Dr. J. Anderson Thomson Jr.
Center for the Study of Mind and Human Interaction
University of Virginia
"When the Slaughter Ceases: Understanding and Assisting
Traumatized Societies"
February 5, 2001

This article was published in Volume 11, Number 3, Societal Trauma: Secondary Prevention of Mind and Human Interaction. The full reference is:

Thomson, J. A. (2000). Terror, tears, and timelessness: Individual and group responses to trauma. Mind and Human Interaction, 11: 162-176.

Terror, Tears, and Timelessness: Individual and Group
Responses to Trauma

J. Anderson Thomson, Jr.

J. Anderson Thomson, Jr., M.D. is Assistant Director of the Center for the Study of Mind and Human Interaction (CSMHI), Staff Psychiatrist at the University of Virginia Student Health Services and in private practice. He is a specialist in Post-Traumatic Stress Disorder, post-traumatic societies, and the psychology of prejudice and racism. He participated in CSMHI’s Baltic and Kuwait projects and is involved in its initiatives in the Republic of Georgia. This paper was developed from a presentation given at a conference in Tbilisi, Georgia organized by the Foundation for the Development of Human Resources on the topic of "Society and Psychological Support."

• • •

Preface

Some of the material for this paper comes from a project conducted in Kuwait during 1993-94. Developed at the request of the Social Development Office of the Amiri Diwan in Kuwait and directed by Amb. Nathaniel Howell, US ambassador to Kuwait during the Iraqi invasion of 1990, the project focussed on diagnosing the societal effects of the Iraqi occupation on Kuwait so as to facilitate effective recovery from this trauma. During the project, CSMHI faculty conducted over 150 interviews with a wide cross-section of Kuwaiti people to form a picture of the aggregate consequences of the experience. Quotations from some of those interviews are included in this article.

Post-traumatic states

Post-traumatic states occur when an individual has been placed in a situation where action is to no avail, where neither successful resistance nor escape is possible. Examples of trauma causing such states include war, combat, terrorist attack, rape, child sexual and physical abuse, domestic battery–i.e., incidents with the common denominator of personal and political violence. For the person who has experienced such trauma, components of normal human responses to danger persist after the fact in altered and exaggerated form. A combination of hyper-arousal states, memories of the trauma, withdrawal, and disconnection is predictable. In their extreme forms, these responses lead to disability of the individual and are readily identifiable as psychiatric illness. The manifestations of post-traumatic states, which constitute serious and lasting changes in arousal, thinking, emotion, and memory, can be summarized and illustrated as follows:

Hyper-arousal

Hyper-arousal states are characterized by unabated physiological arousal. It is as if the central nervous system has been reconditioned and there is no longer a baseline state of calm or comfort. The individual may startle easily and describe him- or herself as constantly vigilant. Often the sufferer is irritable and easily erupts into explosive anger. Chronic anxiety, psychosomatic disorders, and altered pain perception frequently occur. Sleep disturbances–including difficulty falling asleep, being easily awakened, and enduring, repetitive nightmares–are common.

A patient who grew up in a poor rural area of the US and who was severely physically and sexually abused by an older sibling presented with constant anxiety, insomnia, flashbacks, cardiac rhythm disturbances, irritable bowel disease, and chronic physical pain syndromes.

In our work in Kuwait after the Gulf War, nearly all the individuals we interviewed reported not feeling safe. Many were chronically anxious and said that they were easily startled. Most expressed constant concern about and fear of another invasion. Often, we heard "others" described as exhibiting low frustration tolerance, irritability, and explosive bouts of anger. An official in the judicial system told us that people could no longer control their angry impulses; an educator expressed concern that students were easily frustrated, irritable, and more prone to arguing.

Traumatic memories

Trauma-inducing experiences–such as being taken hostage, tortured, raped, and terrorized–resist encapsulation in the normal memory. The memory of such trauma often lacks a clear verbal narrative. Images are vivid, frozen, seemingly indelible, and can be fragmented: overpowering emotion without image or image without emotion. Since they lack the coherent form and clear context of a narrative, there may even be doubt about their reality.

