BOOK REVIEW – Trauma and recovery: The aftermath of violence – from domestic abuse to political terror

The following post reviews J.L. Herman’s influential book, Trauma and Recovery (1997), and highlights several points that relate to a core Thematic Area: The impact of domestic abuse on survivors.

Date Published: 1997
Authors: Herman, J.L.
Full Citation: Herman, J. L. (1997). Trauma and recovery. Basic books.

“Traumatic events are extraordinary, not because they occur rarely, but rather because they overwhelm the ordinary human adaptations to life. … They confront human beings with the extremities of helplessness and terror, and evoke the responses of catastrophe. According to the Comprehensive Textbook of Psychiatry, the common denominator of psychological trauma is a feeling of ‘intense fear, helplessness, loss of control, and threat of annihilation'” (Herman, 1997, p.33).

Judith Herman’s influential book about trauma and its repercussions discusses many types of trauma, from the kind experienced by combat soldiers, to those held captive as political prisoners and hostages. She also pays close attention to those entrapped by the invisible yet powerful boundaries that are unique to domestic abuse. In the book, three symptoms of post-traumatic stress disorder are discussed.

The first, hyperarousal, relates to the perpetual state of anxiety experienced by PTSD sufferers – always on the alert for danger, their baseline levels of arousal are always heightened (Herman, 1997, p.36). Second, intrusion reflects “the indelible imprint of the traumatic moment” (Herman, 1997, p.35). It may cause traumatized people to dissociate by entering an altered state of consciousness (both during and after the trauma) as a coping mechanism to avoid unbearable pain (Herman, 1997, p.42); those unable to dissociate often turn to drugs or alcohol to produce similarly numbing effects. These forms of coping obviously become barriers to recovery once the traumatic event is over (Herman, 1997, p.44).

Finally, with constriction, PTSD sufferers often attempt to avoid any situation that may trigger memories of the past and any plans for the future than may involve risk; inevitably leaving traumatized people severed from the outside world and deprived of “those new opportunities for successful coping that might mitigate the effect of the traumatic experience.” (Herman, 1997, p.47). As Herman says, the lives of traumatized people “lack drama; their significance lies in what is missing. For this reason, constrictive symptoms are not readily recognized, and their origins in a traumatic event are often lost. With the passage of time, as these negative symptoms become the most prominent feature of the post-traumatic disorder, the diagnosis becomes increasingly easy to overlook.” (Herman, 1997, p.49).

Traumatic events are universally linked by the ways in which they overwhelm individual competence, regardless of how brave or resourceful the victims may be; they are defined by actions being insufficient to warding off disaster. As such, in the process of reviewing and judging their own behaviour, survivors are confronted with feelings of guilt and inferiority, regardless of the insurmountable odds that faced them during the traumatic event (Herman, 1997, p.53). This guilt and shame may be exacerbated by the judgement of others, but may also be made worse by a simplification and immediate absolvement of the victim’s responsibility, as “simple pronouncements, even favorable ones, represent a refusal to engage with the survivor in the lacerating moral complexities of the extreme situation.” (Herman, 1997, p.69). Survivors often do not seek absolution, but rather fairness compassion, and “the willingness to share the guilty knowledge of what happens to people in extremity.” (Herman, 1997, p.69).

Herman discusses the characteristics of the perpetrator in many domestic abuse scenarios, outlining their often sophisticated use of power to coerce and control their victims while still giving the appearance of normalcy:

“Authoritarian, secretive, sometimes grandiose, and even paranoid, the perpetrator is nevertheless exquisitely sensitive to the realities of power and to social norms. Only rarely does he get into difficulties with the law; rather he seeks out situations where his tyrannical behavior will be tolerated, condoned, or admired. His demeanor provides an excellent camouflage, for few people believe that extraordinary crimes can be committed by men of such conventional appearance.” (Herman, 1997, p.75).

The tactics used by abusers, while unique for every individual, produce a remarkable pattern of systematic, repetitive infliction of psychological trauma. Disempowerment and disconnection serve to isolate the victim, while “methods of psychological control are designed to instill terror and helplessness and to destroy the victim’s sense of self in relation to others.” (Herman, 1997, p.77). Destroying the victim’s sense of autonomy is also common – often accomplished through the shame and demoralization of controlling the victim’s every move, even down to her bodily functions (Herman, 1997, p.77).

Intermittent rewards are used to bind the victim to the perpetrator, especially if the victim attempts to flee. Apologies, expressions of love, promises of love and appeals to loyalty and compassion are used to win over the victim. Herman notes that “the ‘reconciliation’ phase is a crucial step in breaking down the psychological resistance of the battered woman,” after which time normal patterns of abuse will likely resume (Herman, 1997, p.79). Isolation from information, aid and emotional support also ensures the victim becomes evermore bound to and dependent on her abuser, with him being the only connection to which she becomes allowed: “As the victim is isolated, she becomes increasingly dependent on the perpetrator, not only for survival and basic bodily needs but also for information and even for emotional sustenance. The more frightened she is, the more she is tempted to cling to the one relationship that is permitted: the relationship with the perpetrator.” (Herman, 2997, p.81).

Once physically free of an abusive situation, Herman notes that some theorists have mistakenly labelled abuse survivors with a form of ‘learned helplessness’, without understanding the true motivations for any apparent passivity displayed by the victim. Rather, “a much livelier and more complex inner struggle is usually taking place” (Herman, 1997, p.91). Instead of giving up, the survivor has learned to moderate her behaviour through careful scanning of the environment, always expecting retaliation for any action taken. From this, symptoms of protracted depression often emerge: “Every aspect of their experience of prolonged trauma works to aggravate depressive symptoms. The chronic hyperarousal and intrusive symptoms of post-traumatic stress disorder fuse with the vegetative symptoms of depression, producing what Niederland calls the ‘survival triad’ of insomnia, nightmares, and psychosomatic complaints.” (Herman, 199. p.94).

There is significant risk that victims of chronic trauma may feel themselves irrevocably changed, with some feeling as though they have lost their sense of self entirely. Along with this deep emotional distress, there are also severe physical repercussions of prolonged trauma: “Chronically traumatized people no longer have any baseline state of physical calm or comfort. Over time, they perceive their bodies as having turned against them. They begin to complain, not only of insomnia and agitation, but also of numerous types of somatic symptoms. Tension headaches, gastrointestinal disturbances, and abdominal, back, or pelvic pain are extremely common. Survivors may complain of tremors, choking sensations, or rapid heartbeat” (Herman, 1997, p.86).

The repercussions of trauma can also lead to the unfortunate misdiagnosis of an underlying psychopathology in victims of chronic trauma. As stated by Herman, it is clear that ordinary, healthy people can find themselves entrapped in prolonged abusive situations. Unsurprisingly, they rarely emerge ordinary or healthy. To complicate matters, there is still a tendency to blame the victim for the serious psychological harm she has endured, which can interfere with the correct diagnosis of post-traumatic syndrome: “Instead of conceptualizing the psychopathology of the victim as a response to an abusive situation, mental health professionals have frequently attributed the abusive situation to the victim’s presumed underlying psychopathology.” (Herman, 1997, p.116)

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