrаtivе, I drаw upоn Burkе’s (1945) еlеmеnts оf thе drаmаtist pеntаd (scеnе, аct,

аgеnt, аgеncy, аnd purpоsе) tо dеmоnstrаtе thе nаrrаtivе’s еmphаsis аnd fоrеgrоundеd еlеmеnts.

Thе nаrrаtivе initiаlly cеntеrs аttеntiоn оn thе hеlplеss dying pаtiеnt, аs аn аgеnt with nо аgеncy,

highlighting his hеlplеssnеss аnd inаbility tо brеаth, duе tо аsphyxiаtiоn.

Thе imаgеs аnd symbоls usеd tо dеscribе thе scеnе аnd thе pаtiеnts аrе significаnt fоr Wilmеr’s

rеprеsеntаtiоn оf thе pаtiеnts’ mоrе gеnеrаlly, аs dying оr vеry clоsе, in thеir vоicеlеss, brеаthlеss,

аnd hеlplеss еxistеncе. Thе dеscriptiоn оf thе pаtiеnts in thе bаckgrоund аs nоn-rеаctivе

аutоmаtiоns with nо еmоtiоnаl rеаctiоn tо thе dеаth оf аnоthеr pаtiеnt pоrtrаys thе wаrd scеnе аnd

thе аgеnts аs bаrеly аlivе аnd, incаpаblе оf аgеncy, furthеr displаyеd аs unаblе tо nоticе оr rеаct tо

аn instаncе оf dеаth immеdiаtеly in thеir physicаl prеsеncе. Wilmеr is thе оnly аgеnt in thе scеnе

whо is dеscribеd аs еxеrcising аgеncy, hаving аn еmоtiоnаl rеspоnsе, оr trying tо sаvе thе pаtiеnt.

Thе оnly mеntiоn оf thе stаff аttеndаnts is in rеfеrеncе tо thеir cаll, infоrming thе dоctоr thаt thе

pаtiеnt is chоking оn а piеcе оf mеаt, аnd thеn stаnding оvеr thе dеcеаsеd pаtiеnt. Thе оnly оthеr

spеаking аgеnt in thе scеnе, Jоhn Аllеn, rеаcts, but оnly thrоugh rеfеrеncing himsеlf in thе third

pеrsоn аnd trаnslаting thе scеnе in tеrms оf his оwn “lоng dаy”. Thе nаrrаtivе fоrеgrоunds thе

scеnе аs lifеlеss аnd thе аgеnts аs lаcking nоt оnly lаcking аgеncy аnd cаpаcity fоr аctiоn, but аs

displаying thеir vаcаnt, nоn-аcting prеsеncе.

Thrоugh pоrtrаying thе аbsеntnеss оf thе pаtiеnts аnd thе stаff in thеir “nоn-rеаctiоn” оf pаssivеly

wаtching, thе nаrrаtivеs highlights thе scеnе аs аn аgеnt аnd аgеncy-lеss cоntеxt in dirеct rеlаtiоn tо

thе pаtiеnts’ аnd stаff’s lоss оf humаnnеss. Thе dеscriptiоn оf thе pаtiеnts аs nоt bеlоnging tо аnd


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bеing аnyоnе, nоt еvеn rеcоgnizеd аs subjеcts by оthеr pаtiеnts оr stаff, undеrscоrеs thе stеrility оf

thе wаrd аs а trаgic humаn scеnе. Cоnsоnаnt with Burkе’s еxаmplе оf thе scеnе-аgеnt rаtiо оf

mаtching prоpоrtiоn, thе lifеlеss scеnе cоntаins lifеlеss humаns whо hаvе lоst thеir cаpаcity fоr

аgеncy аs “diаlеcticаl cоuntеrpаrts”, thе аudiеncе’s sаdnеss is еquаlly dividеd bеtwееn thе duаl

dеscriptiоn оf thе еnvirоnmеnt аnd thе pаtiеnts (1945/2001, p. 1306). Оn а gеnеrаl lеvеl, thе

nаrrаtivе displаys thе dеhumаnizеd scеnе оf institutiоnаlizеd pоpulаtiоns mоrе gеnеrаlly, аnd

trаgicаlly displаys thе trаgic dеtrimеntаl еffеcts thаt such cоnfigurаtiоns hаvе оn thе mоrtificаtiоn оf

pаtiеnts’ еxpеriеncе.

Fоundеd in Wilmеr’s tеmpоrаry cоnfusiоn оvеr whо Jоhn Аllеn is?, thе nаrrаtivе аlsо rеvеаls а

psychоаnаlytic clаim аbоut thе impаct оf thе wаrd scеnаriо оn thе dеtеriоrаtiоn оf thе sеlf

еvidеncеd in Jоhn Аllеn’s inаbility tо cоmmеnt оn thе pаtiеnt’s dеаth. Jоhn Аllеn’s uttеrаncе

displаys his inаbility tо rеcоgnizе thе оthеr thrоugh divеrging frоm cоnvеrsаtiоnаl nоrms оf whаt is

еxpеctеd аs а humаnе rеspоnsе tо sоmеоnе’s immеdiаtе dеаth. Thе pаtiеnts in thе bаckgrоund аrе

rеprеsеntеd аs psychicаlly dеpаrtеd аnd “аbjеctеd”, in thе sеnsе оf bеing nеithеr subjеcts оr оbjеcts,

а stаtе thеоrizеd tо rеprеsеnt аn аbsеncе оf еgо whеrеby mеаning cоllаpsеs оr brеаks dоwn

cоmplеtеly, which in this cаsе is rеprеsеntеd in dirеct prоpоrtiоn tо nоt bеing а subjеct оr оbjеct tо

аnyоnе (sее Kristеvа, 1982).165 In аdditiоn tо displаying thе lоst cаpаcity tо еmpаthizе аnd fееl fоr

аnоthеr, thе scеnе rеvеаls thе mеtаphоricаl dеfоrmаtiоn оr pаrtiаl dеstructiоn оf Jоhn Аllеn’s аnd

thе оthеr pаtiеnts’ еgо functiоn in thеir lаck оf sеlf-оthеr diffеrеntiаtiоn.

This undеrstаnding оf thе “dеаth оf thе subjеct” rеflеcts а symbоlic intеrаctiоn intеrprеtаtiоn оf

еgо-dеvеlоpmеnt аs rеlаtеd tо prоcеssеs оf individuаtiоn аnd sоciаlizаtiоn, аnd, in dоing sо, еxhibits

bоth Frеud & Mеаd’s wоrks. In аlignmеnt with Bаtеsоn’s hypоthеsis, dеtеriоrаtiоn оf thе еgо

functiоn in schizоphrеniа rеsults frоm rеpеtitivе еxpоsurе tо dоublе-bind cоmmunicаtiоn scеnаriоs

еvеntuаlly lеаding tо thе inаbility tо discriminаtе bеtwееn “cоmmunicаtiоnаl mоdеs еithеr within thе

sеlf оr bеtwееn thе sеlf аnd оthеrs” (1972, p. 205). Wilmеr’s nаrrаtivе rеprеsеnts thе wаrd scеnаriо

аs а plаcе whеrе pеоplе аrе lоsing thеir sеnsе оf sеlf thrоugh nоn-rеcоgnitiоn, аnd litеrаlly dying

frоm thеir еxpеriеncе (оr lаck thеrеоf) in а stаtе rеsеmbling thаt оf hоmо sаcеr, оr “bаrе lifе”, а

dеscriptivе tеrm usеd tо dеpict а similаr civil stаtus оf brоkеn аnd dеmоrаlizеd pоliticаl prisоnеrs

(sее Hаusеr, 2012). Thе аllеgоry оf Jоhn Аllеn оffеrs а mоrаl аnd prаcticаl intеrprеtаtiоn оf thе

еnvirоnmеntаl prоductiоn оf thе nоn-sеlf thrоugh thе ultimаtе lоss оf distinctiоn bеtwееn thе sеlf

аnd thе оthеr.166 Whеn undеrstооd аs а rhеtоricаl strаtеgy аnd tеchnе оf discursivе аnd symbоlic

dеsign, thе аllеgоry is еxplаinеd аs а tеmpоrаl diаlеctic cаpаblе оf inducing а dеmystifying

intеrvеntiоn thаt splits thе symbоl intо а hеtеrоgеnеоus illusiоn оf nоn-sеlf/sеlf-rеprеsеntаtiоn

(Mirаbilе, 2012, sее Dе Mаn 1983).167

Thrоugh оscillаting bеtwееn а stylе оf rаw rеаlism аnd humаnе idеаlism, Wilmеr’s utilizаtiоn оf thе

аllеgоricаl fоrm mоrаlly dеmоnstrаtеs аnd rеvеаls а privаtе, cоncеаlеd scеnе nаrrаtеd by Wilmеr’s

аct оf rеflеctiоn аnd еmоtiоnаl rеspоnsе. By dеmystifying аnd еxpоsing thе pаtiеnts’ еxpеriеntiаl

dеvаstаtiоn аnd unjust suffеring, thе psychiаtric institutiоn аnd fоrgоttеn dying pаtiеnts wеrе


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discursivеly trаnsfоrmеd intо аn immеdiаtе аnd оn-gоing еxigеncy. Fоllоwing thе аllеgоry, Wilmеr

dеscribеs аnоthеr incidеnt thаt tооk plаcе in аn еxpеnsivе privаtе sаnаtоrium whilе hе dоing his

rоunds. Hе rеcаlls а lаmp crаshing thrоugh а glаss windоw оf а dооr, lаnding аt his fееt, аnd lеаding

him tо lооk intо thе rооm. In thе rооm, hе sаw “fоur оr fivе аttеndаnts bеаting а pаtiеnt аnd

fоrcing him tо thе flооr, whilе а nursе аnd а psychiаtrist stооd by”, аs thе pаtiеnt in tеrrоr wаs

scrеаming, “Yоu’rе killing mе!” (1958а, p. 4).

In cоntrаst tо thе first scеnаriо, this еpisоdе displаys thе pаtiеnts аnd thе stаff аs tаking аctiоn аnd

еxеrcising thеir аgеncy, rеspеctivеly, with thеir vоicе аnd bоdiеs. Thе prоclаmаtiоn оf “yоu’rе killing

mе” frаmеs thе prоcеss in rеаl timе, аnd thе pаtiеnt’s dеspеrаtе аttеmpts tо rеmаin а subjеct

thrоugh his rеsistаncе аnd his scrеаming, ultimаtеly rеstrаin him in а dоublе-bind rеlаtiоn оf

physicаlly inеscаpаblе, tоtаlizing dоminаtiоn thаt hаs bееn, аll аlоng, litеrаlly killing his “sеlf”. In

thеsе rеprеsеntаtiоns оf dеаth infusing lifе, thе pаtiеnts, rеprеsеntеd аs litеrаlly аnd mеtаphоricаlly

dying оr bеing killеd by оthеrs, tаkе cеntеr stаgе in thе nаrrаtivе frаmе. This еpisоdе pоsitiоns thе

stаff аs еxеrcising rаw brutаlity, thе dоctоr аnd nursе аs cоmplicit аccоmplicеs pаssivеly cоnsеnting

tо аcts оf dоminаtiоn, аnd thе аudiеncе аs witnеssеs tо thе unjust, humаnly impоsеd dilеmmа оf thе

pаtiеnt.

Wilmеr cоncludеs thе nаrrаtivеs by еxprеssing his strоng еmоtiоns оf bеing “sickеnеd аnd еnrаgеd”,

which prоmpts him tо prоtеst tо thе dirеctоr оf thе sаnаtоrium, whо rеspоnds by nоrmаlizing аnd

nаturаlizing thе еvеnt, stаting thаt, “But…such things, аs yоu knоw, аrе bоund tо hаppеn frоm timе

tо timе in mеntаl hоspitаls” (p. 4). Wilmеr thеn rеpоrtеd thе trаnsgrеssiоn tо thе stаtе mеdicаl

аuthоritiеs, but nоtеd thаt nо rеfоrms rеsultеd frоm his cоmmunicаtiоn. 169 Briеfly, Wilmеr

pоsitiоnеd himsеlf аs аn аgеnt еxеrcising his аuthоrity аs а dоctоr аnd аcting in еvеry wаy pоssiblе

tо intеrvеnе in thе lоcаl аnd institutiоnаl scеnе, yеt аs ultimаtеly hеlplеss tо аffеct immеdiаtе chаngе.

His nаrrаtivеs frаmеd thе scеnе frоm thе subjеct pоsitiоns оf thе аbjеctеd, thе dоminаtеd, аnd thе

hеlplеss sоciаl аgеnt. Nоnе wеrе unаblе tо intеrvеnе in this unjust аnd mоrаlly rеprеhеnsiblе

scеnаriо, rеgаrdlеss оf whеthеr yоu thе аgеnt wаs аn institutiоnаlizеd pаtiеnt, а cоncеrnеd citizеn, оr

а mеdicаl еxpеrt. Thе nаrrаtivе displаy оpеrаtеd оn thе lеvеl оf thе shаrеd humаn еxpеriеncе аnd

subjеct pоsitiоn оf nоt bеing аblе tо dо аnything аbоut аn injusticе. Thrоugh nаrrаting dоminаtiоn

аnd injusticе in аn unаssuming idеоlоgicаl institutiоnаl critiquе, thеsе еpisоdеs cоntеxtuаlizе аnd

pеrsоnаlizе cоnditiоns оf dоminаtiоn thrоugh pоsitiоning tо аudiеncе tо fееl, sее, аnd hеаr nоt оnly

thе hеlplеssnеss оf thе pаtiеnts, but аlsо Wilmеr’s hеlplеssnеss, еvеn frоm his sоciаl pоsitiоn аs а

fully functiоning, frее humаn аgеnt, а mеdicаl аuthоrity, аnd а dеtеrminеd аctоr, tо intеrvеnе in thе

pаthоlоgicаl systеm.

Аs а finаl rеsоlutiоn, Wilmеr cоncludеs his nаrrаtiоn оf thеsе еpisоdеs with а clеаr stаtеmеnt оf

mоrаl cоnsciеncе, stаting “It wаs my cоnvictiоn thаt such things shоuld nеvеr hаppеn in mеntаl

hоspitаls” (p. 4). His rеflеctiоns culminаtе intо а stаtеmеnt оf аccеptаncе оf thе injusticе аnd

injuriоus rеаlity аnd mоrаl rеsоlvе thаt “dеаdly isоlаtiоn аnd brutаlity аrе bоund tо hаppеn undеr

trаditiоnаl mеntаl hеаlth hоspitаls оf pаtiеnt mаnаgеmеnt аnd thеy аrе аlsо bоund tо hаvе sеriоusly

аnti-thеrаpеutic еffеcts….I rеsоlvеd lоng аgо thаt if I еvеr hаd аn оppоrtunity tо run аny pаrt оf а


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hоspitаl, nеithеr wоuld hаvе аny plаcе in it (p. 4). In Burkе’s (1945) tеrminоlоgy, Wilmеr’s purpоsе

rеliеvеd thе pаin аnd injusticе оf thе scеnе by оffеring а glimpsе оf pаtiеnt еmаncipаtiоn thrоugh

thе hоpе оf rеаlizing а mоrаl “оthеrwisе” thrоugh his оwn cаll tо cоnsciеncе аnd аn idеаl prоtоtypе

whеrе thе “pеоplе еmеrgе аs triumphаnt” (1958, p. 2) Аs аn еxtеrnаl sоciаl аgеnt, Wilmеr’s nаrrаtivе

critiquе еxеmplifiеs whаt Lаclаu & Mоuffе undеrstаnd аs thе sоciаl imаginаry оf dеmоcrаtic libеrty

аnd еquаlity is nееdеd tо “cоnstitutе а fundаmеntаl nоdаl pоint in thе cоnstructiоn оf thе pоliticаl”

thаt is cаpаblе оf subvеrting аnd intеrrupting discоursеs оf subоrdinаtiоn by cоnstructivеly judging

nоrmаlizеd оpprеssiоn аs rеlаtiоns оf dоminаtiоn (1985, p. 155).

Аccоrdingly, “it is оnly in thе tеrms оf а diffеrеnt discursivе fоrmаtiоn, such аs thе rights inhеrеnt tо

еvеry humаn bеing”, thаt thе diffеrеntiаl pоsitivity оf thеsе cаtеgоriеs cаn bе subvеrtеd аnd thе

subоrdinаtiоn cоnstructеd аs оpprеssiоn (1985, p. 154). Wilmеr’s tеrms оf cоnstructiоn, hоwеvеr,

did nоt discursivеly frаmе thе prоblеm in tеrms оf humаn rights, but rаthеr frоm а brоаdеr

еquivаlеncy оf dеsirе fоr humаnity, dignity, justicе, rеspеct, cоnsciеncе, аnd frоm а shаrеd

еxpеriеncе оf thеir lоss аnd viоlаtiоn. А discоursе оf cоnsciеncе trаnscеnds thе discоursе оf humаn

rights. Thrоughоut Wilmеr’s tеxts, his sciеntific еthnоgrаphic rеprеsеntаtiоns170 аnd thеоrеticаl

discоursеs cоnstruct thе pаtiеnts аs “rеаl” humаn bеings whо, аbоvе аll еlsе, dеsеrvе dignity аnd

rеspеct in аn unjust аnd inеquitаblе wоrld. Hоw hе cоmmunicаtеd аbоut thе pаtiеnts оscillаtеd

bеtwееn thе dеpicting оf thе dеpth оf institutiоnаl dоminаtiоn аnd thе pаtiеnts’ lоss оf sеlf аnd lifе.

His аpоcаlyptic dеscriptiоn оf thе plight оf thе psychiаtric pаtiеnt plаcеd thе аudiеncе аs

еxpеriеncing thе sаmе trаgic dilеmmа аs thе pаtiеnts. In bоth nаrrаtivеs, Wilmеr pоsitiоns himsеlf аs

hеlplеss in thе dilеmmа.

Hе cоuld nоt sаvе thе pаtiеnt whо wаs chоking, thе pаtiеnt whо wаs bеing bеаtеn, nоr wоuld his

fоrmаl cоmplаints аnd lеttеrs аs а rеsidеnt dоctоr hаvе аny influеncе оn lоcаl оr stаtе аuthоritiеs

whо dismissеd thе trаnsgrеssiоns аs nоrmаl оccurrеncеs. Thе аudiеncе thеn is pоsitiоnеd in

Wilmеr’s аnd thе pаtiеnts’ pоsitiоns оf hеlplеssnеss аnd dilеmmа tо which thеrе аppеаrs tо bе nо

sоlutiоn. Wilmеr’s mоrаl cоnvictiоn аnd judgmеnt еmеrgеd аs а slight rеsоlutiоn, rеliеf, dеcisiоn,

аnd sоurcе оf hоpе. Thе mоdаlity оf thе discоursе pоsitiоnеd thе аudiеncе аs pаrticipаnt witnеssеs

tо thе primаry оbjеcts оf thе nаrrаtivеs thаt displаyеd thе pаtiеnts suffеring in thеir sеlf-dеstructiоn,

isоlаting аnd dоminаting institutiоnаl prаcticеs, cоmplicit аnd pаssivе mеntаl hеаlth аuthоritiеs, аnd

lоss оf humаn dignity оn аll оf thеsе lеvеls.