Traumatic memories are dreaded, and the suffering individual generally tries to suppress them. They are, however, intense and frequently relived involuntarily in thoughts, daydreams, and nightmares. They may also be relived in actions without the individual being aware of the true source and motivation of his or her behavior.

A patient from an upper class US family with a prominent but alcoholic father who sexually abused her would wake outside her home in a state of terror with only a fragment of a dream or nightmare. The fragment was never complete enough to give her a secure sense that it was from her father’s attacks.

In Kuwait, we learned of a man who, after the liberation, accepted a job as a security guard at the building in which he had been imprisoned and tortured. He was unaware of the connection until it was pointed out to him.

It is believed that traumatic memories differ from usual memories because the normal linguistic encoding of memories is deactivated. The central nervous system reverts to primarily sensory and imagery forms of storage. In this form, they can persist unchanged indefinitely. They are not integrated into the individual’s normal narrative sense of identity and personal history. They break through in flashbacks and nightmares and may easily be triggered.

The woman who was abused by her father became unexpectedly overwhelmed with panic in a dentist’s office when the dentist started to insert an instrument into her daughter’s mouth. One Kuwaiti man who was captured while watching CNN news reported that the theme music from CNN evoked such painful memories that he was no longer able to watch it.

Everyone in Kuwait with whom we spoke expressed vivid memories of the moment when they learned of the invasion. Between that fixed moment and the liberation of the country there was often a temporal gap of painful images and emotions. Many productive, working people described persistent, intrusive thoughts and memories that disturbed, but did not disable, their daily lives. Some spoke of avoiding any reading material or television programming about the occupation out of fear of the distressing feelings they triggered.

Distortions of time are common in the accounts we have heard from survivors in the various traumatized countries in which CSMHI has worked. Many described the period of war as a "dream" or a "nightmare." In fact, in Kuwait some heard the news of the invasion in the early hours of the morning and reported attempting to go back to sleep. Recalling the seven months of occupation, one man remembered: "There was no need for time. I didn’t even wear a watch in that period. There was nothing to do."

For survivors of Iraqi torture, the time distortions were even more pronounced. One man described the Iraqi techniques and duplicity: "After they stopped questioning me, they would take me back to the holding cell and tell me they would come back the next day. But sometimes, they would wait three, maybe four days. I could not tell."

Even after detainees were assured by the International Red Cross that they would be released, the torture of time continued:

A Canadian whose wife kidnapped their two young children and fled with her sociopathic boyfriend developed all the hallmarks of a post-traumatic state. He was helpless to find his children, fearful that they were hidden and his wife had assumed a new identity. He could never feel assured of their safety. He spoke of how time had suddenly slowed to a near standstill and was a constant torment.

Dissociation

In extremely traumatic situations, an individual’s active self-defense system will shut down. There can be a temporary, but drastic, modification of a person’s character or sense of personal identity to avoid or minimize emotional or physical distress (Brenner, 1996). This phenomenon is known as dissociation. The individual will restrict his or her life to recreate some sensation of safety. Capacities for anticipation, initiative, and planning are often curtailed. As described above, survivors begin to live in an "endless present" as a way of protecting themselves from painful disappointment, which would create an even greater sense of desperation.

This dissociative defense can then persist after the trauma has ended. Individuals will narrow and deplete their quality of life. They deprive themselves of new opportunities for coping that might mitigate the effects of the trauma. Living in an "endless present" persists so long after the precipitating event that the reaction is not readily recognized as linked to the trauma. It often has profound impact on personality. The individual may appear years later to be suffering from a personality disorder, and its origins in the trauma may be overlooked.

Numerous interviewees in Kuwait told us how traumatic experiences had changed people’s personalities. Living for today and not thinking about the future was the way many perceived others around them. Several educators talked about students not working as hard as they did before, exhibiting less capability to plan and work for the future. Some saw men as slower to make a commitment to marriage. We heard, on the one hand, that people were afraid to leave their country, even briefly, while others were apprehensive about returning on a permanent basis. Wariness in establishing relationships of all kinds was perceived in a large percentage of interviews.

