Psychoanalysis and Holocaust Testimony

Unwanted Memories of Social Trauma

Dori Laub, Andreas Hamburger, Dori Laub, Andreas Hamburger

• Publisher: Routledge
• Year: 2017
• ISBN:
  9781317510031
• Edition: 1
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Psychoanalytic work with socially traumatised patients is an increasingly popular vocation, but remains extremely demanding and little covered in the literature. In Psychoanalysis and Holocaust Testimony, a range of contributors draw upon their own clinical work, and on research findings from work with seriously disturbed Holocaust survivors, to illuminate how best to conduct clinical work with such patients in order to maximise the chances of a positive outcome, and to reflect transferred trauma for the clinician.

Psychoanalysis and Holocaust Testimony closely examines the phenomenology of destruction inherent in the discourse of extreme traumatization, focusing on a particular case study: the recording of video testimonies from a group of extremely traumatized, chronically hospitalized Holocaust survivors in psychiatric institutions in Israel. This case study demonstrates how society reacts to unwanted memories, in media, history, and psychoanalysis – but it also shows how psychotherapists and researchers try to approach the buried memories of the survivors, through being receptive to shattered life narratives.

Questions of bearing witness, testimony, the role of denial, and the impact of traumatic narrative on society and subsequent generations are explored. A central thread of this book is the unconscious countertransference resistance to the trauma discourse, which manifests itself in arenas that are widely apart, such as genocide denial, the "disappearance" of the hospitalized Holocaust survivors and of their life stories, mishearing their testimonies and ultimately refusing them the diagnosis of "traumatic psychosis".

Psychoanalysis and Holocaust Testimony provides an essential, multidisciplinary guide to working psychoanalytically with severely traumatised patients. It will appeal to psychoanalysts, psychoanalytic psychotherapists and trauma studies therapists.

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Part I

Social trauma in psychoanalytic practice and research

Media and history

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The first section of the book addresses the basic concept of social trauma from a psychoanalytical perspective. It comprises six chapters. The first, by Werner Bohleber, charts the history of the interest of psychiatry and psychoanalysis in traumatization and the political and social events that led to research in this area. Bohleber examines the difficulties psychoanalysis initially faced in conceptualizing traumatic phenomena and the various theories it drew on. He emphasizes how crucial it is to recognize that a real event has occurred and to keep such historicity present in the treatment. Next, Dori Laub and Nannette Auerhahn present a spectrum of traumatic memories, organized on a continuum of ‘knowing and not knowing,’ each form progressively representing a consciously deeper and more integrated “level of knowing,” and hence increasing integration and ownership of the memory. Both deficit and defense, ego capacity and the extremity of the trauma, its immediacy and distance, and, most importantly, its overwhelming nature, are at work in giving form to the traumatic memory. In a further chapter, Laub postulates a theory of object deficit. In his view, the absence of an internal dialogic ‘thou’ is the cause for the shutdown of the processes of narrative and symbolization, thus foreclosing the possibility of an internal representation of the traumatic experience. He attributes that absence to the complete failure of empathy in the external environment of the Holocaust. When there is no responsive ‘other’ on the outside, there is no longer a matrix of two people—the self and the resonating other—in one’s internal world representation. Under such circumstances, faith in human communication dies. In light of the above assumptions, there follows an exploration of the principles of therapeutic intervention. In Chapter 4, Andreas Hamburger differentiates the broad DSM 5 diagnosis of PTSD from a socio-clinical perspective. He distinguishes between individual and social—especially genocidal—trauma. One of the main differences to be recognized here is that social traumatization targets whole groups, and thus affects the individual’s immediate holding environment, cutting it off from important protective processes that foster resilience. Furthermore, social trauma is implemented in a societal context, thus involving the surrounding society in the traumatic process. Both conditions entail major consequences for the impact and prognosis of the resulting posttraumatic disorder. Special attention is devoted to social denial as perpetuating the posttraumatic condition. Next, Francoise Davoine and Jean-Max Gaudillière describe the connection between madness and denied trauma in two case examples, exemplifying the healing affect of a witnessing analyst. In the last chapter of this section, Suzanne Kaplan and Andreas Hamburger discuss the specificity of this kind of traumatization when children and adolescents are afflicted. They illustrate the argument of this chapter with findings from Kaplan’s video testimony work with child survivors of the Rwandan genocide.