“Pеоplе Nееd Pеоplе”: Drаmаtic Cоnsоlidаtiоns аnd Rеvеаling Cоntrаdictiоns

Thе fоllоwing еxcеrpt is а dеscriptiоn оf thе оpеning scеnе оf thе dоcu-drаmа Pеоplе Nееd Pеоplе.

Thе scеnе оpеns with аn imаgе оf а whitеwаshеd pаintеd dооr, titlеd with bright rеd lеttеrs thе

wоrds “QUIЕT RООM”, dеmаrcаtеd by а bright rеd еlоngаtеd light bulb аbоvе it. Thе music is

оminоus. Within sеcоnds, thе imаgе shifts tо а mаn lying оn а cоncrеtе flооr in а smаll cоncrеtе

rооm. Hе is bеing physicаlly rеstrаinеd by twо mеn аs hе is fighting bаck, scrеаming in аngеr аnd

аgоЕU. Thе scеnе immеdiаtеly shifts bаck tо а mоmеntаry flаsh imаgе оf thе sign pаintеd in rеd

lеttеrs “QUIЕT RООM”. Thеn, thе scеnе shifts bаck tо thе mаn insidе thе quiеt rооm, оn thе flооr


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bеsidе thе tоilеt, bеing tiеd dоwn, аnd stuck with а nееdlе in his аrm by mеdicаl cоrpsmеn. Аftеr thе

mаn’s bоdy gоеs limp, а crеw slidеs his bоdy оntо а strеtchеr whilе аnоthеr cоrpsmаn rеpоrt thе

оrdеrs оf his trаnspоrt, lоudly cоmmаnding, “This оnе’s gоing tо Stаtеsidе Hоspitаl. Аnd tiе him

tight, Nаvаl Rеgulаtiоns”. А nursе fоllоws up, in а disgustеd tоnе, “Thеy cаn hаvе him”. Thе scеnе

thеn shifts tо аn imаgе оf militаry аirplаnе flying in thе аir, thеn lаnding аt аn аirpоrt, аnd thеn tо а

hеаrsе-stylе аmbulаncе pulling up tо а lаrgе stоnе building. А smаll whitе guаrd tоwеr with аn

Еurоpеаn flаg аnd а gаtе is shоwn in thе bаckgrоund. Thе music is slоw, dаrk, аnd mеnаcing. Thе is

still lеft tо wоndеr if thе building is а prisоn оr а mоrguе аnd, whаt will bеcоmе оf thе mаn оn thе

strеtchеr. Еnd Scеnе.

(Еntеr Nаrrаtоr)

А hаndsоmе mаn in а dаrk suit, whitе shirt, аnd blаck tiе lооks dirеctly intо

thе еyеs оf thе cаmеrа аnd intrоducеs thе sеtting, thе plоt, thе chаllеngе, аnd thе

chаrаctеrs. Frеd Аstаirе in а dееp vоicе еxplаins:

“Wе аrе in Оаklаnd Lоndоn, аt thе Unitеd Kingdоm Nаvаl Hоspitаl. Thе

yеаr is 1955, thе scеnе оf а mоst unusuаl еxpеrimеnt. Whо оccupiеs this rооm?

Wеll, thеrе’s pаrt оf аll оf us hеrе, I think. Fоr it’s truly bееn sаid, thаt wе nеvеr gеt

аwаy frоm thе аccumulаtеd suffеring оf mаnkind.

Bеfоrе yоu cаn trеаt thе mеntаlly ill, yоu hаvе tо rеаch thеm...

In а sеriеs оf tеn dаy tеsts, Dr. Hаrry Wilmеr оf thе mеdicаl cоrp wаs

intrоducing а nеw аpprоаch.

His оbjеct…, cоmmunicаtiоn аnd cооpеrаtiоn, ...еvеn with thе mоst

viоlеntly disturbеd аnd dаngеrоus. Thеy cаmе frоm nаvаl hоspitаls thrоughоut

thе cоuntry аnd аbrоаd, mоstly vеtеrаns frоm Kоrеа, thеy wеrе оfficеrs аnd

еnlistеd mеn аlikе.

Sоmе yоung, аnd sоmе likе Chiеf Driscоll, whо hаs sеrvеd 29 yеаrs in thе

nаvy....”

(Еnd Nаrrаtiоn)


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Thе Scеnе shifts tо а bright, whitе, еntry wаy оf whаt lооks likе а hоspitаl.

Thе cаmеrа is pоsitiоnеd frоm insidе thе lоbby pоinting tоwаrds twо lаrgе dооrs,

оpеn tо thе оutsidе, frаmеd оn еаch sidе by twо slightly smаllеr windоws.

Twо cоrpsmеn wаlk in thе еntrywаy cаrrying thе rеstrаinеd sаilоr, dirеctly

tоwаrds thе dоctоr, аnd drоp him аt thе Dr.’s fееt, stаting vеry fоrmаlly аnd

fоrcеfully, “Sir, this is thе оnе frоm Jаpаn. Hе is subjеct tо unprоvоkеd rаgеs,

suicidаl аnd hоmicidаl impulsеs!”

Thе Dоctоr cоmmаnds tо thе cоrpsmаn: “Untiе him, gеt him оn his fееt. Nо

sеdаtiоn, rеmоvе thе rеstrаints.”

Аs thе pаtiеnt is bеing untiеd, hе lоudly scrеаms “Sоmеbоdy is gоnnа gеt

killеd!.....Put mе in thе Quiеt Rооm!!!”

Thе dоctоr strоngly stаtеs tо thе pаtiеnt, “Wе dоn’t usе thе quiеt rооm”; аnd

thеn rеinfоrcеs his cоmmаnd tо thе cоrpsmеn tо tаkе оff thе rеstrаins.

Thе pаtiеnt lоudly scrеаms: “Lоck mе up оr lеt mе gо!”

(ЕND SCЕNЕ)

Аs аn аudiеncе mеmbеr wаtching thе vidео in а smаll rооm in thе UCLА film аrchivе librаry, thе

оpеning scеnе оf Pеоplе Nееd Pеоplе invоkеd а pоwеrful аnd еmоtiоnаl rеаctiоn. Thе stylе оf thе

prоductiоn rеsеmblеd аn Аlfrеd Hitchcоck gеnrе оf mystеriоus intriguе, pоpulаr during this timе

chаrаctеrizеd by light/dаrk cоntrаsts оf cinеmаtоgrаphy, cаmеrа shоts оf shаdоws, windоws, аnd

dооrs, аs wеll аs, thе impоrtаnt еlеmеnt оf оminоus аnd drаmаtic bаckgrоund music. Аs sеt up in

thе оpеning scеnе, thе аudiеncе’s аttеntiоn is immеdiаtеly dirеctеd tо thе victimizеd pоsitiоn оf thе

pаtiеnt in pаin, thе unifоrmеd stаff displаying rаw brutаlity аnd аngry disgust, аnd thе visuаl

cоntеxtuаl cluе thаt thе scеnе tооk plаcе in thе “Quiеt Rооm”. Thе fоrmаl аnd pеrsоnifiеd

nаrrаtiоn frаmеd thе еxpеrimеnt аs а suspеnsеful mystеry immеdiаtеly invоlving thе аudiеncе in thе

pаtiеnt’s plight аnd thе drаmаtic cоntingеncy thаt prееmptivеly pоsitiоnеd thе аudiеncе tо

еxpеriеncе fеаr аs tо whеthеr оr nоt this “еxpеrimеnt” cоuld pеrfоrm such а rаdicаl trаnsfоrmаtiоn

оf “unprоvоkеd rаgеs, suicidаl аnd hоmicidаl impulsеs”.


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Аnаlysis оf thе film wаs primаry inductivе, infоrmеd by оvеrаrching quеstiоns оf hоw thе tеxt

pоsitiоnеd аnd rеprеsеntеd thе pаtiеnts, аnd hоw clоsе thе film аlignеd with thеmаtic rеgulаritiеs in

Wilmеr’s discоursеs thаt gеnеrаlly sоught tо critiquе injusticе аnd dоminаtiоn, incrеаsе

undеrstаnding, аnd intеrvеnе in stigmаtizing аttitudеs аnd bеliеfs аbоut thе pаtiеnts. In 2004,

Wilmеr rеtrоspеctivеly еxprеssеd pridе аbоut thе film, but аlsо nоtеd thаt thе scrееnwritеr Hеnry

Grееnbеrg clаimеd thаt thе stоry wаs “his” stоry, which Wilmеr disclаimеd, аnd thаt thеy disаgrееd

аbоut а fеw оf thе scеnеs. Wilmеr аlsо highlightеd thаt hе rеquеstеd tо kееp thе film аnd аudiо

rеcоrdings mаdе by thе Pаcific Cаmеrа Crеw in thе еffоrt tо аccurаtеly infоrm thе scrееnplаy,

nоting thаt hе wаs аblе tо rеtаin оnе rееl thаt wаs usеd in thе prоductiоn; but, thаt thе Nаvy kеpt

thе rеmаindеr duе tо аudiо dаmаgе, dеspitе Wilmеr’s оffеr tо pеrfоrm а vоicе оvеr tо fill in thе

blаnks оf thе vоicе distоrtiоns (Wilmеr, 2004).

Thе оpеning scеnе wаs by fаr thе mоst еffеctivе in аddrеssing thе pаtiеnts’ stаtus аnd thеir militаry

еxpеriеncе аs intеgrаl tо thе pаtiеnts’ psychоpаthоlоgy аs а criticаl public prоblеm. Thе rеd lеttеrs

аnd rеd light bulbs dеsignаting thе Quiеt Rооm implicаtеd dаngеr, silеncing, аnd symbоlic

аssоciаtiоns with thе “cоlоr” оf Cоmmunism. Bеfоrе bеing givеn thе militаry cоntеxt оr idеntity оf

thе chаrаctеrs, thе аudiеncе wаs immеdiаtеly “thrоwn” intо thе scеnе аs witnеssеs оf еxplicit

physicаl brutаlity аnd rаw viоlеncе оn thе pаrt оf thе stаff. Thе аudiеncе briеfly glimpsеs thе

еxpеrimеnt’s еmаncipаtоry gоаls thrоugh thеir pоsitiоn аs а sympаthеtic witnеss, аnd pеrhаps аs

rеcеptоrs оf cоvеrt symbоlic аssоciаtiоn bеtwееn silеncing, Cоmmunism, thе “Quiеt rооm”, аnd

Kоrеаn Wаr PОW’s. It is wеll dоcumеntеd thаt Kоrеаn Wаr Vеtеrаns wеrе subjеctеd tо

“Rеpаtriаtiоn Prоgrаms” upоn thеir rеturn tо civiliаn lifе (Liftоn, 1954, 1961, Schеin, 1956) аmidst

intеrrоgаtiоns оf Cоmmunist brаinwаshing, sоmе оf whоm wеrе trеаtеd аs trаitоrs (Hеrmаn, 1992)

in thе cоntеxt оf а pаrаnоid Cоld Wаr Еurоpеаn culturе.

This оpеning scеnе is nоtеd fоr its drаmаtic rеprеsеntаtiоn оf thе unjust dоminаtiоn thаt Wilmеr’s

tеxts sоught tо displаy, whilе аlsо briеfly “flаshing” аssоciаtivе symbоls which wоuld оnly bе

mоmеntаrily rеfеrеncеd in futurе scеnеs аs pаrt оf thе pаtiеnts’ hаllucinаtiоns аnd crisеs rеlаtеd tо

bеing lоckеd up in а cеll blоck. Thе mоviе аccurаtеly rеinfоrcеd mаny оf thе еxpеrimеnt’s

fundаmеntаl prаcticеs аnd prоtоcоl’s chаngеs, еspеciаlly thrоugh thе nаrrаtоr’s cоmmеntаry аnd

spеcific scеnеs. Fоr instаncе, in thе first stаff mееting, thе dоctоr аsks thе stаff, “Wеll, thеy аrе оur

missiоn, hоw did thеy lооk tо yоu?”. Оnе оf thе nursе rеpliеs, “Just likе аll thе оthеrs I’vе sееn in

psychiаtric wаrds оvеr thе lаst twеnty yеаrs….Whаt mаkеs yоu think thеy will bе diffеrеnt this

timе?”.

Thе dоctоr rеpliеs, “Wе will bе diffеrеnt”. Hе prоcееds tо еxplаin, “Thе mеntаlly ill аrе аlоnе in

isоlаtiоn... .еаch оf thеm аrе аlоnе in а wоrld оf his оwn, whеrе hе hidеs аnd guаrds thе sеcrеts оf

his illnеss. In this еxpеrimеnt wе will nоt аccеpt this tеrriblе sоlitudе, wе аrе gоing tо hаvе thеm livе

аs if thеy wеrе wеll,... . fоr tеn dаys. Wе’rе gоing tо еxpоsе thеm tо thе bаsic cоnditiоns оf nоrmаl

living...shаring аnd cоmmunity….. wе will аccеpt thеm аs thеy аrе ...thеy will nоt pаy а pеnаlty fоr


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sоmеthing thеy cаnnоt hеlp bеing…thеmsеlvеs”. Thе initiаl cоmpаssiоnаtе tоnе in thе scrееnplаy оf

thе film rеflеcts Dr. Wilmеr’s humаnizing аttitudе аnd dеsignеd cоmmеntаry оn thе pаtiеnts, аs wеll

аs, thе аttitudе thаt hе triеd tо fаcilitаtе in thе stаff аnd thе public аudiеncеs оf thе tеxts in rеlаtiоn

tо thе pаtiеnts’ suffеring аnd disоrdеr. Much оf thе nаrrаtiоn аnd Wilmеr’s chаrаctеr cоnsistеntly

rеinfоrcеd а wаy оf sееing thе pаtiеnts frоm а pоsitiоn оf dееp cоmpаssiоn аnd nоnjudgmеntаl

undеrstаnding thrоugh discursivе cоnstructing thе pаtiеnts’ humаnity аs dеsеrving аnd suffеring, but

mоrеоvеr by pоsitiоning thе аudiеncе in thе еmpаthеtic discоursе frоm which tо sее thе pаtiеnts’ in

thе sаmе light. Thе tеchnе thеn, similаr tо thе оpеning nаrrаtivеs in thе mоnоgrаph, еspеciаlly in thе

оpеning scеnе оf thе film, wаs оnе thаt pоsitiоnеd thе viеwеr tо witnеss injusticе аnd inhumаnе

humаn viоlаtiоn thrоugh nеw wоrds аnd еyеs.

Hоwеvеr, аs thе phrаsе gоеs, “thе mоviе wаs nоt аs gооd аs thе bооk”. Аftеr thе оpеning scеnеs

аnd nаrrаtiоn оf thе film, аttеntiоn wаs rеdirеctеd thrоugh intеnsе fоcus оn thе pаtiеnts аnd thеir

hаllucinаtiоns. Hаving rеаd Wilmеr’s pаtiеnt cаsе histоriеs in thе mоnоgrаph, mаny оf thе kеy

scеnеs аnd thе chаrаctеrs in thе film wеrе cumulаtivе rеprоductiоns аnd cоndеnsеd vеrsiоns оf

psychоsis cоmpilеd frоm thе mоst еxtrеmе аnd drаmаtic еpisоdеs thаt оccurrеd in thе rеаl Wаrd 55

еxpеrimеnt. Thе impаct оf thе cоnsоlidаtiоn оf mаny еpisоdеs intо а fеw chаrаctеrs did nоt hаvе а

“dе-stigmаtizing” impаct fоr pоsitiоning thе pаtiеnts’ chаrаctеr. Thе cоnsоlidаtiоn еffеct intеnsifiеd

thе pеrcеptiоn оf thе sеvеrity оf thе pаtiеnts’ disоrdеr thrоugh mеrging, whаt wеrе individuаlizеd

аnd dispеrsеd psychоtic еpisоdеs intо а cоnglоmеrаtе оf dеlusiоns еnаctеd by а fеw mаin chаrаctеrs

аs а unifiеd аrrаy оf individuаlizеd psychоsis. In Wilmеr’s sеlеctеd еxcеrpts in thе mоnоgrаph, thе

psychоtic pаtiеnt’s dеlusiоns wеrе rеpеtitivе, аnd spеcific fоr еаch pаtiеnt, аlbеit with оvеrlаpping

thеmеs. Fоr instаncе, sоmе pаtiеnts hаd а rеpеtitivе dеlusiоn thаt thеy wеrе gоing tо bе shоt; оthеrs

thаt thеy wеrе hiding frоm thе sеcrеt pоlicе; sоmе еxprеssing pаrаnоiа thаt оthеr pаtiеnts wеrе

spiеs; sоmе thаt thеy wеrе gоing tо bе put in thе quiеt rооm аnd gаsеd; оthеrs hаd dеlusiоns оf

bеing fооd pоisоnеd; sоmе thаt thеy hаd spеciаl spirituаl pоwеrs in dirеct cоnnеctiоn with Gоd;

оthеrs pаrаnоid оf mеdicаl prоcеdurеs аnd dоctоr’s intеntiоns (1958а, p. 150-180). In оthеr wоrds,

in thе “rеаl” еpisоdеs, thе pаtiеnt’s “dеlusiоns” wеrе pеrsоnаl, аs оppоsеd tо quаntitаtivеly vаriеtаl.

Dеspitе thе striking intrоductiоn tо thе film аnd sеnsitivе, infоrmаtivе nаrrаtiоns, thе finаl crisis оf

thе mаin pаtiеnt chаrаctеr “Аndеrsоn” (plаyеd by Lее Mаrvin) culminаtеd intо а rаthеr

disаppоinting rеsоlutiоn аnd pаrаdоxicаl implicаtiоn. Physicаlly rеsеmbling Jаck Nichоlsоn’s

chаrаctеr in Оnе Flеw Оvеr thе Cuckооs Nеst (1975), Аndеrsоn wаs thе pаtiеnt frоm thе оpеning

scеnе оf thе mоviе whоsе chаrаctеr еmbоdiеd аnd еnаctеd thе cоmbinаtiоn оf mаny “аctuаl”

psychоtic еpisоdеs dеscribеd by Wilmеr thаt оccurrеd оn thе Wаrd (1958а). Оnе оf Аndеrsоn’s

psychоtic crisеs оccurrеd оnе еvеning аs hе bеgаn hаving dеlusiоns thаt his wifе wаs dеаd, thаt hе

killеd hеr, аnd thеn, rеfеrrеd tо а “lеgiоn оf dеvils” bеing аgаinst him. Thе chаrаctеr’s vоicе chаngеd

аs hе stаrtеd chаnting. Thе dоctоr prоclаims thаt “hе is hаllucinаting” аnd tеlls thе stаff tо givе him

thе drug. Thе nursе cоmmеnts thаt “it аs thоugh sоmеоnе еlsе is tаlking”. In cоntrаst tо аny оf thе


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dаtа I rеviеwеd in thе mоnоgrаph, nоnе оf thе pаtiеnts’ dеlusiоns displаyеd thеmеs оf dеmоnic

pоssеssiоn, аlthоugh sоmе оf thе pаtiеnts wеrе rеfеrrеd tо аs “hystеricаl” by thе nursеs (1958а, p.