Disconnection

Disconnection, or loss of the ideal self, is another manifestation of post-traumatic states. There is disconnection within the individual and disconnection from others. Individuals may be disconnected from the developmental stage that they had attained prior to the trauma. Old conflicts, previously-completed developmental stages, and psychological developmental tasks which have been mastered may all be reopened.

If autonomy has been mastered, then this may be undone, and the individual will begin to experience shame and uncertainty. Where an individual may have once developed initiative, he or she now feels doubt. A person who has reached a level of feeling competent may now feel inferior. Because of having been held against one’s will, a positive identity may now feel contaminated. One student who felt capable and successful before the war was tormented by persistent questions about his personal courage. A young Kuwaiti woman in her thirties who appeared content and at ease with herself revealed a painful, ongoing, internal struggle about her identity and her Islamic faith as a consequence of the Iraqi occupation.

Disconnection from others and from society was pronounced in our samples in Kuwait. We were told repeatedly how individuals felt they had lost the capacity to trust others. A few interviewees revealed that they no longer had confidence in their capacity to determine what is good and what is bad. The assumptions in their value system seemed to have been severely shaken by ethnic war and the strong sense of betrayal associated with it.

Coercive control

The above disturbances in comfort level, memory, a secure sense of self, and connection with others can be explained as a consequence of the brutality inflicted. The Iraqi occupation of Kuwait is a classic example of traumatic captivity in which the population was subjected to coercive control.

The profile of a practitioner of coercive control is often the same whether he is a political tyrant operating on a massive scale, a criminal kidnapping or violating a limited number of victims, a cult leader controlling a small following, a husband who batters, or a child abuser. He may appear outwardly normal, but he is innately authoritarian, secretive, grandiose, and paranoid. Individuals of this type seek situations where they can impose their tyranny and have it tolerated, condoned, and even admired.

The objective is complete control of the victim. Ultimately, they want the victim’s affirmation and "gratitude." Their ideal is to create a willing victim. These individuals attempt the systematic, repetitive infliction of emotional trauma so as to disempower the victim and disconnect him or her internally and from others. To achieve this result, they seek to instill isolation, terror, and helplessness. They destroy the victim’s autonomy and sense of self, especially in relation to others. Not only do they try to inculcate the fear of death by arbitrary murder, but they also desire to make the survivor feel gratitude for being allowed to live.

The perpetrator wishes to convince those under coercive control that their tormentor is all-powerful, that resistance is futile and dangerous, and that survival depends on winning his indulgence through absolute compliance. Techniques of coercive control are universal. Either by design or serendipitously, whenever ruthless people attempt to terrorize and dehumanize their fellow human beings, they resort to similar methods. The perpetrators seek to dominate the body and bodily functions of the victim. They exhibit inconsistent and unpredictable outbursts of violence, capriciously enforcing petty rules, or temporarily granting favors.

Victims of coercive control are often isolated from reliable information, material aid, and emotional support from family, friends, and society. The perpetrator tries to convince the victims that their closest allies have forgotten or betrayed them. He tries to deprive the victims of any objects of symbolic importance, including identity. A victim’s name may be used with derogation, never spoken, or even changed. The name of a country may be literally wiped off the map.

If possible, the practitioner of coercive control tries to force victims to violate their basic moral principles and to betray fundamental human attachments. Classic examples include techniques such as forcing people to stand by while others, particularly loved ones, are tortured or murdered, or presenting victims with the moral dilemma of betraying a friend to save a loved one.

We were told numerous stories of how families were brought outside their homes and made to witness the torment and murder of a loved one. The natural human effect of such an experience is to create intense shame, defeatism, and impotent rage in the surviving witnesses. They feel–and this is the intention of the perpetrator–that they have failed to meet responsibilities and loyalties. They may even feel as if their tormentor has completely usurped their inner life and the core of their identity, which can seem contaminated. According to one Kuwaiti account:

Survivors of such brutality and coercion naturally begin to feel helpless and mask their inability to preserve their autonomy and attachments. Such coping mechanisms certainly apply to those who were in Kuwait during the Iraqi occupation. We found, however, that those trapped outside the country tended to experience analogous reactions. In some cases, individuals in these circumstances shut down their feelings, thoughts, initiative, and judgment as a way of minimizing their pain.