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Chapter 1

Treatment, trauma, and catastrophic reality

A double understanding of the “too much” experience and its implications for treatment

Werner Bohleber

Introduction

For a long time, research on trauma was more or less a blank page in the theoretical and clinical psychoanalytical discourse. Although psychoanalysis had begun as a theory of trauma, and although Freud would return time and again to trauma (particularly during World War I), and despite the looming barbarism of National Socialism, psychoanalysis, as a whole, had not attributed the significance it ought to have done to political and social violence. While the psychic consequences of both world wars compelled one to focus on traumatization, interest therein paled and was extinguished altogether a short time thereafter. Given the multiple catastrophes and extreme experiences that people were exposed to and suffered from during the twentieth century, trauma ultimately became the signature mark of the entire century. Considerable time was to elapse, however, before psychoanalysis, psychiatry, and other human sciences took up this theme and made it a central theme of research. Only after the Vietnam War, once the diagnosis of PTSD became part of psychiatric nomenclature in 1980, did comprehensive research on traumatization get under way. In psychoanalysis, it was, above all, the survivors of the Holocaust who enforced a renewed and sustained pursuit of the theory and treatment of trauma. They confronted psychoanalysts with the effects of extreme experience, which were hitherto unknown. Through the feminist movement in the 1980s, a public debate was initiated on the subject of sexual abuse and its consequences, which then brought about a renewed pursuit of these within psychoanalysis. Taken as a whole, and in recent decades, trauma has experienced a huge boost in attention, so much so that in everyday communication, the concept has assumed an almost banal character. Today, trauma research is anchored in many disciplines, beginning with psychiatry through to literary studies.

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That, for a considerable period of time, psychoanalysis experienced difficulties with the theoretical and clinical understanding of trauma, is a circumstance that goes back to its theoretical preferences. The field of psychoanalysis was the inner world of the human being—the unconscious, and unconscious phantasies. For many analysts, the adequate integration of external reality seemed like an intrusion on psychic reality and the meaning of the unconscious. As a consequence, research into and adequate treatment of traumatization lagged considerably behind. This is owing to the fact that trauma is not only the consequence of a shaking to the core of the psyche’s structure, but also that the ego/self is abruptly overwhelmed and reacts with helplessness, fear of death and annihilation anxiety: the psychic processing mechanisms become paralyzed, and only emergency reactions are possible. This experience of massive psychic overwhelming then results in permanent change to the psyche’s organization. Naturally, not every traumatic situation impacts upon everyone in the same way; predisposing factors also play a role. The normal functioning of psychic organization is, however, suspended. While the traumatic event and the experience thereof are registered, they are not psychically integrated by way of the associative formation of meaning. The attempt at integration is only subsequently set in motion, where the ego/self—challenged by repetition compulsion—attempts to process the consequences, and to integrate the trauma into its patterns of experience.

This description of traumatic processes remains relatively cursory, serving only to emphasize the psychically unbearable weight, the “too much” that characterizes external reality in the case of traumatization. Detailed consideration reveals, however, that the situation is more complex. The reason for addressing the topic here is to elucidate why, for a considerable period of time, analysts have had such great difficulties when it comes to appropriately conceptualizing traumatic phenomena.

Psychoanalytic models of the trauma

How do psychoanalysts describe the psychic reality of traumatic experiences today? For a psychoanalyst, it is not enough to study the affective-cognitive storage of traumatic memories; the aim is rather also to comprehend the horror, the pain, the abandonment, and the fear of death and annihilation which shattered the psychic equilibrium, and which then form the inner core of the traumatic experience. Before pursing this in greater detail, I would like first to give a brief presentation of two of the main models of trauma which we find in psychoanalytic theory. They also form the basis for the further discussion. The first is based on Freud’s psycho-economic model, the second on Ferenczi’s object-relations psychological approach.

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Sigmund Freud’s psycho-economic model of trauma

In Beyond the Pleasure Principle (1920/1955), Freud developed a model of trauma from a psycho-economic point of view. In the moment of traumatization, the excessive quantum of excitation cannot be psychically bound and overwhelms the ego, breaking through the protective shield. The force of the surging quantities of excitation is too great to be mastered. In order to accomplish the task of psychic binding, the psychic apparatus regresses to more primitive modes of response. Freud introduces the concept of the repetition compulsion in order to describe the special nature of this experience beyond the dynamics of the pleasure–unpleasure principle. Through the repetition compulsion, the traumatic experience is actualized in the hope of thereby psychically binding the excitation and setting the pleasure principle back in motion, as well as its associated forms of psychic response.

In Inhibitions, Symptoms and Anxiety (1926/1959), Freud connected the psycho-economic view of trauma with his theory of anxiety. He draws on the concept of automatic anxiety that he developed for the actual neuroses. The excessive quantity of excitation in the traumatic situation gives rise to a massive anxiety. It floods the ego, which is defenceless against this onslaught, and renders it absolutely helpless. Automatic anxiety has an indefinite quality and lacks an object. In a first attempt at mastery, the ego attempts to convert the automatic anxiety into signal anxiety, which makes it possible for the absolute helplessness to be transformed into an expectation. The ego thereby develops an inner activity and repeats the traumatic experience “actively in a weakened version, in the hope of being able itself to direct its course” (1926/1959, 167). The situation of external dangers is thereby internalized and acquires significance for the ego. The anxiety is symbolized and no longer remains indefinite and objectless. The trauma thus acquires a hermeneutic structure and becomes possible to overcome.