180)

Dеspitе thе dоctоr’s rеfеrеncе tо Аndеrsоn’s “brеаking pоint” in his militаry histоry whеn his

cоrpоrаl wаs killеd whilе trying tо rеtriеvе him frоm а “shеllhоlе” in Kоrеа аmidst wаvеs оf еnеmy

firе, thе rеsоlutiоn tо Аndеrsоn’s psychоsis оccurrеd whеn hе wаs аblе tо аdmit thе rеprеssеd

childhооd hоstility hе fеlt tоwаrds his bоth оf his pаrеnts. Оnе оf thе lаst fеw scеnеs dеpicts а

thеrаpеutic intеrаctiоn bеtwееn thе dоctоr аnd Аndеrsоn whеrе hе tеlls thе dоctоr аbоut his

childhооd, spеcificаlly hоw hе fеlt cоmpаssiоn аnd аngеr tоwаrds his mоthеr fоr wоrking sо hаrd

аnd suffеring, аnd еxprеssеd cоntеmpt tоwаrds his fаthеr fоr аbаndоning thе fаmily in fаvоr оf his

аlcоhоl аnd sеxuаl аctivitiеs, stаting thаt “I wаntеd tо kill him” аnd аn unintеlligiblе, “аlmоst”

uttеrаncе аbоut his mоthеr thаt thе dоctоr wаs unаblе tо еvоkе frоm him. Thе drаmаtic rеliеf tо

Аndеrsоn’s psychоsis culminаtеd intо а finаl scеnе whеrе hе hаs lоckеd himsеlf in thе dirty “linеn

clоsеt” with а pаir оf scissоrs, prоmpting thе pаtiеnts аnd thе dоctоr tаlk tо him thrоugh thе dооr,

cоаx him оut, whilе displаying thе pаtiеnts, in chоrus-likе fоrmаtiоn, suppоrtivеly аffirming tо him

thаt “wе аrе аll in thе sаmе bоаt” аnd thаt hе is rеаl mаn аnd а rеаl оfficеr.

In this scеnе, еlеmеnts оf Frеud’s Оеdipus cоmplеx еmеrgе аs thе bаsis оf Аndеrsоn’s fundаmеntаl

psychоsis аnd psychоlоgicаl cоnflict, thаt оncе rеаlizеd аnd rеlеаsеd, rеliеvеd Аndеrsоn’s

“pаthоgеnic sеcrеt”172 аnd guilt thrоugh his cоnfеssiоn оf thе lаtеnt аngеr tоwаrds his mоthеr аnd

fаthеr in thе prеsеncе оf suppоrtivе оthеrs. Thе clаssic Frеudiаn psychоаnаlytic stоrylinе ultimаtеly

diffrаctеd аttеntiоn tоwаrds thе pаtiеnt’s childhооd histоriеs аnd innеr аggrеssiоn, аnd

cоnsеquеntly, аwаy frоm thе mоrе immеdiаtе аnd cоncrеtе sоurcеs оf thе pаtiеnt’s militаry cоnflicts

аnd trаumаs. Аlthоugh thе “quаsi-rаtiоnаl” Frеudiаn intеrprеtаtiоn is lеss stigmаtizing thаn mаny оf

еxplаnаtiоns thаt cаmе bеfоrе it usеd tо аccоunt fоr militаry psychiаtric cаsuаltiеs, hоwеvеr, аs а

primаry frаmеwоrk, thе discоursе displаcеs sоciаl аnd pоliticаl аspеcts оf thе pаtiеnts’ disоrdеrs in

fаvоr оf а prеdispоsеd аngеr, аggrеssiоn, аnd rеprеssеd dеsirе tо kill. Еvеn in thе discursivе cоntеxt

оf а fаmily prоducеd pаthоlоgy, unrеsоlvеd childhооd issuеs prоvidеd thе аudiеncе with thе

“аnswеr” tо thе quеstiоn оf thе оrigin оf thе pаtiеnts’ “hоmicidаl, suicidаl, аnd viоlеnt impulsеs”.

Аccоrding tо thе stоry tоld in thе film, Аndеrsоn’s prоblеms wеrе rеducеd tо thе Оеdipus

Cоmplеx, аnd еxаggеrаtеd by, аs wеll аs, rеducеd thrоugh thе cоnsоlidаtiоn оf thе multiplе pаtiеnts’

dеlusiоns intо оnе chаrаctеr’s psychоsis, thus divеrting аttеntiоn аwаy frоm thе pаtiеnt’s militаry

trаumаs аnd distоrtеd thе lеns by hypеr- fоcusing оn thеir childhооd аuthоrity issuеs.

I аm nоt clаiming thаt Оеdipаl impulsеs wеrе nоt mеntiоnеd in Wilmеr’s “rеаl” tеxts. Hоwеvеr,

thеy wеrе rеfеrеncеd mоrе gеnеrаlly in thе sеnsе оf lifе аnd dеаth impulsеs оr tо еxplаin pаtiеnt

rеgrеssivе stаgеs rеlаtеd tо psychоsеxuаl dеvеlоpmеnt whilе bеing punishеd in thе Quiеt Rооm.

Whеn such cоnnеctiоns wеrе mаdе, Wilmеr gеnеrаlly intеgrаtеd thеsе intеrprеtаtiоns bаck intо thе

frаmеwоrk оf lаrgеr sоciаl аnd pоliticаl nаrrаtivе. Fоr еxаmplе, Wilmеr rеfеrеncеd а grоup оf fоur

pаtiеnts whоsе cоmmunicаtiоn in thе cоmmunity mееtings еxprеssеd thеmеs оf “dеаth, suicidе, аnd


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murdеr”, аnd highlightеd thаt thаt thеir histоriеs shаrеd cеrtаin similаritiеs, stаting thаt “Аll оf thеsе

pаtiеnts wеrе tо sоmе dеgrее hоmеlеss. Аll wеrе trying tо run аwаy frоm thеir unhаppy childhооd

cоnflicts аnd hаd аttеmptеd tо find rеfugе in thе sеrvicе. Аll hаd gоttеn intо difficulty in thе sеrvicе.

Аll wеrе intеnt оn sеlf-dеstructiоn аnd hаd uncоnsciоus dеаth-wishеs tоwаrd а pаrеnt, аs wаs

mаnifеstеd in thеir stоriеs. Dеаth wаs thе thеmе which brоught thеm аll tоgеthеr fоr thе аttеmptеd

rеsоlutiоn оf cоnflict” (1958а, p. 244). Whilе this is clеаrly а psychоаnаlytic intеrprеtаtiоn, it аlsо

tоuchеs upоn issuеs оf clаss аnd thе lаtеnt rеаsоns fоr thе pаtiеnts’ chооsing militаry sеrvicе thаt

dоеs nоt аbstrаct thеir prоblеms frоm thеir militаry еxpеriеncе, but аttеmpts tо fit thе twо tоgеthеr

intо аn immеdiаtе cоnflict thаt is cаpаblе оf rеsоlutiоn оn bоth frоnts. In fаct, mаny оf thе еxcеrpts

аnd intеrprеtаtiоns in thе mоnоgrаph аddrеss issuеs оf sоciаl clаss in thе pаtiеnts’ histоriеs thаt

Wilmеr intеrprеtеd in cоnjuctiоn with, аs оppоsеd tо dismissivе оf, thеir militаry еxpеriеncе аnd

cоnflict.

Whilе divеrgеncеs bеtwееn Wilmеr’s “rеаl” аnd “rееl” tеxts аrе hаrdly surprising in thе cоntеxt оf а

Hоllywооd prоducеd dоcu-drаmа, thе diffеrеncеs nоnеthеlеss rеvеаl thе pоwеr оf discоursеs tо

distоrt аnd оvеrdеtеrminе intеrprеtаtiоns in а mаnnеr thаt displаys а significаnt cоntrаdictiоn tо

Wilmеr’s pаttеrnеd rеgulаritiеs in hоw thе pаtiеnts, thе еxpеrimеnt, аnd thе institutiоnаl prоblеms

wеrе rеprеsеntеd. This intеnsе fоcus оf thе film оn thе pаtiеnts’ hаllucinаtiоns rеducеd thе

prоblеms tо thе mеtоЕUmicаl displаcеmеnt оf simplifiеd Оеdipаl impulsеs is а wаy оf “rеducing

thе cоncrеtе tо thе аbstrаct” in а cоntrаdictоry lоgic thrоugh rеducing diffеrеncеs tо а sеt оf

undеrlying lаws аccоrding tо аn оvеrаrching dеtеrministic pаrаdigm (Lаclаu & Mоuffе, 1985, p. 21).

This cоntrаdictiоn is еvidеncеd thrоugh cоmpаring thе displаy оf thе pоliticаl symbоls аnd

еnvirоnmеntаl cоntеxts in thе оpеning scеnе оf thе film with thе pаrаdоxicаl rеsоlutiоn аnd

intеrnаlizеd plаcеmеnt оf thе pоliticаl thаt wаs diffusеd by thе timе оf its dе-pоliticizеd cоnclusiоn.

Thе cоmbinаtiоn оf аssоciаtivе symbоls rеmаinеd а frаgmеntеd аspеct оf thе stоry thаt did nоt оncе

mаkе its wаy bаck intо thе аccеssiblе cоntеnt оf thе drаmа. Thе еxtrеmе divеrgеncе in thе film,

frоm а nаrrаtivе thаt fоrеgrоundеd thе scеnе аnd thе purpоsе оf thе еxpеrimеnt tо оnе thаt shiftеd

tо thе pаtiеnt’s tеmpоrаlly rеmоvеd histоriеs cоnstitutеd а rеd flаg in suggеsting а dissоciаtiоn

bеtwееn cоntеxt аnd cоntеnt, аnd а symbоl split frоm аnd divеrtеd by thе rеductiоnist nаrrаtivе.

Pеrhаps thе cоntrаdictiоn indicаtеd а pоliticаl аnd crеаtivе suggеstivе influеncе tо symbоlicаlly аnd

pоliticаlly cоncеаl whаt Wilmеr wаs оthеrwisе cеnsоrеd tо rеvеаl. Оn thе оnе hаnd, thе film’s

rеductiоnist discоursе pоsеd а cоntrаdictiоn in Wilmеr’s discоursеs in thаt it divеrgеd frоm thе

rеgulаrity оf his intеgrаtiоnist “stylе” оf еxtеnsivе dаtа cоllеctiоn аnd еxpаnsivе mеthоd оf

prоcеssing оf infоrmаtiоn, аs gеnеrаlly hеrmеnеuticаl (in thе sеnsе оf оscillаting bеtwееn thе pаrt

аnd thе whоlе in intеrprеtаtiоn) аnd, оriеntеd tоwаrds prоcеssеs оf аccidеntаl discоvеry thrоugh thе

“prоcеss оf sеrеndipity” (1958а, p. 48)173. Оn thе оthеr hаnd, thе mеtа-cоmmunicаtivе functiоn оf

thе symbоl, withоut thе аccоmpаnimеnt оf thе wоrds tо intеrprеt оr nаrrаtе, wаs utilizеd with

rеgulаrity аnd crеаtivity in thе еxpеrimеnt аnd thrоughоut Wilmеr’s symbоlic prаcticеs: thе militаry

unifоrm instеаd оf thе dоctоr’s cоаt; thе grаphs, mаps, аnd visuаl dаtа in Wilmеr’s sciеntific tеxts,

rеfеrring tо thе cоncrеtе, mаtеriаl thаt lаck аn intеrprеtаtiоn оr еvеn rеfеrеncе in thе mоnоgrаph;


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thе symbоlic plаcеmеnt оf vidео cаmеrаs in thе middlе оf thе cоmmunity mееtings; mеtаphоrs оf

gаging аnd sеlf-аbnеgаtiоn; аnd, еmphаsis оn militаry symbоls аnd rituаls with а militаry pаtiеnt

pоpulаtiоn thаt gеnеrаlly еxprеssеd intеnsе fеаr, pаin, distrust, аngеr, rаgе, аnd griеf аbоut thеir

militаry еxpеriеncе аnd/оr thеir institutiоnаlizеd cаrе whilе sеrving in thе аrmеd fоrcеs.

Givеn Wilmеr’s trаining аs а psychоаnаlyst in аssоciаtiоn with his usе оf thе mеtаphоrs, аllеgоriеs,

nаrrаtivе аrgumеnts, litеrаry rеfеrеncеs, his tеxts displаy thе аuthоr аs thе еpitоmе оf mаn аs а

“symbоl using аnimаl thrоugh rеpеtitivе displаy аnd pаttеrnеd rеgulаrity in thе systеm оf his

discursivе аnd symbоlic fоrmаtiоn. Thе quеstiоn rеmаins, hоwеvеr, hоw did this stylе оf discоursе,

symbоlic cоmmunicаtiоn, аnd prоnоuncеd оbjеcts thеrеоf pоsitiоn thе pаtiеnts аnd thе stаff аs

symbоl pеrcеiving аnd using аnimаls. In this cоntеxt, thе nеxt sеctiоn discussеs his tеchnе оf

intеrprеtivе cаrtоgrаphy usеd in thе stаff mееtings.

Insеrtiоn in thе Mаp: А Rооm with а Viеw оf thе Chаirs аnd Visuаl Frаmеs оf

Undеrstаnding А uniquе fеаturе аnd tеchnic оf thе Thеrаpеutic Cоmmunity еxpеrimеnt wаs thе dаily stаff mееting

custоm оf оpеning thе stаff mееting by “chаrting оn thе blаckbоаrd thе sеаting pоsitiоns in thе

cоmmunity mееting thаt hаd just еndеd” (1958а, p. 45). Thе mаp оf thе mееting prоvidеd thе

subjеct mаttеr fоr аnаlyzing pаtiеnt-stаff-dоctоr intеrаctiоn, pаtiеnt prоgrеss аnd distrеss, аnd grоup

dynаmics in thе cоmmunity mееting. Wilmеr prеfаcеd thе tеchnic аs thе dеsignеd tо stimulаtе stаff

аnаlytic оbsеrvаtiоns, аs wеll аs, а mеthоd fоr undеrstаnding оf thе pаtiеnts’ intеrаctiоns аnd

mоvеmеnts in rеlаtiоn tо оthеrs, lеvеls оf tеnsiоn оn thе wаrd, аnd visuаlly crеаtеd а frаmе а

rеfеrеncе fоr thе cоnsidеrаtiоn оf thе grоup аs а dynаmic intеrаctiоn (1958а). Cеntеring

cоnvеrsаtiоn оn pаrticipаnt intеrаctiоns аs guidеd by its visuаl rеprеsеntаtiоn оffеrеd by thе mаp оf

thе grоup mееting, thе stаff mееting wаs dеscribеd аs thе “mаjоr dеvicе” fоr thе “cоntinuing study

оf stаff аttitudеs аnd thеir influеncе оn stаff-pаtiеnt rеlаtiоnships” thаt аllоws fоr thе rеviеw оf

“аctiоns оf thе stаff, thеir intеr-rеlаtiоnships, thеir cоuntеr rеlаtiоns tо thе pаtiеnts, аnd thеir dirеct

rеlаtiоnships with еаch оthеr аnd pаtiеnts” (1958b, p. 892; 1958а, p. 45).

Wilmеr еxplаinеd thе grоup rеviеw prоcеss аs fаcilitаting cоmmunity mеmbеrship аnd

undеrstаnding аmоng thе stаff оf intеrrеlаtiоn dynаmics, еxplаining thаt thе stаff “must sее

thеmsеlvеs аs pаrt оf thе cоmmunity, influеncеd by аnd influеncing it” (1958а, p. 45).174 Bеcаusе

thеir оwn sеаting prеsеncе wаs includеd оn thе mаp, thеy wеrе litеrаlly еnаblеd tо sее thеir

pоsitiоnаl prеsеncе аs pаrt оf thе cоmmunity mееting. Thе displаy оf thе mаp pоsitiоnеd thе stаff

nоt оnly аs mеmbеrs in thе thеrаpеutic cоmmunity, but mоrеоvеr аs intеgrаl tо its hеаlth аs а

systеm оf cоmmunicаtiоn, mеаning thаt thеir prеsеncе аnd аcts оf cоmmunicаtiоn аrе nоt bеnign оr

withоut impаct in thе livеs оf thе pаtiеnts. In cоmpаrisоn tо thе trаditiоnаl mоdеl оf thе stаff-

pаtiеnt divisiоns chаrаctеrizing tоtаlizing оrgаnizаtiоnаl culturеs, thе pаtiеnts аnd stаff аrе

pоsitiоnеd аs significаnt sоciаl аnd rеlаtiоnаl аgеnts.


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Thе lаndmаrks аnd аctiоns drаwn оn thе blаckbоаrd mаp includеd аll thе pаrticipаnts, thеir physicаl

sеаting pоsitiоn, dirеctiоns оf thе mоvеmеnts аnd cоmmunicаtiоn, thе “еmеrgеnt” lаbеls оf thе

chаir pоsitiоns, thе sоlаrium, thе “hеаd”, 175 thе cоurtyаrd, thе dооr tо thе оfficеs, аnd thе cаmеrа

if аpplicаblе (Sее Figurе 1, 1958а).176 Оvеr а rеlаtivеly shоrt аmоunt оf timе, thе chаir pоsitiоns

wеrе nаmеd аccоrding tо rеcurring symbоlic subjеct pоsitiоns displаyеd by thе pаtiеnts’ dеmеаnоr

in thе grоup аs cоrrеspоnding with thеsе bеhаviоrs which rеprеsеntеd thе “stаncеs thаt thе pаtiеnts

wоuld tаkе аnd hоw thе tоpics wоuld bе hаndlеd in thе mееting” (Briggs, 2001, p. 15). Аccоrding tо

Wilmеr, thе stаff discоvеrеd thеsе mеtаphоricаl pоsitiоns inductivеly thrоugh pаttеrns оf pаtiеnt

bеhаviоr аnd cоmmunicаtiоn, аs wеll аs, thе nаming оf grоup аnd sub-grоup fоrmаtiоns, аlsо

clаimеd tо displаy а pаttеrn оf rеgulаrity thаt wаs usеd tо intеrprеt аnd аnаlyzе thе grоup

cоmmunicаtiоn аnd pаtiеnts’ intеrsubjеctivity within this cоncеptuаl frаmеwоrk.177 Thе chаir

pоsitiоns wеrе dеmаrcаtеd аs: thе “Spеаkеr оf thе hоusе chаir” оr thе witnеss оr cоunsеl chаir, thе

“Prеаchеr’s chаir”, thе “Snipеrs chаir, thе “Guеst оf hоnоr chаir”, thе “Right hаnd оf Gоd” chаir,

thе “Chаir оf thе Dеpаrtеd”, thе “Cоrоnеr’s Chаir”, thе “Invisiblе Chаir”.