Many have fought valiantly against perpetrators of coercive control. We have heard many cases of resistance, both physical and mental, and of those martyred in the effort. The present state of our scientific knowledge does not allow us to measure the degree to which such resistance to coercive control may mitigate the psychological effects of the perpetrator’s campaign for total dominance of body and mind. Finding a means of resisting the onslaught, however, could theoretically enable one to carve out small areas of autonomy and to feel better about oneself.

Systematic analysis

A more systematic way of looking at post-traumatic stress in individuals, as well as society, is to organize the effects into six areas (Herman, 1992):

These alterations can occur in any individual who has been subjected to totalitarian control. Victims of torture, hostages, prisoners of war, political prisoners, terrorized civilian populations, survivors of sexual assault, or anyone subjected to a form of coercive control, experience them in direct proportion to the degree of trauma endured.

Changes in the regulation of emotion include persistent sadness and protracted depression. There may be chronic suicidal feelings and self injury, sometimes manifested, for example, in automobile "accidents." The individual may alternate between episodes of explosive anger and periods of extremely inhibited anger. There may be, alternately, compulsive or extremely inhibited sexuality. A Kuwaiti war survivor hinted at his depression when he remarked, "I don’t know what I’ll do in five years. Maybe I will be dead by that time." Another young man added, "This war has made us all older and weary. We are young and should be planning our lives and planning to marry. Instead, we wait and worry."

Changes in consciousness include amnesia or hyper-amnesia (vivid memory) of traumatic events. The individual may experience transient dissociative episodes, or temporary, but drastic, modifications of character or sense of personal identity to avoid distress as discussed earlier. The most dramatic examples among those interviewed in Kuwait occurred in persons who were held prisoner and tortured. Some of them experienced episodes of rank dissociation and psychosis that were evident to their fellow prisoners.

Victims may experience de-realization, a subjective sense that their familiar surroundings are strange or unreal, or they may report a feeling of change in reality. Distortions of space may be evident from the first surreal moments of any invasion. Suddenly, there can be alien tanks, soldiers, and corpses, in the streets and in quiet residential neighborhoods.

One Kuwaiti resident recalled:

Depersonalization, a subjective sense of being unreal, strange, or unfamiliar to one’s self, may persist long after the events. The victim may relive the trauma even in the form of intrusive symptoms or unusual preoccupation. A middle-aged professional man, who was "safe" in Europe throughout the Iraqi occupation, reported to us the persistent, intrusive, daytime image of Iraqi soldiers chasing him as he fled with his infant daughter in his arms. Three years after liberation, he continued to experience this image daily with all the accompanying feelings of vulnerability and terror.

Changes in self-perception include a sense of helplessness or paralysis of initiative. The individual may continue to experience shame, guilt, and self-blame. One young man painfully acknowledged, "When I think about the bodies that were dropped in front of us, I feel like crying. Sometimes I am brought back to that time."

There is frequently an internal sense of defilement or stigma. A Kuwaiti student who was caught outside his country during the conflict and remained abroad for the duration of the war admitted that he was preoccupied with the belief that he was a coward. He was tormented by a question he could never answer–what would he have done if he had been at home at the time?–and by fears that the answer would shame him. In another case, the male victim of sexual assaults by other men persistently questioned his sexual identity and carried a deep sense of internal "dirtiness."

Victims may experience a sense of complete differentiation from others that can be manifested in a feeling of specialness, utter loneliness, or the belief that no one else can understand or empathize with what they went through. Often, there is a contaminated identity with an internalized image of an "enslaved self." A man described to us his feeling of altered personality: "I used to live my life one way, then suddenly it is completely different. I feel that I am still utterly alone."

There are also changes in the perception of the perpetrator. Victims are frequently overly preoccupied with their relationship to the author of their trauma, including an obsession with revenge. Often the perpetrator is accorded unrealistic attributes of the total power he wished to project. There may even be idealization of or paradoxical gratitude toward the tyrant, the criminal, the rapist, or the child abusing parent. A sense of special or supernatural bond between aggressor and victim is possible. Sometimes, when the victim accepts the belief system or rationalizations of the perpetrator, there is a traumatic bonding.