Baranger, Baranger, and Mom (1988) have rightly emphasized this economic aspect of automatic anxiety as a key element of the traumatic experience. They characterize the anxiety situation, with its psychic indeterminacy and objectlessness, as the “pure trauma.” What the authors characterize as pure trauma, Freud conceptualized as absolute helplessness. The traumatized person attempts to control and alleviate the pure trauma by giving it a name and incorporating it into a comprehensible, causal system of behavior. The authors emphasize the paradox that the trauma—as something alien—is actually intrusive into the psychic organization; however, as long as it remains alien, it is revived and falls into repetitions without becoming comprehensible. Since human beings generally cannot live without explanations, they attempt to give the trauma an individual meaning and to historicize it. These retroactive historicizations are mainly screen memories. It is the task of the analytic process to recognize these screen memories as such, and to reconstruct the authentic history, whereby the task of historicizing, which means comprehending the trauma as a part of the past, is open-ended, basically endless.

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In Inhibitions, Symptoms and Anxiety, Freud repeatedly described the helplessness experienced by the ego as the consequence of an object loss. This form of complete loss of internal protective objects constitutes the foundation of the second model of trauma.

The model of trauma in object-relations theory

With the development of object-relations theories, quantitative considerations concerning an intolerable mass of excitation that floods the ego were rejected. The paradigm for the model is no longer an isolated experience with a shock impact—such as an accident—but the object relationship itself. Ferenczi anticipated many insights of later research into trauma. Above all, his work on the “Confusion of the Tongues Between the Adults and the Child” (1933/1949) is an analysis of traumatic disorders that still remains modern today. Michael Balint (1969) was the first to follow him in this respect. He emphasized that the traumatogenic quality of a situation depends on whether an intensive relationship has developed between the child and the object. The object relationship itself thus acquires a traumatic quality. As later studies (Steele, 1994) confirmed, it is not primarily the child’s injuries from physical force that produce a traumatic disorder; rather, the most intensely pathogenic element is mistreatment or abuse by the person whose protection and care is actually needed. This viewpoint broadens the understanding of psychic reality in a traumatic situation. The greater the trauma, the more severe the damage to the internal object relationship, and the more severe the breakdown in the protective, stabilizing internal communication between self- and object-representations. This gives rise to isolated fragments of traumatic experience that are encapsulated and cut off from the internal communication.

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The object-relations theory approach to trauma theory was further developed by research into the severe traumatization that was suffered during the Holocaust. A key psychic consequence of such experiences is the breakdown of the empathic process. The communicative dyad between the self and its good internal objects breaks down, resulting in absolute internal isolation and the most intense desolation. The internal good object becomes silent as an empathic mediator between self and environment, and the trust in the continual presence of good objects and the expectation of human empathy is destroyed (Cohen, 1985; Kirshner, 1993; Laub & Podell, 1995). This conception gives us a better understanding of the experiential core of severe traumatization. It consists of a domain of experience that is almost incommunicable: a catastrophic isolation, an inner abandonment that not only paralyzes the self and its possibilities of action, but also annihilates it, which is at the same time accompanied by mortal fear, hatred, shame, and despair.

Attachment research has also developed, in a similar way, a conception of an inner traumatic core which is almost incommunicable. An attachment trauma is generated by neglecting the child in the sense of leaving the child psychologically alone in the midst of emotional distress. Allen described this point with extreme simplicity: “the essence of traumatic experience is being afraid and alone” (Allen, 2013, 164). Being alone means that there is no one to help regulate the intense emotional distress. The traumatic experience is conceptualized as an unmentalized inner core of experience.

The conceptions in object relations theory represent a major advance in the understanding of trauma. We nevertheless require both the psycho-economic models and the models based on object relations theory in order to comprehensively cover the psychic processes of traumatization. Allow me to recapitulate how the different conceptualizations of trauma have described the intrusion of an excessive reality and its effect on the psychic organization. The psycho-economic models center on the violence and abruptness of the intrusion of an overwhelming outside reality into the psychic organization. Metaphorically speaking, the psychic texture cannot absorb or bind the stimuli because of their excessiveness of excitation. Other concepts used in this context are ‘automatic objectless anxiety,’ ‘pure trauma,’ and an ‘absolute helplessness of the ego.’ The object relational models, however, center on the destruction of the empathic protective shield which is formed by the internalized primary objects; a destruction with absolute inner loneliness and the most extreme hopelessness as a consequence thereof. Other concepts used in this context are a quasi-autistic incommunicable region, an unmentalized foreign body, a rupture of the network of signifiers (Kirshner, 1994), a black hole (Kinston & Cohen, 1986). Seeing both models together, then, the object relational group of concepts are better suited to explain the psychic phenomena of loss of trust in the continuous presence of good objects, and the loss of trust in the shared s...

Table of contents

• Cover Page
• Psychoanalysis and Holocaust Testimony
• Praise
• Title
• Copyright
• Dedication
• Contents
• List of Contributors
• Introduction
• Part I Social Trauma in Psychoanalytic Practice and Research: Media and History
• Part II Perspectives on Testimony
• Part III Exploration in the Social Void: The Israel Video Testimony Project
• Part IV Manifestations of Extreme Traumatization in the Testimonial Narration of Hospitalized and Non-Hospitalized Holocaust Survivors: Two Case Studies
• Part V Conclusions
• Index