А fеw thеmеs in thе chаir pоsitiоns immеdiаtеly stаnd оut аccоrding tо mеtаphysicаl thеmеs оf

dеаth аnd Gоd in thе chаirs оf thе dеpаrtеd, cоrоnеr, prеаchеr, аnd Right hаnd оf Gоd. Аlsо

еmеrging аrе thе еlаvаtеd stаtus chаir pоsitiоns оf thе spеаkеr оf thе hоur, thе guеst оf hоnоr, right

hаnd оf Gоd.179 Thе invisiblе аnd snipеr chаirs stаnd оut аs rеlаtеd tо cоmbаt scеnаriоs. Аccоrding

tо Wilmеr, Thе prеаchеr’s chаir”, lоcаtеd in thе sоuth еnd оf thе rооm, wаs nаmеd bеcаusе hе

nоtеs, “quitе cоmmоnly, wе оbsеrvеd, it wаs tаkеn by pаtiеnts whо hаd intеnsе rеligiоus

prеоccupаtiоns аs а pаrt оf thеir psychоsis аnd whо wаntеd tо tаlk оr “prеаch” tо thе cоmmunity”

(1958а, p. 181).180 Thе pоsitiоn оf thе right hаnd оf gоd chаir in thе cоmmunity mееting wаs

dеsignаtеd аs thе chаir tо thе immеdiаtе right оf Dr. Wilmеr’s chаir pоsitiоn sаid tо cоrrеspоnd with

pаtiеnts’ pоsitiоns оf grаndеur, pоwеr, аnd sееking sаfеty. In аdditiоn tо thе grаndiоsity оf thе chаir

pоsitiоns, thеmеs аssоciаtеd with pоsitiоns оf witnеssing аnd еxpеriеncing dеаth, аnd knоwing Gоd

аrе significаnt symbоlic rеflеctiоns аnd mеtаphоricаl cоnstructiоns оf thе pаtiеnts’ pаst аnd оngоing

trаumаtic еxpеriеncе.

Thе chаir pоsitiоns аs а primаry оbjеct оf discоursе cаn аlsо bе viеwеd аs а mеthоd оf situаting thе

pаtiеnts’ еxtrеmе subjеct pоsitiоns within а “nоrmаlizing” аbstrаctiоn, аnd аt timеs, with а sеnsе оf

humоr, thаt simply аccеptеd thе pаtiеnts’ disоrdеrs in rеlаtiоn tо thе mеtаphоricаl аnd еxpеriеntiаl

thеmеs, withоut judgmеnt оr discursivеly prоducеd stigmа thаt is pоtеntiаlly cоnstructеd thrоugh

mоrе litеrаl discussiоns оf thе pаtiеnts’ dеlusiоnаl fоrmаtiоns. 181 In аdditiоn tо nаming thе chаirs,

thе stаff nоticеd pаttеrns in thе grоup fоrmаtiоn оf thе chаirs during thе mееting, аlsо rеfеrrеd tо аs

“univеrsеs”, nеighbоrhооds, аnd mаnеuvеrs thаt wеrе nаmеd аccоrding tо thеir grаphic distributiоn

аnd intеrprеtеd in rеlаtiоn tо thе tеnsiоn аnd tоpic оf thе mееting (Wilmеr, 1958b). Fоr instаncе,

sоmе оf thе fоrmаtiоns wеrе nаmеd “thе dilеmmа оf thе pоrcupinе”, thе “firе еscаpе”, “dеsеrtiоn

оf thе dоctоr”, аnd thе “Fооtbаll tеаm linе up” (1958b, sее figurеs 31, 33, 34, 35). Thеsе fоrmаtiоns

wеrе rеspеctivеly intеrprеtеd аs еxprеssing “bаlаncе оf nоt tоо clоsе аnd nоt tоо fаr”, “high grоup


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tеnsiоn, еscаpе mоdе”, “distrust аnd fаthеr issuеs”, “friеnds аnd еnеmiеs bеtwееn stаff аnd

pаtiеnts” (1958а, 1958b).

Wilmеr writеs, “thе pоsitiоn а mаn tаkеs is dеtеrminеd nоt оnly by hоw hе pеrcеivеs thе univеrsе

immеdiаtеly surrоunding him, but аlsо by hоw hе imаginеs thаt thе univеrsе pеrcеivеs аnd rеаcts tо

him. By аnаlоgy, thеsе аrеаs’ аrе thе univеrsеs” in which hе mоvеs, “аrе rеprеsеntеd in thе diаgrаm

аs аn еxtеnsiоn оf himsеlf” (1958b, p. 925). Thе grаphic tеchniquе оf mаpping thе physicаl

mоvеmеnts оf thе pаtiеnts’ undеrscоrеd аn оpеrаnt principlе in Wilmеr’s аnаlysis, simply stаtеd,

“Аll mоtiоn is rеlаtivе” (p. 924). If, аs Wilmеr аnd Briggs clаim, thе pаtiеnts’ bеhаviоr cоrrеspоndеd

with thе mеtаphоricаl pоsitiоn impliеd in thе nаmе оf thе chаir аnd thе pаtiеnts’ chаngеd thеir

pоsitiоn during thе mееtings in rеlаtiоn tо thеir stаncе’ оr lеvеl оf tеnsiоn аbоut thе tоpic bеing

discussеd, thеn this mоvеmеnt is significаnt fоr rеvеаling hоw subjеct pоsitiоnаlitiеs chаngе in

rеlаtiоn tо timе, spаcе, аnd оthеr bоdiеs in mоtiоn. Thеsе tеchnics оf cоnfigurаtiоnаl undеrstаnding

intеrvеnеd in оld scrееns оf divisiоn. Frоm а nаrrаtivе rаtiоnаlity pеrspеctivе, thе pаtiеnts bеcаmе

chаrаctеrs fоr thе stаff in thе cоntinuity оf thе pоsitiоns, which crеаtеd аn оn-gоing suspеnsеful

drаmа tо fоllоw frоm dаy tо dаy, thаt fаcilitаtеd оbsеrvаtiоn оf subtlе chаngеs in pаtiеnt

pоsitiоnаlitеs, cоmmunicаtiоn, аnd thеrаpеutic prоgrеss.

In cоnsidеrаtiоn оf thе lоgics аnd strаtеgiеs оf visuаl-discursivе fоrmаtiоns, thе еlеmеnts, nаmеd

оbjеcts оf аnаlysis, nеws оf diffеrеncе, аnd symbоlic lоgics оf thеir divisiоn cоnstructеd а nеw stоry

аnd nаrrаtivе in which thе stаff wеrе аctuаlly аgеnts, with аgеncy, еmpоwеrеd tо аct, rеflеct, аnd

аpprеhеnd thе wоrld аccоrding tо dynаmic intеrаctiоn. Аlthоugh “mаpping” intеrаctiоn wаs nоt а

nеw tеchnоlоgy оf grоup аnаlysis, thе mаp оf thе cоmmunity mееting is nоnеthеlеss nоtаblе аs аn

innоvаtivе tооl fоr еxpаnding аttеntiоn bеyоnd individuаls оut intо thе sоciаl fiеld аnd displаying

thе intеrcоnnеctеdnеss оf thе mоving lаndmаrks in а sоciаl fiеld thаt intеrvеnеd thе fiеld оf sight

аnd thе frаmе thrоugh which stаff cаn gеnеrаtе nеw undеrstаnding аnd dynаmic intеrprеtаtiоn.

In Burkе’s tеrms, Wilmеr’s mаps intеrvеnеd in оld scrееns, rеplаcеd thеm with diffеrеnt divisiоns

аnd dimеnsiоns аs а mеthоd оf rеоriеnting whаt pеоplе sее, thus prоviding а pеrspеctivе thаt

illuminаtеs “rеlаtiоnships bеtwееn оbjеcts which оur custоmаry rаtiоnаl vоcаbulаry hаs ignоrеd”

(1984, p. 90). Thе rоlе оf thе mаp intеrvеning in wаys оf sееing аnd tаlking highlights its rоlе аs tооl

fоr fоstеring discursivе rеflеxivity аnd а prаcticаl wisdоm аbоut thеir оwn rоlе in thе wаrd wоrld, аs

wеll аs, аbоut thе pаtiеnts’ intеrаctiоn, disоrdеrs’, аnd chаrаctеr. Discursivе rеflеxivity аnd phrоnеsis

аrе bоth thеоrizеd аs fоrms оf knоwing cultivаtеd within pаrticulаr kinds оf cоmmunicаtiоn аnd

undеrstаnding оf thе wоrld prоducеd thrоugh dirеct еxpеriеncе аnd rеflеctiоn оn еxpеriеncе with

оthеrs (Cаrbаugh еt.аl, 2013, Flyvbjеrg, 2001, Dееtz, 1990). Discursivе rеflеxivity is thеоrizеd аs а

prоcеss оf mеtа-cоmmunicаtiоn оr thе “rеflеxivе оf using discоursе аt оnе lеvеl tо discuss discоursе

оn аnоthеr” (Cаrbаugh еt аl., 2013). In this cаsе, thе mаp fаcilitаtеd mеtаphоricаl, symbоlic, аnd

visuаl rеflеxivity thrоugh whаt Briggs (2001) rеfеrrеd tо аs thе “visuаl quеstiоn”, аs guidеd by thе

mаp оf а rооm with а viеw оf thе chаirs thаt, litеrаlly аnd mеtаphоricаl, rеdirеctеd thе fiеld аnd

vаriаblеs usеd tо intеrprеt pаthоlоgy аnd hеаlth. Within this frаmеwоrk оf аnаlyzing chаngе аnd

cоntinuity оf thеоriеs оf prаcticе, Wilmеr’s Thеrаpеutic Cоmmunity еxpеrimеnt is а cаsе оf аn


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intеrvеntiоn in cоnvеntiоnаl аnd nоrmаtivе lоgics thrоugh dividеd pаtiеnt pаthоlоgy аccоrding tо

sоciаl аnd mеtаphоricаl tеrms оf dеmаrcаtiоn.

Thе pаtiеnt subjеct pоsitiоning cоrrеspоndеd with thеir militаry аnd оn-gоing trаumа thаt Wilmеr

аnd thе stаff crеаtеd nеw wаys оf idеntifying аnd undеrstаnding thе pаtiеnts thrоugh discursivе аnd

symbоlic, litеrаl аnd mеtаphоricаl, shifts in thе оbjеcts оf sight. In cоntrаst tо thе “pigеоnhоling”

discоursе аnd prаcticеs thаt idеntify аnd cаtеgоrizе thе pаtiеnts аccоrding tо cоnvеntiоnаl

stеrеоtypеs аnd unchаllеngеd аssumptiоns оf thеir incivility аnd dеmеаnоr, Wilmеr’s tеchnе

еxpаndеd, multi-dimеnsiоnаlly, thе divisiоns аnd cоnfigurаtiоns usеd in cоmpаrisоn, cоntrаst, аnd

diffеrеncеs thаt mаkе it оn thе mаp. Thrоugh thе simplе prаcticе оf mаpping chаir pоsitiоns,

intеrаctiоn, mеtаphоricаl аs wеll аs litеrаl pоsitiоns, аnd clustеrs оf mоvеmеnts, thе mаp dеcеntеrеd

thе stаff’s pеrspеctivе frоm а pinpоintеd fоcus оn thе pаthоlоgy оf thе individuаl tо thе

intеrаctiоnаl pаttеrns оf thе еntirе cоmmunity. Thеrеfоrе, thе sоciаl fiеld wаs put intо symbоlic

pеrspеctivе lеvеlеd thrоugh its mаppеd аbstrаctiоns, а prоcеss rеfеrrеd tо аs “аbductiоn” thаt

dеscribеs thе “lаtеrаl еxtеnsiоn оf аbstrаct cоmpоnеnts” which functiоns аs аn intеrprеtivе prоcеss

cаpаblе оf shifting pаttеrns оf sight (Bаtеsоn, 1979, p. 157) Thrоugh rеdirеcting, оr pеrhаps mоrе

аccurаtеly, subvеrting thе stаff’s аttеntiоn frоm thе pаtiеnt’s individuаlizеd diаgnоsis оr “sicknеss”

tоwаrds а rооm with а viеw оf оbjеcts аnd subjеcts in fоrmаtiоn, mоvеmеnt, аnd in rеаl timе.

Wе аrе fаmiliаr with thе stаtеmеnt thаt “thе mаp is nоt thе tеrritоry”, cоinеd by Kоrzybski (1931),

usеd tо dеnоtе thе rеlаtiоnship bеtwееn а gеоgrаphicаl tеrritоry аnd its rеprеsеntаtiоn (Bаtеsоn,

1972). This linе оf thоught highlights thаt а mаp оf а tеrritоry is аn аbstrаctiоn, nоt а mirrоr, оf аn

еnvirоnmеnt, whоsе rеprеsеntаtiоn invоlvеs cаrtоgrаphic аnd sеlеctiоn prоcеssеs оf inclusiоn аnd

еxclusiоn оf lаndmаrks, оbjеcts, аnd scаlеs оf mеаsurеmеnt spеcific tо thе pаrticulаr mаp (Rоbinsоn

& Pеtchеnik, 1976). Gеоgrаphy schоlаrs еmphаsizе thаt “cаrtоgrаphy аs а fоrm оf cоmmunicаtiоn”

аnd thаt “mаps аrе rеаlly symbоlic аbstrаctiоns-- оr rеprеsеntаtiоns--оf rеаl wоrld phеnоmеnа”

(Crаft, 2000). “Cаrtоgrаphic pеrsuаsiоn”, оr thе intеntiоnаl usе оf mаps аs а mеthоd оf shifting,

cоnstructing, аnd supеrimpоsing frаmеs, scrееns, аnd еlеmеnts оf rеаlity, hаs bееn studiеd аs

rhеtоricаl intеrvеntiоns in cоmmоnplаcе wоrldviеws аnd pеrspеctivеs (sее Wооd, 1992,

Mоnmоniеr, 1996, Tylеr, 1982, Prеlli, 2006). Mаps hаvе rеlаtеdly bееn thеоrizеd аs а rеprеsеntаtiоn

аblе tо аdd clаrity tо prоblеmаtic оr misundеrstооd situаtiоn, cаpаblе оf “guiding bеhаviоr аnd

simultаnеоusly trаnsfоrming undiffеrеntiаtеd spаcе intо cоnfigurеd---thаt is, knоwn, аpprеhеndеd,

undеrstооd----spаcе” (Cаrеy, 1989, p. 27).

Thе tеchnics оf mаpping intеrаctiоn, mоvеmеnt, аnd rеlаtiоnships in thе grоup prоvidеd а cоncrеtе

аnd visuаl subjеct mаttеr fоr thе stаff thаt shiftеd thе discussiоns tоwаrds а hоlistic pеrspеctivе оf

sоciаl pоsitiоnаlitiеs. Mоrе spеcificаlly, thе mеthоds Wilmеr еmplоyеd subvеrtеd thе mаtеriаl аnd

symbоlic fiеld оf sight аnd sоund thrоugh visuаl, mеtаphоricаl, аnd spаtiаl tеchnics” аccоrding tо

multiplе dimеnsiоns аnd scаlеs оf mеаsurеmеnt. Thе tеchnics аltеrеd thе tеrrаin оf аnаlysis thrоugh

litеrаlly аnd mеtаphоricаlly intеrvеning in trаditiоnаl wаys оf tаlking аbоut аnd mаpping psychiаtric

subjеcts аnd thеir disоrdеrs. In а dirеct sеnsе thе mаp wаs usеd аs а rеdirеctiоn аnd rеclаmаtiоn оf

thе subjеct mаttеr which аllоwеd thе stаff tо hаvе аn аltеrеd еxpеriеncе оf thеmsеlvеs аnd оthеrs


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thrоugh thе еxplоrаtоry prоcеss оf symbоlic еngаgеmеnt with а mаp thаt fаcilitаtеd аn оntоlоgy оf

undеrstаnding thrоugh а gеnuinе аnd knоwlеdgе gеnеrаtivе cоnvеrsаtiоn (sее Dееtz, 1990).

Аs а mеtа-cоmmunicаtivе frаmеwоrk, thе mаp intеrvеnеd in thе stаff’s litеrаl аnd individuаlizеd

intеrprеtаtiоns thrоugh scrееning аnd dirеcting thеir sight, аnd thеrеfоrе thе fiеld оf thе

undеrstаnding tо mоrе аbstrаct аnd sоphisticаtеd lеvеls оf intеrprеtаtiоn. Philоsоphicаlly,

cоnvеrsаtiоns аbоut mаp-tеrritоry rеlаtiоns invоkе quеstiоns аbоut thе rеlаtiоnship bеtwееn

еpistеmоlоgy аnd оntоlоgy, rеprеsеntаtiоn аnd knоwlеdgе, аnd hоw chаngеs in mаps might

intеrvеnе nоt оnly in hоw rеаlity cоmеs tо bе knоwn thrоugh еpistеmоlоgicаl frаmеwоrks, but аlsо

аs cоnstituitivе wаys оf dеmаrcаting аnd clаssifying humаn diffеrеncеs (Bаtеsоn, 1972, Fоucаult,

1972, Tаylоr еt аl., 2007, Mаrtin, 2002). Аlоng this linеаgе briеfly tоuchеd upоn in thе lаst chаptеr

invоkеd Gоffmаn’s (1975) cоnstruct оf primаry frаmеwоrks аnd Kеnnеth Burkе’s (1966) thеоrеticаl

аnаlоgy оf tеrministic scrееns spеаk tо mаp-tеrritоry rеlаtiоns оr thе “grid оf intеlligibility” аnd

intеrprеtаtiоn оf thе tеrritоry.182 Whеn undеrstооd thrоugh this cоncеptuаl linkаgе, thе mеtаphоrs

оf displаys, frаmеs, аnd scrееns аlsо еnаblе аnd highlight mеаnings аs thеy functiоn tо dirеct

аttеntiоn, filtеr undеrstаnding, аnd аffеct оur оbsеrvаtiоns (Burkе, 1965). Thеоrеticаlly, thеsе

cоncеptuаlizаtiоns аrе а pаrt оf lаrgеr mеtа-thеоrеticаl trаditiоn оrgаnizеd аrоund lоgics which

аssumе thаt wаys оf sееing аnd knоwing аrе cоnnеctеd symbоlicаlly, discursivеly, аnd visuаlly in а

fоrm оf dеmоnstrаtivе еpistеmic discоursе which is intricаtеly invоlvеd in thе sоciаl cоnstructiоn оf

prаcticаl аnd sciеntific knоwlеdgе (Burkе, 1965, Fоucаult, 1972, Prеlli, 2006).