One of the most striking aspects of our interviews in Kuwait was the common fixation, in one form or another, with Saddam Hussein. None of those with whom we talked could comfortably incorporate him into their thinking. Many recalled their admiration for him before his attack and had believed his reassurances until the last moment. His acts of treachery were universally incomprehensible: "How do I feel?" responded one male interviewee, "Stabbed in the back!"

For some Kuwaitis searching for a role model before 1990, Saddam served as an idealized vessel. He was an Arab, "a Muslim brother, one of us," who appeared to be strong and to combine aspects of modern secularism with an Arab mantle. A number of our respondents confessed, regretfully in retrospect, that they had chosen to overlook or deny the brutal manner with which he treated his internal enemies. They were then all the more horrified and ashamed when he unleashed his brutality on Kuwaitis. A teenaged boy remembered the time when Saddam gave His Highness the Amir a red ribbon and reinterpreted the gesture: "That symbolized something, I think, a foretelling that Saddam would surround us with blood and destruction."

The betrayal by Saddam Hussein was so unanticipated, so sudden and complete, and so disorienting that it still could not be fully digested and integrated into the "history" of many Kuwaitis. To accept what he did was to call into question all the assumptions about the environment in which Kuwaitis placed their trust prior to the Iraqi invasion. Some sought to bridge the chasm with conspiracy theories that attempted to absolve Saddam of sole and ultimate responsibility for his actions. If they were not completely wrong in their trust in Saddam Hussein, they might not be totally wrong in the other convictions which they held. Other Kuwaitis, various Arab governments, and the United States were occasionally drawn into these theories in partial exculpation of Iraq’s treachery. It was less important whether or not these explanations could bear critical scrutiny than that some Kuwaiti victims were prepared to embrace them in an effort to re-establish some continuity in their view of their world.

Many with whom we talked explained the invasion and occupation as punishment from God for straying from their faith, and they sought to rectify their perceived failings by a stricter interpretation of and adherence to that faith. By believing that the invasion was in part a result of their own failings, they restored some sense of control over their fate at the hands of the Iraqis. Although this necessitated accepting much of the blame themselves, it also allowed them to avoid feeling utterly helpless over the human and other losses associated with the trauma.

Some persons interviewed by the research team expressed the conviction that stricter observance of religious ritual could give them a sense of control over their destiny and protect them from the terrifying prospect of a repetition of the helplessness experienced during the occupation. Although we talked both with women and girls who did not wear traditional clothing and those who did, there was broad agreement that the number of females adopting the veil had increased during and since the Iraqi occupation. The reflections of one well-educated woman regarding the current significance of the veil provided important insights into its function in enhancing the security of the wearer:

In post-traumatic stress states there may also be profound changes in relations with others. These are characterized by isolation and withdrawal and by disruption in intimate and non-intimate relationships. Repeatedly, we heard concerns expressed about increased rates of divorce and the breakdown of trust between individuals. The survivor may engage in a repeated search for a rescuer, the active search phase alternating with periods of isolation and withdrawal. Persistent distrust of others is common.

A teenaged boy summed up the way he saw such changes:

Perhaps the most unexpected theme in our Kuwait interviews concerned disapproval of the outlook and behavior of "others" in the wake of the occupation experience. A substantial majority expressed the perception that others were more focussed on "making money" and fulfilling personal goals today than before the invasion. They perceived a broad decline in social consciousness, cohesion, and concern for other Kuwaitis. Similar themes emerged among the interviewed survivors of the wars in the Republic of Georgia in the early 1990s.

Another striking effect is a change in systems of meaning. There can be a loss of sustaining faith and a feeling of hopelessness and despair. Some of the phenomena described above, including the perception of others, ambivalence toward the perpetrator, and differential approaches to the place of religion in personal life, appear to reflect an absence of consensus in the post-trauma period in any group fragmented by violent conflict.

