Friday, August 25, 2023

Pushing Back Against Trauma Culture

I'm seeing a more concerted effort lately to push back against the culture of "trauma," that 1) sees all our problems as the result of terrible things that happened to us in the past and 2) sets an extremely high value on protecting traumatized people from anything that might trigger bad memories. We've all read stories in this vein, like the "safe space" set up at Brown in 2015 where students upset over an on-campus debate about "rape culture" could color and watch puppy videos.

The pushback is coming from some psychologists, who think talking about trauma and safety is terrible psychological practice and also not supported by much in the way of data; from critics who are sick of "trauma plots" in books and film; from university administrators like the ones at Cornell who recently shot down student resolution calling for trigger warnings, and from social and political commentors who think this is ridiculous and want everyone to grow up. 

Which is not to say that there is no such thing as trauma, or that some people haven't been traumatized. The complaint is, basically, ENOUGH ALREADY. We have more discourse about trauma than ever before, with no evidence that we have more trauma and some evidence that we have less. If the point of talking about trauma is to improve mental health, it seems to be failing specatularly.

It's hard to talk about, though, because if you say "we're just inventing trauma so we have a way to excuse our own failings" to someone you don't know very well, the comeback may be, "Well, I was raped repeatedly by my stepfather and when I told my priest he raped me, too." (An actual story from the Boston Catholic abuse blow-up.) Maybe you think, "well, the issue is that a lot of people who weren't really traumatized are claiming the label for their own self-aggrandizement and we need to distinguish them from the truly traumatized." But who decides who has "really" suffered trauma? One thing I have learned in life is that experiences some people can just wave off feel horrific to others. What is trauma to one person is a crappy day to another.

I often think that maybe telling people "Oh my god something terrible happened to you and you're going to be scarred for life!!!" is not the best way to help them get past it. I read a few years ago about a Danish study that found people visited after a disaster by "crisis counselors" did worse than those who were ignored. On they other hand I know at least two people who had bad experiences and did get past them by taking them very seriously and confronting them head on; neither uses the language of "trauma" but then both are from an older generation.

But I will say this: the goal should always be, not to indulge weakness, but to cultivate strength; not to think the world should be made perfect, but to gain the resiliency you need to survive in an imperfect world.

One of the standard anti-trauma arguments goes like this Vox piece:

“Trauma” in its current usage has created a tidy framework within which to understand our lives and roles. The word evokes a narrative in which one is stripped of agency: An event happens to us, an aggressor attacks us, we are born into generations of suffering. In this telling, we are powerless. Our minds protect us, or our memories get stuck, or our behavior changes — and it’s beyond our control.

“The trauma narrative became a very easy one to adopt, even for the people who didn’t have what we would call a lot of trauma,” Whitlock says. “It has currency, so people broker in it.”

Whitlock began hearing trauma used to describe more universal, upsetting experiences about 15 years ago, as she was conducting interviews for a self-injury study among youth. It was the heyday of Myspace and LiveJournal, when “for one of the first times, we went all in online,” she recalls. “People were sharing their lives, candidly.” That included posting about mental health and personal struggles. “One of my participants talked specifically about how she perceived a hierarchy of trauma,” Whitlock says. “There was a sense of, the worse your trauma is, the more justified your mental health challenges.”

Which I rush to say is nothing new; consider this, from John Steinbeck's East of Eden:

Do you take pride in your hurt? Does it make you seem large and tragic? Well, think about it. Maybe you’re playing a part on a stage with only yourself as audience.

Here is Jill Filipovic at The Atlantic:

My own doubts about all of this came, ironically, from reporting on trauma. I’ve interviewed women around the world about the worst things human beings do to one another. I started to notice a concerning dissonance between what researchers understand about trauma and resilience, and the ways in which the concepts were being wielded in progressive institutions. And I began to question my own role in all of it.