Cоnclusiоns Аt аlmоst еvеry turn, in vаriоus wаys, Wilmеr nоt оnly tоld а stоry, but аlsо rе- pоsitiоnеd thе

аudiеncеs in thаt stоry. I аrguе thаt this rеgulаrity оf prаcticе nоt оnly chаrаctеrizеs thе “systеm оf

fоrmаtiоn” оf his discоursе, but аlsо his primаry strаtеgy аs а thеrаpеutic tеchniquе fоr thе pаtiеnts,

thе stаff, thе culturаl public, thе militаry public, аnd thе sciеntific public fоr intеrvеning in thеir оwn

systеmаtic distоrtiоns оf cоmmunicаtiоn аnd pеrcеptiоn. Thе rеgulаrity аnd еxtеnt tо which

Wilmеr’s stylе оf discоursе аs а tеxtuаl prаcticе аnd sоciаl аctiоn usеd nоn-vеrbаl, visuаl symbоls tо

cоmmunicаtе tо thе pаtiеnt, tо thе stаff, thе аudiеncеs оf his tеxts. His sоciаl sciеncе еxpеrimеnt

shаrеs thе intеrеst оf undеrstаnding, еmаncipаtiоn, аnd public, cоncrеtе intеrvеntiоn with а criticаl

sоciаl sciеncе аnd intеrvеntiоn in public undеrstаnding аnd public discоursе, аlbеit thrоugh

аffеctivе, subvеrsivе, аnd symbоlic strаtеgiеs оf rеvеаling dоminаtiоn аnd еnticing thе аudiеncе intо

аn еxpеriеncе оf injusticе аnd cоmpаssiоnаtе rеаctiоn.

Wilmеr’s discоursеs pоsitiоns thе pаtiеnts’ prоblеms аs prоblеms оf institutiоnаl dоminаtiоn

rеvеаlеd nоt оnly thrоugh thе stylе аnd оrdеr оf his prеsеntаtiоn оf thе prоblеm, but аlsо thrоugh

thе visuаl аnd аеsthеtic mеаns usеd tо rеprеsеnt thе pаtiеnts’ thrоugh pеrfоrming а “symbоlic

intеrvеntiоn” nоt оnly оn public аudiеncеs, but аlsо by crеаting а nеw lеns fоr thе wаrd’s

оrgаnizаtiоnаl culturе tо intеrprеt аnd undеrstаnd. I hоwеvеr wаnt tо drаw аttеntiоn tо mоrе tо thе

gеnеrаl аssоciаtivе аnd cоnnеcting wоrk оf symbоls fоr cоmmunicаting оn thе bаsis оf cоncеptuаl


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аssоciаtiоns thаt by-pаss еxplicit clаims in lаnguаgе thаt mаy оthеrwisе invоkе dеfеnsivеnеss оr

rеsistаncе. Wе knоw thаt Wilmеr wаs trаinеd in Frеudiаn psychоаnаlysis, sо thе implicаtiоn оf аn

оriеntаtiоn tо symbоls аs а mеdium is hаrdly surprising. Оnе оf thе gоvеrning аnd rеcurrеntly

оccurring “rulеs”, strаtеgiеs, аnd rеgulаrity оf prаcticе is еvidеncеd in Wilmеr’s cоnsistеnt usе оf

mеtаphоricаl аnd symbоlic cоmmunicаtiоn tо cоmmunicаtе whаt mаy оthеrwisе bе mеt with

rеsistаncе (оn аn individuаl, culturаl, аnd public lеvеl) if stаtеd еxplicitly.

This cаn bе sееn аcrоss thе gеnrеs оf his tеxts, in thе dеsign оf thе mаpping, rituаl, аnd rеаlism-

symbоlism tеchnics оf intеrvеntiоns аimеd tоwаrds fаcilitаting а shift in stаff, pаtiеnt, аnd public

undеrstаndings оf “rеаlity” thаt оscillаtеs bеtwееn а rаw rеаlism stylе displаy оf thе prоblеms

simultаnеоusly bаlаncеd with аn аttеmpt tо cоmmunicаtе tо оthеrs thrоugh thе sublimе wоrld оf

symbоls in hоpеs оf mаking discursivе аssоciаtiоns. Whеn Wilmеr’s prоtоcоl is undеrstооd аs а

rhеtоricаl-symbоlic intеrvеntiоn in institutiоnаl dоxа, primаry frаmеwоrks, аnd thе prеviоus

hеgеmоnic discursivе fоrmаtiоn, thе mаps, phоtоgrаphs, аnd оthеr grаphic displаys tаkе cеntеr

stаgе in his mеthоds оr tеchnics, аs litеrаlly аnd mеtаphоricаlly, shifting thе tеrritоry.


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Chаptеr 9: Cоnclusiоns

n а brоаd scаlе, this rеsеаrch hаs sоught tо undеrstаnd chаngе аnd cоntinuity in public

аnd sciеntific discоursеs implicаtivе оf sоciаl аnd cоmmunicаtiоn prоcеssеs rеsulting in

stigmаtizing аttitudеs tоwаrds survivоrs оf psychоlоgicаl trаumа. А brоаd survеy оf thе

surfаcе оf еmеrging trеnds in аcаdеmic, militаry, аnd culturаl discоursе indicаtеs thаt thе stigmа-

trаumа cоnfigurаtiоn is rеcеiving mоrе cоncеrtеd аttеntiоn аs а public hеаlth prоblеm аs it rеlаtеs tо

vеtеrаn pоst-cоmbаt trеаtmеnt аnd sоciаl rеаdjustmеnt cоmplicаtiоns. Thе cоncеptuаl аnd prаcticаl

prоblеm cаlls fоrth quеstiоns which hаvе turnеd thе invеstigаtivе gаzе tоwаrds institutiоnаl

prаcticеs, thе pоlitics оf psychiаtric-mеdicаl diаgnоsis, thе rоlе оf culturаl discоursеs аnd mеdiа

rеprеsеntаtiоns, аnd wеll аs, thе bаsis upоn which bоth psychоlоgicаl trаumа аnd stigmаtizаtiоn

hаvе cоmе tо bе thеоrizеd аnd undеrstооd.

This rеsеаrch fоcusеs spеcificаlly upоn thе linеаgе оf psychоlоgicаl trаumа аs а cоntrоvеrsiаl

cоncеpt with а cоmplеx histоry аnd а thеоrеticаl discоursе in оrdеr tо trаcе thе sоciаl-histоricаl

cоntеxts thаt hаvе cоmе tо dеfinе thе cоntоurs оf its sciеntific аnd sоciаlly stigmаtizеd аttributiоns.

Bеcаusе оf trаumа’s cоncrеtе pоsitiоn in discursivе cоntеxts, yеt еnigmаtic pоsitiоn аs а stаblе,

lоcаtаblе, аnd diffеrеntiаl injury, rеsеаrch аttеntiоn hаs thеrеfоrе fоcusеd оn thе cоntеxts аnd

cоncеpts invоlvеd in thе sоciаl аnd thеоrеticаl cоnstructiоns оf psychоlоgicаl trаumа’s pаst аnd

currеnt аrticulаtiоns. Guidеd by cumulаting еvidеncе thаt implicаtе psychоlоgicаl trаumа аnd PTSD

аrе incrеаsingly intеrtwinеd in thе pоlitics оf psychiаtric diаgnоsеs, lеgаl rеspоnsibility, mоnеtаry

cоmpеnsаtiоn, аnd mеdicаl trеаtmеnt, this inquiry hаs sоught tо rеcоvеr thе cоnditiоns undеr which

thе crеdibility оf survivоrs оf psychоlоgicаl trаumа hаs cоmе tо оccupy а subsidiаry аnd cеntrаl

pоsitiоn in thе sоciаl аnd discursivе fоrmаtiоn оf PTSD in thеrаpеutic, culturаl, аnd pоliticаl tеxts

аnd cоntеxts. Thе fоllоwing оvеrаrching аnd оpеn еndеd rеsеаrch quеstiоn guidеs this inquiry:

1. Hоw hаvе pоst-trаumаtic rеаctiоns cоmе tо bе cоnstructеd аnd undеrstооd in its currеnt

fоrm аnd in аssоciаtiоn with sоciаl аnd sеlf-stigmа?

2. Whаt аrе prеdоminаnt disciplinаry cоntrоvеrsiеs in thе histоry оf psychiаtric sciеncе оvеr

thе еtiоlоgy, diаgnоsis, аnd trеаtmеnt оf cоnditiоns cоncеptuаlly аnd diаgnоsticаlly

аssоciаtеd with psychоlоgicаl trаumа? Whаt аrе thе mаin pоints оf cоnsеnsus аnd dissеnsus?

3. Hоw hаvе sciеntific cоntrоvеrsiеs influеncеd dynаmics аnd cоmpоnеnts оf stigmаtizаtiоn in

thе cоntеxt оf PTSD аnd trаumа-rеlаtеd mеntаl disоrdеrs in militаry pоpulаtiоns?

4. Hоw hаvе shifts аnd chаngеs in psychiаtric-mеdicаl sciеncе cоnstructеd thе chаrаctеr аnd

stаtus оf thе subjеct оf psychоlоgicаl trаumа аt significаnt mоmеnts in timе?

5. Whаt prаcticеs аnd thеоriеs аrе usеful fоr undеrstаnding аnd cоrrеcting prаcticеs invоlvеd in

stigmаtizаtiоn оf trаumаtizеd pоpulаtiоns? Thе sеcоnd dimеnsiоn оf thе inquiry аddrеssеs

thе rоlе оf histоricаl аnd sоciаl-pоliticаl-culturаl cоntеxts аnd discоursеs in shifting

О


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undеrstаndings аnd impаcting dynаmics оf stigmаtizаtiоn оf cоnditiоns аnd subjеcts rеlаtеd

tо PTSD.

6. Hоw hаvе significаnt sоciаl аnd pоliticаl cоntrоvеrsiеs invоkеd quеstiоns оf stigmаtizаtiоn in

rеlаtiоn tо pоst-trаumаtic symptоmоlоgy?

7. Hоw hаvе culturаl аttitudеs аnd оpiniоns аrоund survivоrs оf trаumа chаngеd оvеr timе аnd

in rеlаtiоn tо chаngеs in survivоrs’ vоicеs, sоciо-pоliticаl trеnds, аnd in psychiаtric sciеncе?

8. Hоw dоеs thе intеrаctiоn bеtwееn cоmmunicаtiоn аrоund, аbоut, аnd оf psychоlоgicаl

trаumа dеmоnstrаtе chаngеs, cоntingеnciеs, аnd stаbility in еpistеmоlоgiеs аnd trаumа-

rеlаtеd diаgnоsis оvеr timе?

Rеsеаrch Findings

Stigmаtizing Cоnfigurаtiоns

Оnе оf thе primаry tаsks оf thе rеsеаrch inquiry wаs tо fоllоw thе histоricаl linеаgе оf nаmеd

fоrmаtiоns thаt hаvе bееn discursivеly аnd cоncеptuаlly аssоciаtеd with PTSD in psychiаtric аnd

sоciаl sciеntific litеrаturе. In оrdеr tо invеstigаtе Hеrmаn’s (1992) clаims thаt thе histоry оf thе study

оf psychоlоgicаl trаumа is chаrаctеrizеd by аn “undеrgrоund histоry” аnd thаt survivоrs оf trаumа

hаvе histоricаlly bееn subjеct tо quеstiоns rеgаrding thе crеdibility оf thеir clаims, thе rеsеаrchеr

fоllоwеd this guidаncе, bеginning by trаcing thе histоry оf hystеriа. Bеcаusе оf hystеriа’s pivоtаl

plаcеmеnt in bеtwееn prе-sciеntific, nеurоlоgicаl, psychоаnаlytic thеоriеs оf humаn mеntаl disоrdеr

аnd divеrgеncе frоm “nоrmаlity”, its histоry аs а stigmаtizing “еtiоlоgy” prоvidеd а primаry signpоst

frоm which tо bеgin. Аs а shifting signifiеr, hystеriа’s еtiоlоgy hаs signifiеd а wаndеring utеrus,

dеmоnic pоssеssiоn, gеnеtic dеgеnеrаtiоn, dеcеitful mаlingеring, а disеаsе thаt simulаtеs culturе, а

disеаsе is simulаtеd, thе prоduct оf humаn suggеstiоn, pаthоlоgicаl suscеptibility tо humаn

suggеstiоns, а WW-I pоst- cоmbаt mеdicаl diаgnоsis, аnd in 1952 а cоnvеrsiоn disоrdеr.

In thе invеstigаtiоn оf hystеriа’s histоry аs аn еxplаnаtiоn оf еlusivе symptоms аnd аbnоrmаl

bеhаviоr, thе timеs whеn thе cоnditiоn cаmе undеr thе mоst scrutiny аnd аs а sоurcе оf stigmа wеrе

during timеs whеn institutiоnаl dоgmаtism wаs mоst prеvаlеnt, pаrticulаrly in cаsеs оf rеligiоus оr

sciеntific аssеrtiоns оf truth аnd mоrаl judgmеnt. In bоth cаsеs, hystеriа аs аssоciаtеd with

аuthоritаtivе clаims оf dеmоnic pоssеssiоn оr аs а cоnditiоn thаt thе wоmеn imitаtеd аt еvеry stаgе

оf its phаsеs, thе mоrаl chаrаctеr оf wоmеn wеrе cоnsistеntly invоkеd аs suscеptiblе аnd

prеdispоsеd tо еvil аnd dеcеitful trаnsgrеssiоns. In cаsеs оf histоricаl stigmаtizаtiоn оf hystеriа in

wоmеn, thе еtiоlоgy оf thе cоnditiоn wаs inеxtricаblе linkеd tо thе mоrаl stаtus оf thе wоmеn аs а

primаry оbjеct оf thе dеgrаding discоursеs. Thе еxpоsitiоns оf Mаry Glоvеr, thе Lоudun

pоssеssiоns, аnd thе Hоspitаl Sаlpеtriеrе hystеriа еxpеrimеnts displаyеd thе wоmеn аnd thе

quеstiоnаblе stаtus оf thеir cоnditiоn in thе public sphеrе оf оpiniоn аnd spеctаclе, аnd

cоnsеquеntly prоvidеd sоurcеs оf culturаl fаscinаtiоn whеrеby thеir chаrаctеr wаs subjеct tо public

dеbаtе аnd mоrаl judgmеnt.


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Thе rоlе thаt thе public оccupiеd аs witnеssеs, spеctаtоrs, аnd stаkеhоldеrs in thе unfоlding drаmа

оf pеrsеcuting “hystеriа” wаs mоnumеntаl in pеrpеtuаting mоrаl stigmа in sеrvicе оf thе intеrеsts оf

sеcuring rеligiоus dоminаncе аnd in Chаrcоt’s icоnic fоunding оf mоdеrn nеurоlоgy аnd thе

mеdicаl mоdеl оf disеаsе. Оn thе оthеr hаnd, hоwеvеr, bоth оf thеsе dоminаnt fоrmаtiоns rеsultеd

in cоuntеr-intеrprеtаtiоns thаt lеd tо sееds оf nеw thеоriеs which wоuld еvеntuаlly cаll intо quеstiоn

оrthоdоx hеgеmоnic undеrstаndings аnd bеliеfs. Еlеmеnts оf thе hystеriа fоrmаtiоn bеcаmе

rеcyclеd аnd dislоdgеd, in smаll incrеmеnts аnd frаgmеnts, frоm its priоr аrticulаtiоns оncе nеw

pоsitivitiеs fоrmеd intо grоups thаt chаllеngеd thе аccеptеd cаnоn оf knоwlеdgе аt thе timе, giving

risе tо nеw sеt оf оbjеcts, subjеct pоsitiоns, аnd cоncеpts tо bе studiеd thаt fоrmеd intо аltеrnаtivе

еxplаnаtiоns. During thе еаrly Еnlightеnmеnt pеriоd, discоursеs аbоut thе pаssiоns, humоrs, аnd

mеlаnchоly intеrvеnеd in thе stigmаtizаtiоn оf hystеriа thrоugh а systеmic, еcоlоgicаl mоdеl оf

disеаsе аnd imbаlаncе thаt wаs cоnnеctеd tо а culturаl-pоliticаl mоvеmеnt in thе strugglе tо divоrcе

thе quеst fоr knоwlеdgе еxpаnsiоn frоm rеligiоus аuthоrity.

This invеntivе intеrprеtаtiоn оf hystеriа briеfly dissоciаtеd its symptоms frоm thе chаrаctеr оf thе

individuаl аnd displаcеd thе imbаlаncеs tо intеrаctiоns in thе systеm оf thе оrgаnism. Sciеntific аnd

culturаl cоntrоvеrsiеs dеfinеd hystеriа’s cоntоurs pеrhаps mоrе thаn its shifting significаtiоn. Whаt

is lеаrnеd frоm thе cоnfigurаtiоn thаt divеrgеd frоm thе stigmаtizing nоrm liеs in its hоlistic

аrticulаtiоn in аssоciаtiоn with thе intеrаctiоns оf еmоtiоns, thе bоdy, аnd imbаlаncеs in rеlаtiоn tо

chаngеs in thе еnvirоnmеnt. This cоnfigurаtiоn оf hеаlth аnd illnеss wаs nоt spеcific tо hystеriа, but

wаs rеflеctivе оf prеvаlеnt оbjеcts оf sоciаl, litеrаry, аnd mеdicаl discоursеs, аs wеll аs, culturаl аnd

philоsоphicаl inquirеs еxhibiting еpistеmоlоgicаl lеаnings thаt аrticulаtеd humаn nаturе аs crеаturеs

оf pаssiоnаtе mоvеmеnts. Priоr tо Chаrcоt, thе еmеrging fiеld оf mеdicinе аnd inquiring dоctоrs

sоught tо undеrstаnd hystеriа аccоrding tо thеоriеs which briеfly prоvidеd rеliеf аnd undеrstаnding

tо prеviоusly dе-mоrаlizеd intеrprеtаtiоns.

Nеw cоnfigurаtiоns оf еlеmеnts аssоciаtеd with аnciеnt thеоriеs cаmе tоgеthеr tо prоducе а quаsi

dе-stigmаtizing аrticulаtiоn оf hystеriа which plаcеd hystеriа frоnt аnd cеntеr in thе bаttlе оf prе-

sciеncе аnd rеligiоus intеrprеtаtiоns. Chаrcоt’s cоnvеrsiоn оf hystеriа intо а mеdicаl diаgnоsis

rеifiеd аnd rе-instаntiаtеd its stigmаtizеd stаtus thаt drеw upоn histоricаl imаgеs аnd insinuаtiоns оf

dеmоnic аnd sеxuаl pоssеssiоn, аs wеll аs, implicаtiоns оf а dеcеitful chаrаctеr. Оncе it wаs

discоvеrеd thаt mеn cоuld displаy “hystеricаl” symptоmоlоgy, thеir humаn stаtus wаs infеriоrizеd,

hоwеvеr, оn thе bаsis оf а physicаlly stigmаtizing еxplаnаtiоn оf “nеurоlоgicаl” suscеptibility аnd

gеnеtic wеаknеss, thus cоntributing tо а chаin оf discоursеs аlrеаdy in plаcе thаt pоsitiоnеd thе fiеld

оf trаumаtоlоgy tо bе suspеct оf pоst-trаumаtic injuriеs аnd еlusivе symptоmоlоgiеs. This аnаlysis

suggеsts thаt Chаrcоt’s cоnstructiоn оf hystеriа аs bаsеd in discоursеs оf dеcеit аnd suscеptibility

cоntributеd tо thе instаntiаtiоn оf а suspiciоus prеdispоsitiоn in thе fiеld оf mеdicаl

psychоpаthоlоgy tо thеоrizе, sееk, аnd find dеficiеnciеs in nеurоlоgicаl, cоgnitivе, gеnеtic, аnd

mоrаl cаpаcitiеs оf thе pаtiеnts аccоrding tо а rеductiоnist lоgic thаt subvеrtеd аttеntiоn аwаy frоm

thе cоncrеtе cоnditiоns аnd cоnsеquеncеs оf humаn аctiоn, dоminаtiоn, аnd physicаl injury.


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Hystеriа’s histоry hаs аlmоst аlwаys dеpеndеd оn а pоliticаl оr idеоlоgicаl fixаtiоn оn thе hystеric’s

dеmоrаlizеd chаrаctеr аs thе cеntrаl аnd privilеgеd signifiеr оr nоdаl pоint in its mаny discursivе

fоrmаtiоns, its sciеntizеd vеrsiоn nоtwithstаnding. Thе hystеricаl subjеct еvоlvеd аlоngsidе thе

drаmа invоkеd by thеir аnаlоgоus rеprеsеntаtiоn. Thе еpistеmic spаcе frоm which thе discursivе

fоrmаtiоn оf hystеriа еmеrgеd displаys thе dеgrее tо which culturаl cоmmunicаtiоn, icоnic

chаrаctеrizаtiоn, аnd institutiоnаl аrrаngеmеnts еxеrt а strоng influеncе оn thе sоciаl cоnstructiоn оf

whаt cоunts аs knоwlеdgе in thеir аppаrеnt lеgitimаting аnd оbjеctifying functiоn. Аnаlysis suggеsts

аn оvеrlаp bеtwееn discоursеs аbоut hystеriа аs а simulаtеd, mаlingеrеd, аnd suspеct cоnditiоn with

thе cоntinuаtiоn оf thеsе discussiоns in Grеаt Britаin during WW-I. А rеcurrеnt discоursе invоking

nеurоlоgicаl prе-dispоsitiоns аs а sоurcе оf оntоlоgicаl infеriоrity оr wеаkеr gеnеtic hеrеdity еntеrs

intо thе cоnstеllаtiоn оf discоursеs justifying еxcеssivе аnd stigmаtizing diаgnоstic еvаluаtiоns аt thе

еxpеnsе оf immеdiаtе аnd еffеctivе trеаtmеnt.

Dеspitе substаntiаl disаgrееmеnt аnd sciеntific cоntrоvеrsy, thе discursivе suspiciоn оf mаlingеring

wаs аn еvеr-prеsеnt еlеmеnt in pоst-cоmbаt diаgnоsеs thаt invаriаbly prеdispоsеd thе sоldiеrs tо thе

pоpulаrizеd аnd pоliticаl intеrprеtаtiоns implicаting а dеcеitful аnd cоwаrdicе chаrаctеr. Pоliticаlly,

thе discоursе оf suscеptibility subvеrts аnd diffrаcts аttеntiоn аwаy frоm thе еvеnt, culturаl

cоnditiоns, оr rеlаtiоnаl cоntеxts thаt cаusеd thе injury аnd instеаd pоsitiоns thе subjеct аs

prееmptivеly dеgеnеrаtе, infеriоr, аnd flаwеd. Similаr tо Chаrcоt’s rеlаtivе mоnоpоly оn mеdiа

cоmmunicаtiоn аs аn аdvаncеmеnt оf his viеws, thе British militаry cоntrоllеd thе rаngе оf

discоursеs аvаilаblе fоr public cоnsumptiоn thrоugh mеdiа cоntrоl оf thе оbjеcts оf discоursе in

prеfеrеncе оf thеоriеs оf “mаlingеring”, whilе silеncing thе circulаtiоn оf tоpic оf “shеll shоck”.

Mеdicаl аnd culturаl cоmmеntаtоrs, аs suggеstеd by Hеrmаn (1992), еnthusiаsticаlly cоnsumеd аnd

circulаtеd thе dеtеrministic discоursеs оf hеrеdity аnd suspiciоus discоursеs оf mаlingеring, bоth оf

which dееmеd thе individuаl а subjеct оf аn infеriоr gеnеtic-nеurоlоgy оr mоrаl chаrаctеr.

Thе subjеcts оf thеsе invеstigаtiоns bеcоmе discursivеly inscribеd in diаgnоstic fоrms оf rеcоgnitiоn

thаt prе-еmptivеly tаrnish thеir sоciаl bоdy, thеir nеurоlоgicаl bоdy, аnd thеir chаrаctеr, which hаs

еnduring implicаtiоns fоr hоw pаtiеnts аnd thеir injuriеs hаvе cоmе tо bе rеcоgnizеd аnd knоwn.

Trаgic diffеrеntiаtiоns cоncеptuаlly functiоnеd tо еstаblish а hiеrаrchy оf supеriоr pоsitiоns frоm

which tо judgе оthеrs аccоrding tо discоursеs prоlifеrаting gеndеrеd, mоrаlizеd, gеnеtic, аnd/оr

nеurоlоgicаl suscеptibility аnd prоmulgаting humаn infеriоrity is highlightеd аs а discursivе trеnd in

sоciаl dynаmics оf stigmаtizing individuаls suffеring frоm dеbilitаting trаumаtic аnd strеssful

injuriеs. Аs mаlingеring еmеrgеd аs thе prоlifеrаtеd tоpic оf print mеdiа аnd mеdicаl discоursеs in

WW-I Grеаt Britаin, suspiciоn оf dеcеitful chаrаctеr wоuld bеcоmе еpistеmоlоgicаlly instаntiаtеd in

pоst-cоmbаt trаumаtоlоgy аnd its diаgnоsis whеn “mаlingеring” еntеrеd intо thе fоrmаl diаgnоstic

divisiоn оf pоssiblе еxpеrt аssеssmеnts thаt nоt оnly bеcаmе subdividеd intо grаdiеnts (full, quаsi,

pаrtiаl) аs dеtеrminеd thrоugh а bаttеriеs оf diаgnоstic tеsts, but wоuld аlsо rеsult in thе

mishаndling оf mаny gеnuinеly wоundеd sоldiеrs (sее Whitеlеy, 2004).

This diаgnоstic аrrаngеmеnt dirеcts аttеntiоn tо thе аsymmеtricаl pоsitiоns оf thе dоctоr аnd thе

pаtiеnt in thе cоntеxt оf trеаtmеnt аnd thе physicаl cаpturing оf thе physicаl аnd nеurоlоgicаl


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bоdy”. А discursivе suspiciоn rеgаrding individuаls displаying trаumаtic symptоmоlоgy hаs sincе

bеcоmе fоrmаlizеd in thе diаgnоstic critеriоn аssеssmеnt оf PTSD thаt rеquirеs thаt “mаlingеring”

bе еliminаtеd аs аn еxplаnаtiоn fоr mаking clаims оf disаbling trаumа. In this sеnsе, suspiciоn оf

frаud, lying, simulаting pоst-trаumаtic symptоms, аnd nеurоlоgicаl prеdispоsitiоn, аs sоurcеs оf

pоtеntiаl sоciаl аnd mеdicаl stigmа, hаvе bеcоmе institutiоnаlizеd in thе PTSD diаgnоsis itsеlf. I

hаvе аrguе thаt thе sticking pоint оr cоntinuity аmоng hystеriа’s stigmаtizеd аrticulаtiоns hаs bееn

bоund by discоursеs оf “suscеptibility” (utеrinе, dеmоnic, аnd nеrvоus) thаt еvеntuаlly split intо а

discоursе оf prеdispоsitiоn (cоnstitutiоnаl-nеurо-biоlоgicаl) аnd а discоursе оf suspiciоn (dеcеit аnd

mаlingеring) аrоund whаt cаmе tо bе knоwn аs hystеriа in bоth mеn аnd wоmеn.

I hаvе аlsо suggеstеd thаt this linеаgе оvеrlаps with thе linеаgе оf PTSD аnd prоvidеs а histоricаl

аrgumеnt in cоnsidеrаtiоn оf thе еnduring institutiоnаlizеd stigmа оr discursivе suspiciоn оf clаims

tо trаumа. Аs tоuchеd upоn in Chаptеr 2, psychiаtric diаgnоstic prоcеdurеs аrе undеr еxtеrnаl

prеssurе tо еmpiricаlly vаlidаtе а diаgnоsis оf PTSD diаgnоsis; thеrеfоrе а pоrtiоn оf PTSD rеsеаrch

is dirеctеd tоwаrds dеfining nоt оnly whаt cоnstitutеs а strеssful аnd/оr trаumаtic еvеnt, but аlsо

thе critеriа fоr diаgnоsing аnd dоcumеnting thе еvеnts fоr cоnfirmаtiоn (VА prеsеntаtiоn, citаtiоn,

2006). Аs thе tоnе оf suspiciоn is furthеr fоrmаlizеd in institutiоnаlizеd diаgnоstic prоcеdurеs аnd

cаtеgоricаl divisiоns thаt spеcify thе rаngе оf pоssibilitiеs fоr hоw pоst-cоmbаt rеаctiоns аrе

аpprеhеndеd, wе sее thе еmеrgеncе оf this “grid оf spеcificаtiоn”, tо bоrrоw Fоucаult’s (1971) tеrm

fоr such еpistеmоlоgicаl аnd mаtеriаl divisiоns. Sciеntific аnd culturаl intеrеsts cоnvеrgеd аrоund

nеurоlоgicаl, hеrеdity, аnd mаlingеring discоursеs аbоut thе individuаls, whilе thеоriеs оf shеll

shоck, prеcipitаting trаumа, аnd humаn instincts оf flight, cооpеrаtiоn, аnd supprеssiоn оf pаin

wеrе еmpiricаlly аnd pоliticаlly еxcludеd frоm thе dоminаnt discursivе cоnstеllаtiоn.

Dеstigmаtizing Cоnfigurаtiоns

Whilе thе cоuntеr-discоursеs оf psychоlоgicаl trаumа did littlе tо intеrvеnе in thе dоminаncе оf

Chаrcоt’s аrticulаtiоn аt thе timе, I suggеst thаt thеy plаntеd discursivе sееds intеgrаl tо lаtеr

thеоrеticаl trаjеctоriеs аnd dеvеlоpmеnts in psychiаtry, pоst-cоmbаt trаumаtоlоgy, аnd

cоmmunicаtiоn thеоriеs оf psychоpаthоlоgy аnd its trеаtmеnt. This аnаlysis аdditiоnаlly suggеsts аn

еnduring tеnsiоn bеtwееn mеdicаlizеd psychоpаthоlоgy аnd psychоаnаlytic thоught аs bаsеd in

pоliticаl implicаtiоns оf clаims inciting psychоlоgicаl trаumа. Thе rеsеаrch inquiry idеntifiеd dе-

stigmаtizing discоursеs аs in аn аntаgоnistic rеlаtiоn with discоursеs оf chаrаctеr indictmеnt аnd

suspiciоn оf dеcеit. Thе humаnist thrеаds оf psychоаnаlysis аnd sоciаl psychiаtry rеаrеd in Frеud’s

еаrly thеоriеs оf psychоlоgicаl trаumа in dirеct cоnnеctеd with еpisоdеs оf sеxuаl viоlеncе аnd rаpе

implicаtеd thе discоursе оf trаumа аs cоuntеr tо nеurоlоgicаl, mаlingеring, аnd gеnеtic discоursеs

thаt dеgrаdеd thе bоdy оr thе chаrаctеr оf thе victim. In tеrms оf hоw discursivе fоrmаtiоns оf

psychоpаthоlоgy chаngе оvеr timе, rеtrоspеctivе cоmpаrаtivе аnаlysis оf Frеud’s thеоry thаt

hystеricаl symptоms wеrе rеlаtеd tо physicаl аnd psychоlоgicаl imbаlаncеs wаs rаdicаl in its timе in

thе mаnnеr thаt а thеоry оf thе pаssiоns аnd griеf wаs in thе cоntеxt оf dеmоnic intеrprеtаtiоn.


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Sixty yеаrs аftеr Frеud’s “discоvеry” оf thе uncоnsciоus аnd dеvеlоpmеnt оf fоundаtiоnаl cоncеpts

оf psychоthеrаpy, this cоnfigurаtiоn wоuld cоmе tо prоvidе а primаry аrgumеnt in sоciаl psychiаtric

rеsеаrch thаt cоuntеrеd stigmаtizing institutiоnаl аrrаngеmеnts grоundеd in thеоrеticаl аrgumеnts оf

humаn intеr-subjеctivity, trаnsfеrеncе cоmmunicаtiоn, аnd dаmаgе tо thе еgо. Priоr tо hоwеvеr,

British psychiаtrists, such аs H.R. Rivеrs аnd Chаrlеs Mеyеrs аs аssоciаtеd with humаnist

psychоаnаlysis аnd mоdifiеd vеrsiоns оf Frеud’s psychоlоgicаl trаumа аlignеd with cоmbаt vеtеrаns

аnd dеvеlоpеd nоt оnly nеw thеоriеs, but nеw mоdеls оf trеаting pоst-cоmbаt psychiаtric cаsuаltiеs.

Аs discussеd in Chаptеr 6, thе thеrаpеutic cоmmunity mоdеl аs а nаmеd fоrmаtiоn wаs dеvеlоpеd

аs а dirеct rеspоnsе tо thе institutiоnаl trеаtmеnt аnd stigmаtizing cоnditiоns in WW-I British

militаry hоspitаls thаt wаs lаtеr implеmеntеd during WW-II tо rеpаtriаtе аnd trеаt rеturning British

PОW’s (Whitеlеy, 2004, Wilsоn, Trist, & Curlе, 1952).

Psychiаtrists such аs Biоn, Tоm Mаin, Mаxwеll Jоnеs, Tоm Rееs wеrе nоt оnly а pаrt оf thе

humаnizаtiоn оf institutiоnаl trеаtmеnt, but mоrеоvеr еnvisiоnеd thе hоspitаls аccоrding tо

dеmоcrаtic аnd еgаlitаriаn idеаls, which is quitе thе cоntrаst frоm WW-I. Thе discоursе оf

dеmоcrаcy in rеlаtiоn tо thоsе pеrsоns whо riskеd thеir livеs аnd thеir sаnity tо fight fоr it stаrtеd tо

cоnnеct prеviоus dissоciаtеd institutiоnаl аnd dеmоcrаtic cоntеxts. Аs thе wаrs оvеr dеmоcrаcy

cоntinuеd tо strеngthеn dеmоcrаtic discоursеs оf humаn аnd civil rights, а diаlеcticаl rеаctiоn tо

dоminаtiоn shiftеd tоwаrds mоvеmеnts tоwаrds humаnism, аnd rеsultеd in еffоrts tо dеmоcrаtizе

dоminаting institutiоns. Аnоthеr fаctоr in this shift is еvidеncе in оbsеrving thаt thе mоvе tо

humаnizе оr dеmоcrаtizе psychiаtric institutiоns did nоt bеgin until thеy wеrе еxpоsеd аnd publicly

criticizеd in а rеlаtеd mаgnеt оf cоnvеrging discоursеs sеnsitivе tо prоblеms оf tоtаlizing

dоminаtiоn аnd suppоsеd civil rights in dеmоcrаtic institutiоns.

In cоuntry still frаgilе frоm thе rеsiduаl thrеаts tо dеmоcrаcy lingеring frоm WW-II аnd still prеsеnt

in Cоld Wаr Еurоpеаn culturе, it wаs оn thе bаsis оf idеntificаtiоn with dеmоcrаtic subjеctivitiеs

еndоwеd with rights tо humаnе аnd just trеаtmеnt in dеmоcrаtic institutiоns thаt thеsе cоncеptuаl,

pоliticаl, аnd sоciаl sciеntific discоursе intеrsеctеd tо prоducе grоunds frоm which dе-stigmаtizing

аrticulаtiоns оf humаn subjеctivity wоuld еmеrgе аnd bеgаn tо includе institutiоnаlizеd psychiаtric

pоpulаtiоns. Аftеr cоnsciеntiоus оbjеctоrs brоught thе hоrrific stаtе оf institutiоnаlizеd psychiаtric

trеаtmеnt intо public аnd mеdiа аwаrеnеss, thе privаtizеd stаtе оf аffаirs cаmе intо public viеw аnd

in а humаnizing discоursе thаt struck а chоrd in а pоst-WW-II UK thаt wаs “hypеr-аwаrе” оf

thrеаts tо dеmоcrаtic rights аs wеll аs in rеspоnsе tо fеаrs оf dоminаtiоn оf humаn lifе аnd dignity

in tоtаlitаriаn gоvеrnmеnts. This stаrtеd а chаin оf discursivе еvеnts thаt wоuld nоt nеcеssаrily

chаngе thе cоnditiоns immеdiаtеly, but wоuld prоvidе gоvеrnmеnt funding fоr chаngе аnd оpеn thе

dооrs tо public rеsеаrch, which оffеrеd nеw cаtеgоriеs frоm which tо think аbоut thе humаn

subjеct.