Feminist writers were trying to make our little corner of the internet a gentler place, while also giving appropriate recognition to appallingly common female experiences that had been pushed into the shadows. To some extent, those efforts worked. But as the mental health of adolescent girls and college students crumbles, and as activist organizations, including feminist ones, find themselves repeatedly embroiled in internecine debates over power and language, a question nags: In giving greater weight to claims of individual hurt and victimization, have we inadvertently raised a generation that has fewer tools to manage hardship and transform adversity into agency? . . .

“I think it’s easier for them to artificially curate environments that are comfortable,” Shaili Jain, a physician and PTSD specialist, told me. “And I think that is backfiring. Because then when they’re in a situation where they’re not comfortable, it feels really alarming to them.”
We know a lot about how to treat phobia; in fact that may be the only psychological condition we are really good at treating. And the treatment involves, not avoiding the thing that scares you, but encountering it over and over (in a safe setting) until you get used to it. So if, say, you have been raped and even the word "raped" upsets you, it may be that instead of trying to get your law school professors to never talk about rape (a real thing that has happened more than once) you should use safe spaces like the criminal law classroom to help you get past being upset at the very word.

Anyway this brings me to David Brooks, whose recent NY Times piece is instructive, as Brooks often is, by expressing a thoroughly conventional sentiment among moderately conservative people like him. He begins by saying that whatever we are doing seems to be the wrong thing, since our mental health is worse – "an epidemic of hopelessness and despair among the young" – and our politics seems to be more and more about people on both sides getting upset with each other. And why might that be?

If I were asked to trace the decline of the American psyche, I suppose I would go to a set of cultural changes that started directly after World War II and built over the next few decades, when writers as diverse as Philip Rieff, Christopher Lasch and Tom Wolfe noticed the emergence of what came to be known as the therapeutic culture.

In earlier cultural epochs, many people derived their self-worth from their relationship with God, or from their ability to be a winner in the commercial marketplace. But in a therapeutic culture people’s sense of self-worth depends on their subjective feelings about themselves. Do I feel good about myself? Do I like me?

From the start, many writers noticed that this ethos often turned people into fragile narcissists. It cut them off from moral traditions and the normal sources of meaning and identity. It pushed them in on themselves, made them self-absorbed, craving public affirmation so they could feel good about themselves. As Lasch wrote in his 1979 book, The Culture of Narcissism, such people are plagued by an insecurity that can be “overcome only by seeing his ‘grandiose self’ reflected in the attentions of others.”

Citing The Culture of Narcissism is always a bad sign, since that book deals mainly with how the 1970s were the worst decade in human history because everybody pissed off Christopher Lasch so much. But I only discovered this when I went and read Christopher Lasch after seeing him cited all over the place by people wondering why everyone around them seems to have gone insane. Brooks then moves on to trauma:

This was accompanied by what you might call the elephantiasis of trauma. Once, the word “trauma” referred to brutal physical wounding one might endure in war or through abuse. But usage of the word spread so that it was applied across a range of upsetting experiences. . . .

For many people, trauma became their source of identity. People began defining themselves by the way they had been hurt.

Brooks thinks a lot of our problems can be traced to thee errors that psychologists into cognitive behavioral therapy often cite:

The first was the notion that “what doesn’t kill you makes you weaker,” inducing people to look at the wounds in their past and feel debilitated, not stronger.

The second false idea was, “I am a thing to whom things happen.” The traumatized person is cast as a passive victim unable to control his own life. He is defined by suffering and lack of agency.

The third bad idea is, “If I keep you safe, you will be strong.” But overprotective parenting and overprotective school administration don’t produce more resilient children; they produce less resilient ones.
Here is Parul Seghal:
Never mind pesky findings that the vast majority of people recover well from traumatic events and that post-traumatic growth is far more common than post-traumatic stress. 
Which gets us to the theory that, often unexpressed, underlies a lot of the trauma pushback: taking risks is good for you, even when you get hurt. A life lived to avoid harm leads only to weakness. In the long run what we need is not to avoid danger, but to become strong enough to overcome it, and hiding from it will never get you there.