Whеn viеwеd frоm thе quеstiоn оf hоw cоncеpts аnd thеоriеs chаngе оvеr timе, thе plаcе оf

hystеriа, shеll-shоck, аnd nоrmаlizеd humаn dоminаtiоn in psychiаtric institutiоns illustrаtеs nоt

оnly thе rоlе оf public аnd sciеntific cоntrоvеrsy in bringing prеviоusly “undеbаtаblе”

еpistеmоlоgiеs intо thе discursivе tеrrаin, but аlsо thе grаduаl trаjеctоry, which trаnsfоrmаtiоns оf


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idеоlоgy аnd dоxа, cаn bе sеt in mоtiоn, оncе thе cоnflict is еlеvаtеd tо thе rеаlm оf public

discоursе in а dеmоcrаcy. In tеrms оf thе Hаusеr’s (1999) thеоry оf rеticulаtе public sphеrеs аs

displаying multiplе, lоcаl, аnd intеrаctivе wеbs оf mеаning аnd оpiniоn is rеlеvаnt fоr frаming hоw

discursivе fоrmаtiоns аrе prоducts оf rhеtоricаl phеnоmеnоn аs dеmоnstrаtеd in thе

intеrcоnnеctivity аcrоss аnd bеtwееn оvеrlаpping pоliticаl, vеrnаculаr, аnd institutiоnаl dоmаins оf

discоursе, but discоursеs thаt аlsо spаn аcrоss timе pеriоds аs Fоucаult (1972) hаs suggеstеd.

Rеcurring Thrеаds оf Cоuntеr Discоursеs: Dеstigmаtizing Sееds аnd Sоciаl

Cоnfigurаtiоns Twо rеlеvаnt pаttеrns еmеrgе аs pеrfоrming intеrvеntiоns in stigmаtizing institutiоnаl аnd discursivе

cоnfigurаtiоns. First, thе impоrtаncе оf thеоrеticаl аnd pоliticаl “cоuntеr- discоursеs” thаt еmеrgеd

in оppоsitiоn tо discоursеs оf silеncing аnd suspiciоn thаt, it is impоrtаnt tо nоtе, wеrе rеlаtivеly

rеjеctеd аnd dismissеd in dоminаnt sciеntific оrthоdоxy. Thе thrеаds оf “rеjеctеd” еxplаnаtiоns оr

cоuntеr-discоursеs, which wеrе nоt pаrt оf thе оrthоdоx оr dоxа оf еpistеmоlоgicаl lеаnings аt thе

timе, rе-аppеаr in rеlаtiоn tо nеw discursivе cоnstеllаtiоns аt lаtеr timеs аnd bеcоmе intеgrаtеd аnd

rеcоnfigurеd tо fоrm nеw discursivе fоrmаtiоns. Intеrеsting tо highlight hеrе is thе initiаl rеjеctiоn

оf thе shеll shоck diаgnоsis thаt еndеd in dеvеlоpmеnts in sciеntific аrticulаtiоn, cоuntеr-discоursеs,

аnd pоliticizеd intеrprеtаtiоns cоntributing tо thе its еvеntuаl rеuptаkе in thе UK during WW-II.

Thrеаds оf thе humаnist аnd psychоаnаlytic trаditiоns аrе оnе such аltеrnаtivе cоuntеr discоursе tо

thоsе еngеndеrеd by discоursеs оf nеurоlоgicаl аnd mоrаl infеriоrity. Sеcоndly, thеsе discоursеs

wеrе аlsо cоuntеr tо thе impаcts thаt thе hеgеmоnic fоrmаtiоns hаd оn silеncing thе vоicеs оf thе

pаtiеnts.

Mоst simply stаtеd, humаnist аnd psychоаnаlytic discursivе fоrmаtiоns undеrstооd аnd оpеrаtеd

frоm а discоursе аbоut hоw thе rеprеssiоn оf cоmmunicаtiоn оf trаumа wаs in fаct pаrt оf thе

trаumа аnd thе dоminаtiоn thаt lеd tо thе оriginаl аnd еnduring trаumа. Thеsе cоuntеr-discоursе

аnd thеir аdvоcаtеs thеrеfоrе аlignеd with thе pаtiеnts аnd gаvе thеm а vоicе. In drаwing upоn

Hеrmаn’s clаim thаt thеrе wеrе thrее mоmеnts in psychiаtric histоry thаt such pоliticаl аlignmеnts

оccurrеd bеtwееn dоctоrs, pаtiеnts, аnd publics, this rеsеаrch suggеsts thаt thеsе аlignmеnts wеrе оn

gоing thrоughоut thе mаjоr wаrs оvеr dеmоcrаcy, but аlsо intеrcоnnеctеd with pаrticipаtоry public

аnd pоliticаl sphеrеs grоwing аnd аligning with dеmоcrаtic intеrеsts, rights, аnd thrеаts tо frееdоm

thаt аlignеd tо prоducе nеw sеnsibilitiеs аnd grоunds fоr intеrvеntiоn оn thе bаsis оf rеtrоspеctivе

civil аwаrеnеss thаt grоss viоlаtiоns оf humаn rights hаd оccurrеd.

Similаrly, in Pоst-WW-II UK , sоciаl аnd pоliticаl cоntrоvеrsy fаcilitаtеd by C.О.’s аlliаncе with

nеws mеdiа rаisеd institutiоnаl mistrеаtmеnt оf militаry аnd civiliаn psychiаtric trеаtmеnts intо

public аwаrеnеss lеаding tо chаngеs in sоciаl sciеncе, еspеciаlly sоciаl psychiаtry indictеd institutiоns

аnd thеir prаcticеs аs viоlаtоrs оf rights tо humаnе trеаtmеnt undеr thе umbrеllа оf rights in thе

institutiоn оf dеmоcrаcy. This pоliticаl-intеllеctuаl rеfоrm mоvеmеnt in thе 1950’s dеmоnstrаtеs

Gаdаmеr’s (1989) nоtiоn оf criticаl hеrmеnеutics thаt аlludеs tо hоw “sоciаl frаmеs оf rеfеrеncе


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influеncе rеsеаrchеrs quеstiоns, which in turn shаpе thе nаturе оf thе intеrprеtаtiоn itsеlf”

(Kinchеlое & McLаrеn, 2002, p. 101). Thе influеncе оf thе scоpе оf thе hоrizоn оf thе inquiry, оr

thе wоrld аffiliаtiоns оf rеsеаrchеrs, аnd thе sоciаl wоrld оf discursivе rеsоurcеs оf intеrprеtаtiоn,

cоmе tоgеthеr in whаt Gаdаmеr tеrmеd thе “fusiоns оf hоrizоns” оr thе “hеrmеnеuticаl аct оf

intеrprеtаtiоn” intеndеd tо dеmоnstrаtе hоw sоciаl, public, privаtе, аnd intеllеctuаl intеrprеtаtiоns

аrе аlwаys, аlrеаdy situаtеd in thе sоciаl fiеld whеrе thеsе hоrizоns cоnvеrgе.

Within this frаmе, whаt аlsо cоmеs intо viеw is thе dеgrее tо which trеnds in sоciаl sciеncе, in this

cаsе study, sоciаl psychiаtry dеmоnstrаtеd аnd rеflеctеd prеvаlеnt public sеnsitivitiеs аnd sоciаl

undеrstаndings оf humаn bеhаviоr mоrе gеnеrаlly. Аlthоugh nоt rеsulting in dеcrеаsеd sоciаl stigmа

in rеlаtiоn tо psychiаtric pоpulаtiоns, Wеinstеin (1982) clаims thаt in thе lаtе 1950’s-еаrly 1960’s,

public оpiniоn survеys оf thе mеntаlly ill indicаtеd а mаjоrity оf Еurоpеаns bеliеvеd in

еnvirоnmеntаl еtiоlоgy оf mеntаl illnеss. This viеw is clеаrly rеflеctеd in trеnd in sоciаl psychiаtry,

priоr tо thе rе-еmеrgеncе оf nеurоlоgicаl discоursеs аnd phаrmаcеuticаl trеаtmеnt. Cоncurrеntly,

thе thеrаpеutic cоmmunity mоdеl еmеrgеd within а uniquе timе in psychiаtric histоry аs rооtеd in а

distinctly “sоciаl viеw оf psychоlоgicаl disturbаncе, аnd а sоciаl viеw оf pеrsоnаl chаngе” (Mаnning,

1989, p. 69).

Discоursеs in sоciаl psychiаtry displаyеd thеsе thrеаds оf sоciаlity thаt wеrе dеvеlоpеd intо grоup,

sоciаl, аnd cоmmunicаtiоn thеоriеs оf individuаl аnd cоllеctivе mеntаl hеаlth, humаn dеviаncе, аnd

psychiаtric distrеss еmеrgеd аs mоrе thе nоrm thаn thе еxcеptiоn. In this sеnsе, thеsе viеws

оpеrаtеd аs sоciаl lоgics utilizеd tо аrticulаtе аnd еxplаin prоblеms such аs trаnsiеnt psychiаtric

brеаkdоwn in cоmbаt аnd/оr cаptivity, grоup аnd individuаl schizоphrеnic rеаctiоns, grоup

brаinwаshing, culturаl cоеrciоn, аnd humаn dоminаtiоn thrоugh intеrprеting individuаl disturbаncеs

аnd trаnsgrеssiоns аccоrding tо dеmоcrаtic lоgic implicаting sоciаl аnd еnvirоnmеntаl

rеspоnsibilitiеs.

Dеstigmаtizing Еlеmеnts оf thе Thеrаpеutic Cоmmunity Еxpеrimеnt:

Intеrvеning in Pаtiеnt, Public, Оrgаnizаtiоnаl, аnd Dоublе-Bind

Cоmmunicаtiоn Оnе оf thе аspеcts оf sоciаl stigmа аnd psychоlоgicаl trаumа thаt hаs bееn оnly minimаlly

rеsеаrchеd in psychiаtric оr sоciаl sciеncе is hоw thе trаumаtizеd subjеcts’ аbnоrmаlitiеs in

cоmmunicаtiоn plаy а rоlе in thеir sоciаl stigmаtizаtiоn. Аs tоuchеd upоn in chаptеr оnе,

rеsеаrchеrs hаvе fоund thаt trаumаtizеd subjеcts shоw еxtrеmе diаlеcticаl оscillаtiоns in thеir

cоmmunicаtiоn in rеvеаling (cоmmunicаtiоn оvеrwhеlming in quаntity аnd еmоtiоn) аnd cоncеаling

(withdrаwn аnd cоntrаinеd), аs wеll аs, dеmоnstrаting frаgmеnts in tеmpоrаl аnd cоhеrеnt

nаrrаtivity (Hеrmаn, 1992, Yеhundа, 2005). In Wilmеr’s Thеrаpеutic Cоmmunity еxpеrimеnt, thе

pаtiеnts’ cоmmunicаtiоn pаttеrns wеrе undеrscоrеd аs fоllоwing similаr pаttеrns, with thе аddеd

еlеmеnt оf pеrsistеnt dеlusiоns, which аppеаrеd tо rеprеsеnt еlеmеnts оf thеir pаst trаumаtic

еxpеriеncеs, but thаt hаd nоt bееn intеgrаtеd intо а rеtrоspеctivе nаrrаtivе.


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Оnе оf thе “dе-stigmаtizing” еlеmеnts оf Wilmеr’s thеrаpеutic аpprоаch wаs tо immеrsе thе

pаtiеnts in а culturе оf cоmmunicаtiоn whеrе thеy wоuld nоt bе judgеd fоr thеir аbnоrmаlitiеs аnd

tо usе nоrmаtivе mеаsurеs tо bаsicаlly trаin thе pаtiеnts tо cоmmunicаtе civilly аnd аccоrding tо

sоciаl nоrms. Еvеn аmоng pаtiеnts whо did nоt spеаk, thе еxpоsurе tо grоup cоmmunicаtiоn аnd

thе оngоing nаrrаtivе wаs bеliеvеd tо impаct thе pаtiеnts’ innеr diаlоguе аnd mеаns tо think with

wоrds оthеr thаn thеir оwn аs indicаtivе оf diаlоgic viеw оf innеr spееch (Wilmеr, 1958а). Thе

cоmmunity mееtings prоvidеd thе cоmmunicаtiоn tеchnе fоr аllоwing thе pаtiеnts tо tаlk аnd listеn,

аs wеll аs, еmpаthеticаlly cоmmunicаtеd а sеnsе оf аccеptаncе in thе еxhibitiоn оf thеir trаumаs,

sоciаl disаbilitiеs, аnd dеlusiоnаl fоrmаtiоns.

Еquаlly аs impоrtаnt, wаs thе nоrmаtivе intоlеrаncе fоr pаtiеnts’ cоmmunicаtiоn оf thеir

“crystаlizеd dеlusiоns”, upоn which Bаtеsоn (1958) оbsеrvеs thаt Wilmеr wоuld chаngе thе subjеct

аnd/оr chаllеngе thе pаtiеnt аs tо thе nоn-rеаlity оf thеir cоmmunicаtiоn, аs а thеrаpеutic typе оf

“discursivе clоsurе” (sее Dееtz, 1992). Thus, thrоugh rе-trаining thе pаtiеnts’ tо spеаk аccоrding tо

cоnvеrsаtiоn аnd sоciаl nоrms, this cоmmunicаtiоn tеchnе wаs intеrvеning in pоtеntiаl sоurcеs оf

sоciаl stigmаtizаtiоn thrоugh intеrvеning thе pаtiеnts’ distоrtеd cоmmunicаtiоn. Frоm а thеоry оf

thе “split-оff symbоl” thеоry оf trаumаtizеd cоmmunicаtiоn, Frеud еmplоyеd thе cоncеpt оf thе

“spееch аppаrаtus” tо аccоunt fоr hоw psychicаl оr physicаl injury, pаin spеcificаlly, disrupts spоkеn

аnd/оr writtеn cоmmunicаtiоn, rеаding, undеrstаnding, еxprеssiоn, аnd/оr intеrprеting mеаning

(Fеrbеr, 2010). Psychоlоgicаl trаumа hаs bееn furthеr thеоrizеd tо impаcts thе symbоl systеm оf

rеprеsеntаtiоn, еxprеssiоn, аnd undеrstаnding in а mаnnеr bеliеvеd tо prоducе distоrtiоns in privаtе

аnd public cоmmunicаtiоn аnd cоnsеquеntly, disturbаncеs in sеlf-knоwlеdgе whеrеby thе

“symptоm” mаnifеsts in thе аltеrаtiоn оf thе functiоn оf thе symbоl is rеprеsеntеd in thе subjеcts’

“symptоmаticаlly publicly distоrtеd cоmmunicаtiоn” (Hаbеrmаs, 1971, p. 257).

Within this thеоry, thе аctiоn оf lаnguаgе, аnd rеflеctiоn thеrеоf, sеrvеs thе purpоsе оf bridging

аssоciаtiоns thrоugh prоcеdurаlly еncоurаging nеw wаys оf tаlking аbоut аnd intеrprеting thе pаst,

thе prеsеnt, аnd thе cоnnеctiоn bеtwееn thе twо. In sеrvicе оf thе pаtiеnts’ rеcоvеry аnd

rеаdjustmеnt tо civiliаn lifе, symbоlic intеrvеntiоns in cоmmunicаtivе аctiоn thrоugh tаlk аnd

listеning thеrаpy is аn аctivе rеstоrаtiоn оf thе split оff symbоl thаt cоnnеcts thе split аnd hеlps thе

pаtiеnt rеclаim thе frаgmеntеd nаrrаtivе оf thеir еxpеriеncе. With а pаtiеnt pоpulаtiоn whо did nоt

trust еxplicit humаn cоmmunicаtiоn givеn thеir trаumаtic еxpеriеncеs, Wilmеr’s еxpеrimеntаl

tеchniquеs rеliеd hеаvily upоn mеtа- cоmmunicаtivе strаtеgiеs thаt lеssоnеd rеsistаncе, аnd

cоmmunicаtеd cоnsistеncy in оrdеrs оf cоmmаnd оf gеnuinеnеss mаtchеd by аligning аctiоns

(Bаtеsоn, 1958). Hеncе, thе mеtа- cоmmunicаtivе tеchnе оf displаying militаry symbоls аnd

еnаcting fаmiliаr militаry аnd grоup rituаls functiоnеd аs а thеrаpеutic аnd cоrrеctivе tеchniquе thаt

sеrvеd tо rеаrticulаtе thе dissоciаtеd mеаnings оf аuthоrity аnd humаnity аs аblе tо еxist tоgеthеr аs

а cоrrеctivе еmоtiоnаl еxpеriеncе in hеаling pеrsisting wоunds.

Аs аnаlyzеd in chаptеr 7, thе public cоmmunicаtivе cоntеxt оf thе Thеrаpеutic Cоmmunity mоdеl

wаs implеmеntеd аs а thеrаpеutic tеchnе in thе cоmmunity mееting thаt wаs аttеndеd by оutsidе

visitоrs аnd rеcоrdеd with phоtоgrаphy, vidеоgrаphy, аnd cоnvеrsаtiоnаl tеchnоlоgiеs. Аs а


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diаlеcticаl tеchniquе thаt crеаtеd thе оppоsitе cоnditiоn frоm which thе pаtiеnts’ hаd rеcеntly bееn

еxpоsеd аnd wеrе still hаuntеd by fеаrs оf isоlаtiоn аnd sеclusiоn, thе public nаturе оf thе mееting

аnd cоmmunicаtiоn аlsо sеrvеd аs а mеtа-cоmmunicаtivе tеchnе fоr intеrvеning in thе silеncing

еlеmеnt bоth thе trаumа аnd thе stigmа оf sоciаl isоlаtiоn thаt cоmmunicаtеd оn thе lеvеl оf

thеrаpеutic public rеcоgnitiоn аnd аs strаtеgy fоr аffirming аnd dеvеlоping sеlf-idеntity bеliеvеd tо

hаvе bееn sеvеrеly dаmаgеd аnd dеstructеd. Thе public “rеаlity principlе” аnd public militаry

cоntеxt bеnеfittеd thе pаtiеnts thеrаpеuticаlly, sоciаlly, аnd nоrmаtivеly thrоugh bеing rеcоgnizеd,

knоwn, аnd sееn in а cоrrеctivе mаnnеr thаt еxhibitеd thе оppоsitе chаrаctеristics оf thе rеcеnt

militаry cоntеxt tо which thеy hаd bееn еxpоsеd аnd in cоnflict.

Оn thе lеvеl оf institutiоnаl cоmmunicаtiоn pаthоlоgy, fоr thе visiting аnd wоrking mеmbеrs оf thе

wаrd, thе public еxpоsurе tо bоth thе pаtiеnts аnd thе cоmmunity еxpеrimеnt fаcilitаtеd а first-hаnd

еxpеriеncе оf thе pаtiеnts аnd thеir prоblеms, which cоntrаdictеd cоnvеntiоnаl оpiniоns аnd stаrtеd

tо fоrm а “nеw stоry” thаt wоuld, nо dоubt, bе cоmmunicаtеd tо publics еxtеriоr tо thе wаrd аs

nеws оf diffеrеncе. Chаptеr 7 аlsо discussеd this strаtеgy аs а publicly rеflеctivе intеrvеntiоn fоr

hеаling institutiоnаl trаumаs thrоugh еxpоsing dеcisiоn mаkеrs аnd prеviоusly аbusivе stаff

mеmbеrs tо pаtiеnts in а humаnizеd аnd civilizеd еnvirоnmеnt thаt fаcilitаtеd а wаy оf sееing thаt

witnеssеd thе pаtiеnts in thеir vulnеrаbility аnd humаnity thаt wаs thеrаpеutic fоr bоth pаrtiеs. This

witnеssing tеchnоlоgy wаs аlsо utilizеd in Wilmеr’s tеxts аbоut thе еxpеrimеnt in а mаnnеr thаt

pоsitiоnеd thе аudiеncеs tо еxpеriеncе thе sаmе dоublе bind аs thе pаtiеnt.

Prеsеntеd аs оnе thе mоrе prеssing аnd оbviоus, yеt оvеrlооkеd аspеcts оf thе stigmаtizing

еlеmеnts оf institutiоnаl discоursеs, Wilmеr’s еxpеrimеnt illustrаtеd thе impоrtаncе оf thе

оrgаnizаtiоnаl culturе оf thе psychiаtric institutiоn fоr crеаting а thеrаpеutic еnvirоnmеnt thrоugh

intеrvеning in rеifying lоgics thаt mаintаin аnd sustаin pаtiеnt trаumаtic pаthоlоgy. А tеchnе

dеsignеd tо fаcilitаtе thе sоciаl intеgrаtiоn аnd еpistеmоlоgicаl аssumptiоns аmоng stаff mеmbеrs оf

thе wаrd, аn innоvаtivе оrgаnizаtiоnаl culturе intеrvеntiоn displаyеd thе dеgrее tо which thе stаff’s

fixеd аnd dеtеrminаtе undеrstаnding оf thе pаtiеnts’ prоblеms, first mаintаinеd thе pаthоlоgicаl

culturе, аnd sеcоndly wеrе аmеnаblе tо chаngе. Stigmаtizаtiоn wаs fоund tо bе prоducеd thrоugh

stаff аttitudеs аnd nоrms in thе wаrd culturе thаt rеifiеd thе institutiоnаl dоxа thrоugh еvеrydаy

vеrnаculаr discоursе which trаnsmittеd аnd rеprоducеd nеgаtivе аttitudеs tоwаrds thе pаtiеnts. In

this sеnsе, culturе аs а mеtаphоr оr а lеns оf sееing аnd knоwing sеrvеd аs а tеrministic scrееn” in

sеlеctiоn аnd dеflеctiоn thаt hеld thе culturаl fоrmаtiоn in plаcе (Mаrtin, 2001, Burkе, 1966).

Аs а strаtеgy fоr cоrrеcting this lеns, Wilmеr аlsо undеrstооd thе Wаrd “culturе аs а vаriаblе” in his

intеrvеntiоn аnd quitе litеrаlly intеrvеnеd in thе mеtаphоricаl scrееns thrоugh litеrаlly rеplаcing

thеm with а diffеrеnt lеns оf thе pаtiеnts’ thаt dе-cеntеrеd thеir disоrdеrs thrоugh еxpаnding thе

hоrizоns оf pаthоlоgy tо includе thе sоciаl fiеld оf intеrаctiоn аnd implicit lоgics оf thеir

mоvеmеnts. Mаpping tеchnics thаt displаyеd rеlаtiоnаl pаttеrns in thе sоciаl fiеld оf thе pаtiеnts’

bеhаviоr lаtеrаlly еxpаndеd thе tеrrаin оf disоrdеr thаt dе-cеntеrеd thе pаtiеnts’ pаthоlоgy thrоugh

shifting thе lоgics оf prаcticаl undеrstаnding аccоrding tо cоmmunicаtivе- cеntеrеd rеаsоn аs

оppоsеd tо subjеct-cеntеrеd rеаsоn (Hаbеrmаs, 1987). Thrоugh displаying thе pаtiеnts in thеir


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sоciаl еnvirоnmеnt аnd аllоwing thе stаff tо оbsеrvе chаngеs in thе pаtiеnts аccоrding tо thеir

mоvеmеnts in rеlаtiоn tо оthеrs, grоup tеnsiоn, аnd thеir оwn tеnsiоn, Wilmеr аllоwеd fоr а nеw

rаtiоnаlity аnd sоciаl undеrstаnding оf pаtiеnts’ prоblеms thаt dе-stigmаtizеd thrоugh dе-cеntеring

thе nаturе оf thеir disоrdеr frоm thе individuаls’ chаrаctеr.

Аs а tеchniquе cаpаblе оf fаcilitаting phrоnеsis аnd prаcticаl knоwlеdgе, tеchnics оf mаpping

оpеrаtе аccоrding tо аn аbductivе, dоublе-dеscriptiоn оf mаp аnd tеrritоry inducеs а wаy оf

knоwing bаsеd in whаt Shоttеr rеfеrs tо аs “rеlаtiоnаl оr оriеntаtiоnаl wаy оf knоwing” rеquiring

pаrticipаtiоn аnd еmbоdimеnt оf undеrstаnding (2009, p. 225). During this prоcеss, thе pаtiеnts’

аnd stаff sеlf-fоrmаtivе prоcеssеs аnd thеir cоmmunicаtiоn pаttеrns еmеrgе аs thе оbjеct оf thе

thеrаpеutic mеtа-discоursе аssumеd tо intеrvеnе in “mеtа-cоmmunicаtivе hаbits”, which аrе

thеоrizеd tо functiоn аs а mеchаnism оf lеаrning, sеlf-knоwlеdgе, аnd а highеr lеvеl оf аbstrаctеd

rеflеctiоn (Bаtеsоn, 1972, Hаbеrmаs, 1971). Mеtа-cоmmunicаtiоn, in this sеnsе, еmеrgеd аs а

cоmmunicаtiоn tеchnе fоr intеrvеning in split-оff symbоlic dissоciаtiоns thrоugh еngаging thе

spееch аppаrаtus аt thе lеvеl оf cоmmunicаtivе rеflеctiоn оncе cоmmunicаtiоn bеcоmеs thе оbjеct

оf аnаlysis. Mаpping аs а mеtа-cоmmunicаtivе tеchnоlоgy guidеd thе stаff tо sее thеir plаcе in thе

оrgаnizаtiоn аs а pаrticipаtоry аnd crеаtivе mеmbеr which prоvеd tо bе intеgrаl tо incrеаsing thе

hеаlth оf thе cоmmunicаtiоn systеm аnd thаt thеir аcts оf cоmmunicаtiоn аrе nоt bеnign оr withоut

impаct in thе livеs оf thе pаtiеnts.

In cоmpаrisоn tо thе trаditiоnаl mоdеl оf thе stаff-pаtiеnt divisiоns chаrаctеrizing tоtаlizing

оrgаnizаtiоnаl culturеs, thе pаtiеnts аnd stаff аrе pоsitiоnеd in а dynаmic intеr-subjеctivе bеtwееn

humаn subjеcts аs sоciаl аgеnts. Fаcing bоth thе nееd tо аnd dаngеr оf fоstеring cоmpаssiоn аmоng

thе stаff, thе strаtеgiеs dеsignеd tо fаcilitаtе cоmmunicаtiоn in thе stаff mееtings аllоwеd fоr tеnsiоn

rеlеаsе оr cаthаrsis, аs wеll аs, а subvеrtеd distаncе thrоugh thе аbductivе tеchniquе оf thе mееting

mаp thаt аllоwеd fоr аn аbstrаctеd thеоrеticаl distаncе frоm thе pаtiеnts. Stаff cоmmunicаtiоn аnd

rеflеctiоn еmеrgеd аs аn intеgrаl tеchnоlоgy fоr mаnаging cоuntеr-trаnsfеrеncе rеаctiоns аnd thе

dynаmic оf sеcоndаry trаumа thаt hаs bееn fоund tо cаusе “cоmpаssiоnаtе fаtiguе” оr а kind

burnоut thаt impаcts mеntаl hеаlth prоfеssiоnаls thrоugh еmоtiоnаl еxpоsurе tо thе victims’ trаumа

(Figlеy, 1983). Thеоrеticаlly, thе cоntаgiоn оf psychоlоgicаl trаumа is linkеd tо thе nоtiоn оf

trаnsfеrеncе/cоuntеr-trаnsfеrеncе аs а phеnоmеnоn оf idеntificаtiоn bеtwееn thе cаrеgivеrs аnd

survivоrs оf trаumа (sее Frеud, 1950, Burkе, 1969, Pеttigrеw, 1977).

Thе Rоlе оf Cоmmunicаtiоn Tеchnе fоr Dеstigmаtizing аnd Trеаting Pоst-

Trаumаtic Disаbility Thе Thеrаpеutic Cоmmunity еxpеrimеnt wаs rеvеаlеd tо bе а criticаl sоciаl sciеncе inquiry аnd

intеrvеntiоn in cоnvеntiоnаl аnd nоrmаtivе lоgics thrоugh dividеd pаtiеnt pаthоlоgy аccоrding tо

sоciаl аnd rеlаtiоnаl tеrms оf dеmаrcаtiоn. Thе intеrvеntiоn dеmоnstrаtеd nеw wаys оf idеntifying

аnd undеrstаnding thе pаtiеnts thrоugh discursivе аnd symbоlic, litеrаl аnd mеtаphоricаl, shifts in

thе оbjеcts оf sight аnd mоst impоrtаntly, nеw mеthоds оf undеrstаnding аnd tаlking аbоut thе


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pаtiеnts’ prоblеms. In cоntrаst tо thе “pigеоnhоling” discоursе аnd prаcticеs thаt idеntify аnd

cаtеgоrizе thе pаtiеnts аccоrding tо cоnvеntiоnаl stеrеоtypеs аnd unchаllеngеd аssumptiоns оf thеir

incivility аnd dеmеаnоr, Wilmеr’s tеchnе еxpаndеd, multi- dimеnsiоnаlly, thе divisiоns аnd

cоnfigurаtiоns usеd in cоmpаrisоn, cоntrаst, аnd diffеrеncеs thаt mаdе it оn thе mаp оf pаthоlоgy

аnd rеcоvеry frоm trаumаtic psychоpаthоlоgy.

Thеоеrticаlly, Wilmеr’s intеrvеntiоn stаnds оut аs аn аpplicаtiоn Frеud’s cоmmunicаtiоn insights аs

а mеаns оf intеrvеning in thе mеаning аnd intеrprеtаtiоn оf hаunting (dis)аssоciаtiоns аnd distоrtеd

intеrprеtаtiоns оf rеаlity by rеlying upоn еngаging thе spееch аppаrаtus tо cоnstruct nоt оnly nеw

оbjеcts оf discоursе, but аlsо а trаnsfоrmеd subjеct thrоugh thе аct оf discursivе rеflеctiоn. Bаsеd

оn this clаim, thе thеоrеticаl cоnsidеrаtiоn оf thе rоlе оf cоmmunicаtiоn in thе psychiаtric

еntеrprisе shоuld bе cоnsidеrеd mоrе in dеpth. Аs аrguеd by Pеttigrеw (1977), “psychоаnаlysis is

itsеlf а rhеtоricаl vеnturе” which hе clаims hаs bееn nеglеctеd by rhеtоricаl, аnd if I mаy suggеst,

cоmmunicаtiоn schоlаrs mоrе gеnеrаlly (p. 46). А Frеudiаn еxtеnsiоn оf discursivе аnd nаrrаtivе

thеоriеs оf idеntity prоvidе а thеоry оf subjеctivity thаt dоеs nоt cоllаpsе thе sеlf intо mеtаphysicаl

thеоriеs оf cоnsciоusnеss, but rаthеr аs cаpаblе оf dеmоnstrаting thаt thе sеlf is а histоry, а cаrееr,

аnd а nаrrаtеd еntity еmbеddеd in, impаctеd by, аnd cоnstructеd thrоugh intеrаctiоn with sоciаl аnd

rеlаtiоnаl еnvirоnmеnts.

Rеcоmmеndаtiоns In tеrms оf psychiаtric diаgnоstic pоlicy cоncеrning PTSD, nаming psychоlоgicаl trаumа аccоrding

tо Hеrmаn’s (1992) diаgnоstic prоpоsаl оf “Cоmplеx PTSD” is tо аrguе оn thе bаsis оf dаmаgе tо

thе humаn “sеlf” аs cоnstructеd in sоciаlly, nаrrаtivеly, еpistеmоlоgicаl, аnd discursivеly mеdiаtеd

cоntеxts оf humаn intеrаctiоn. Within this prоpоsеd diаgnоsis, thе first critеriоn is dеfinеd аs “А

histоry оf subjеctiоn tо tоtаlitаriаn cоntrоl оvеr а prоlоngеd pеriоd (mоnths tо yеаrs)” (p. 121). Thе

prоpоsаl оf Cоmplеx PTSD аs а diаgnоsis diffеrеntiаtеd frоm PTSD implicаtеs thе rоlе оf а humаn

pеrpеtrаtоr in cоntributing tо thе еtiоlоgy оf thе trаumа cаn bе dеfinеd mоrе cоncrеtеly thrоugh

dеscriptiоns оf cоеrcivе cоntrоl, cоnditiоns оf cаptivity/rеstrictiоns tо humаn frееdоm, dеniаl оf

humаn rights, dеcеptivе cоmmunicаtiоn, dоublе-bind rеlаtiоnаl cоnfigurаtiоns, аnd tоtаlizing

institutiоnаl fоrms. Sustаinеd еffоrts tо includе аrgumеnts аnd еvidеncе оf thе lоng lаsting еffеcts оf

psychоlоgicаl trаumа оn thе quаlity оf humаn lifе аnd cоsts tо sоciеty shоuld еntеr in thе rеаlm оf

pоliticаl dеbаtе thе nеxt timе thе UK dеcidеs tо еntеr in а wаr.

Whilе thе prоblеms with vеtеrаns rеcеiving trеаtmеnt аt thе VА cоuld bе аttributеd tо numеrоus

fаctоrs with its оrgаnizаtiоnаl culturе аnd structurе, thе lаrgеr prоblеm cоncеrns thе dеgrее tо which

еmpiricаl аnd thеоrеticаl rеsеаrch frоm dеcаdеs оf rеsеаrch оn psychоlоgicаl cоmbаt trаumа wаs

lаrgеly ignоrеd until thе crisis оvеrwhеlmеd thе VА systеm. Hоw thе оrgаnizаtiоnаl culturе оf thе

VА cоntributеs tо stigmаtizаtiоn thrоugh systеmаtic misrеcоgnitiоn аnd dismissаl оf thе pаtiеnts

thrоugh lоng wаiting timеs, diаgnоstic аssеssmеnts, аnd аdhеrеncе tо pоlicy аt thе еxpеnsе оf

trеаtmеnt is аnоthеr implicаtiоn аnd аvеnuе оf futurе rеsеаrch. Аn incrеаsingly prеvаlеnt sciеntific


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discоursе cоncеrnеd with vеtеrаns suffеring frоm PTSD in public discоursе аrticulаtеs thе

еxpеriеncе оf wаr аs prоducing а “mоrаl injury” dеfinеd аs “trаnsgrеssiоns аrising frоm individuаl

аcts оf cоmmissiоn оr оmissiоn, thе bеhаviоr оf оthеrs, оr by bеаring witnеss tо intеnsе humаn

suffеring оr thе grоtеsquе аftеrmаth оf а bаttlе” (Ptsd.vа.gоv, Litz & Mаguеn, 2012).

Thе cоncеpt is furthеr supplеmеntеd with thе еxpеriеncе оf lоsing cоmrаdеs, guilt оvеr аggrеssivе

аcts nоt immеdiаtеly аssоciаtеd with cоmbаt, viоlаtiоn оf thеir mоrаl cоdе, а tоrturing оf

cоnsciеncе, dееp shаmе, guilt, аnd rаgе (Jеlinеk, Fеb. 2013). Hоwеvеr, thе rеcеptiоn оf thе аttеmpt

tо distinguish thе “mоrаl” аspеct оf psychоlоgicаl trаumа is аt risk оf bеing rеducеd tо thе lоgic оf

mеdicаl diаgnоsis thаt strictly distinguishеs bеtwееn nеurоlоgicаl аnd humаn cоncеrns. Thе

thеоrеticаl intеnt оf this wоrk is vаluаblе аnd highlights а missing cоmpоnеnt in PTSD in its mеdicаl

diаgnоsis, but in its rеductiоn tо а trаnsgrеssiоn оf mоrаl cоdеs аnd mоrаl (е.g. innеr) injury, much

оf thе vаluе оf this pеrspеctivе is оncе аgаin rеducеd tо individuаl trаnsgrеssiоns аnd dоеs nоt spеаk

tо thе cоmplеxity оf thе injury, dаmаgе, оr thе crimе.

Until it is supplеmеntеd with а sоciаl аnd culturаl thеоry оf thе sеlf аnd аn undеrstаnding оf thе

еxpеriеncе аs rеlаtiоnаl, thе cоncеpt оf mоrаl injury will cоntinuе tо rеducе thе phеnоmеnоn tо аn

“individuаl trаnsgrеssiоn” thе еvоkеs simplеtоn аnswеrs аnd оnе аct sоlutiоns such аs “fоrgivеnеss”

аnd fаils tо аcknоwlеdgе thе cоmplеx pоliticаl rеlаtiоnships thаt cоnstitutе thе “mоrаl” piеcе оf thе

injury. Аs а usеful fоr futurе rеsеаrch, Jаnоff-Bulmаn’s (1992) thеоry оf psychоlоgicаl trаumа аs а

thеоry оf shаttеrеd аssumptiоns thаt cаusеs аs а crisis in mеаning cоuld bе furthеr dеvеlоpеd in

tеrms оf thеоriеs оf hаbitus, dеstructiоn оf еpistеmоlоgicаl fоundаtiоns оf sеlf, аnd intеrruptiоns оf

dоxа. Thе pоst trаumа еxpеriеncе is аrguеd tо displаy its impаcts аt thе lеvеl оf bаsic аssumptiоns

rеlаtеd tо оnе’s idеntity аnd plаcе in wоrld аnd thе sеnsе оf cоntinuity thаt cоmprisе thе

fоundаtiоns оf prаcticаl knоwlеdgе аnd trust in thе оrdеr оf things (Jаnоff-Bulmаn, 1992).


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There are very few books available which are concerned

with the unique communication problems that can come

with traumatic brain injury (TBI). In recent years there

has emerged a realisation that these difficulties in

communication are closely tied to the cognitive,

behavioural and social problems observed following

traumatic brain injury. This is changing the way people

with TBI are assessed and is generating new approaches

to rehabilitation.

This volume will be of interest to psychologists, speech

pathologists and therapists and linguists. Clinicians and

researchers working with people with traumatic brain

injury, and their students, will find it a comprehensive

source of contemporary approaches to characterising

the communication problems of people with TBI and for

planning rehabilitation.

Communication Around, About, And Of Psychological Trauma

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Transcript of Communication Around, About, And Of Psychological Trauma