As a general theory, this has much to recommend it. A child who didn't play rough enough to get skinned knees missed out on a lot, and if you've never been hurt by other people that can only be because you've never gotten close to them. The oldest idea in education is probably that young people have to struggle, suffer and fail in order to really learn and grow.

Against it one could look at the evidence from soldiers in war, who have been studied intensively since WW I. We know that combat veterans can acquire a lot of toughness, and some serve through long wars without being much troubled; the very toughest can endure the unimaginable for extended periods. I used to know a former combat medic who loved taking care of men with horrible wounds – "you just have to shut out the screaming" was one thing I heard him say more than once – and he didn't seem particular ruined by it. On the other hand, many people are haunted by combat for the rest of their lives. Long-term studies of American WW II vets, who had about the best experience one can have of a terrible war, show that the more combat men saw, the more likely they were to become alcoholics or have other mental problems. Most were fine so far as anyone could tell, but the impact of combat is pretty much a straight linear effect: any amount, even a skirmish, even entering the war zone, raised their chance of mental illness by a small amount. Which was all by way of saying that there is no general level of trouble that will make everyone tougher without ruining some.

Like all of these critics, I am skeptical of people who post TikToks about their trauma, which I can't believe is helping us, or them. I am sick of a politics that seems to be as about who is being mean or scornful to whom more than any problem the government might actually be able to fix. If the old joke was, "Stop oppressing me!" now we have "Stop causing me harm!"

But I also believe trauma is a real thing.

If I had to sketch a model right now, it would be that both trauma and excessive concern about trauma are harmful, in differing degrees to different people. The goal should be to find a balance, neither over-indulging whiners nor ignoring preventable brutality; treading softly around victims without encouraging them to define themselves by their suffering. 

That is a hard enough thing to do within one's own mind, and, I suspect, all but impossible for a contentious public culture like ours. But we should still try.

2 comments:

  1. This is a very judicious and well-written post that actually puts the well-being of patients at the center, rather simply serving as an excuse to indulge in a Laschian complaint about other people complaining (and, of course, I'm delighted to see you denounce Lasch).

    Two more or less historical points: 1, I'm struck by Brooks' nostalgia for a past where "many people derived their self-worth from their relationship with God, or from their ability to be a winner in the commercial marketplace." He seems to me to be talking in some part about an imagined self-image of America's small-town ruling class c. 1890 One could point out the other side of that self-image, on view in chronicles like "Wisconsin Death Trip." But there's also the simple fact that so much of American culture since--arguably, the vast bulk of it, if one may talk of culture in crudely quantitative terms--has since then been a quite hostile reaction to that world Brooks misses. This is the reaction that gave us "sad white man novels," as John has chronicled, and the whole "darkness behind the white picket fence" schtick, often quite overdone and now rather tired--but the accuracy or attractiveness of the challenge to Brooks' ideal is not really my point. For better or worse, there's been a both broad and deep rejection of that world--which, okay, I will say must at least in part reflect some real problems in that culture, and not simply us being unworthy whelps of our mighty ancestors, though there may be some of that too--and there's no going back. I would mention also that the "relationship with God" I suspect Brooks has in mind probably has more to do with a relatively anodyne civil religion than the kind that left many of the Wisconsinites in Lesy's book (which I admit I've only read a bit of myself), in the words of the sources, "disturbed in the matter of religion."

    2. FWIW, my remembered experience is that contemporary trauma culture postdates the culture of lengthy therapy (which itself arguably originates in Brooks' beloved 19th century). I think it may really get its start with popular guilt toward Vietnam vets in the late 70s, but my memory is it doesn't become a major public theme until the 80s and especially the 90s. I think of things like the Satanic child abuse scare and the Menendez brothers' defense, as well as films like 1989's "Born on the Fourth of July," which arguably starts in Brooks' longed-for world of "church, country, work" and doesn't include much of a positive, problem-solved outcome.

    ReplyDelete
  2. In that first line, I meant "rather THAN simply."

    ReplyDelete