Treatment and recovery

There are basically three necessary stages that apply to dealing with post-traumatic states in the individual. The first is to establish security; the second, to remember and mourn; and third, to reconnect with ordinary life. Many experts in the field regard the first step, establishing safety, as an absolute prerequisite for recovery. Of paramount importance are physical security (safety of the body), the safety of the environment, the restoration of self care, the re-establishment of social networks, and concrete plans for future protection. There must also be a clear acknowledgment of the psychological harm done.

The second stage in treating an individual is remembering and mourning. One must mourn all of the losses that occurred during the period of trauma. Ordinarily, there are no customary conventions of bereavement for the kinds of losses sustained during massive trauma. Whatever means one seeks to mourn loved ones are prevented or disrupted. Even after liberation in Kuwait, losses were so numerous and widespread that there were no conventional rituals in place for appropriate bereavement. Like individuals, societies that have undergone trauma must see mourning as necessary, good, a sign of courage, and ultimately healthy. They must develop collective ways of expressing memories and effects of the trauma, so that it may be recognized and mourned rather than incorporated into the identity of the group as an unhealed wound.

The objectives of the remembering and mourning phase (Herman, 1992) are:

The final phase in helping the traumatized individual is enabling reconnection. This entails reconciliation with one’s self and reintegration into a normal life. To achieve reconciliation with the self, the individual must integrate his past identity with the positive aspects of the traumatic period and accept himself as recovering. The goal is to recreate an ideal sense of self and to recover aspirations, confidence, and initiative.

Finally, successful reconciliation requires the survivor to embrace the traumatic past in order to escape a continuing possession by it. This necessitates a full disclosure of the traumatic period. After this, it is possible to renew the capacity for tolerance and trust.

Although individuals will naturally question how they were before the aggression and will search for things that may have made them vulnerable to attack, such self-examination occurs optimally only after there is an unequivocal establishment and acceptance of the perpetrator’s sole responsibility for the trauma.

Another important aspect of reconciliation with one’s self is an acceptance of the memory of the traumatized self and of the inevitability of incomplete recovery. Stress, anniversaries, and other reminders will unavoidably reawaken memories of the trauma.

The literature on post-traumatic stress cites several criteria for recovery (see Herman, 1992):

From individual to societal identity

Assessing the signs and symptoms of post-traumatic states in individuals is relatively easy compared with the task of discerning the effects of a massive trauma on an entire society. A review of the literature regarding Post Traumatic Stress Disorder (PTSD) confirms that the overwhelming bulk of serious study in the field has concentrated on the individual, with occasional attention to relatively small groups of "survivors" of terrorist incidents or natural disasters. Two of the primary reasons for this bias are evident: the physical difficulty of dealing with large numbers and the lack, historically, of an adequate conceptual framework for ordering and processing the data involved. Even if it were theoretically possible to interview every member of a large group, the conceptual problems would not be solved because society is both more and less than the sum of all individual identities.

As children, we all develop an idea of who we are by incorporating from the adults in our group shared reservoirs, symbols, assumptions, and "history" that define the common elements of our society or culture and differentiate "our" group from "others." Normally, this is a natural process whereby adults, secure in their social identity, pass on their values, preferences, and prejudices.

The strength and durability of ethnic groups and nations derive from this natural human impulse to belong, to define identity in terms of those who are "like me" and those who are not. The resulting identity is neither inevitable nor accidental. It is the product of both conscious and unconscious decisions, shared dedication, and a common history.

When such a process of ethnic or national identity formation is interrupted by massive trauma, however, confidence in these "certainties," in the identity of the group, is shaken, and children may find themselves absorbing their corporate identity from adults who are also attempting to come to grips with a new conception of their identity.

Trauma and the ethnic "tent"

The University of Virginia’s Center for the Study of Mind and Human Interaction (CSMHI) has been a pioneer in the effort to develop theories on the integral link between the individual and his or her larger social order. CSMHI’s director, Dr. Vamžk Volkan (1997), has described this complex relationship this way:

As far as ethnicity is concerned, all the individuals under this tent–men or women, rich or poor–are equal. If they are all Polish, for example, their Polishness is not affected by such factors as social status or level of wealth. All members share equally in the Polishness of the group. As long as the tent remains stable and strong, the members of the group can go about their lives without paying too much attention to it. If the tent is disturbed or shaken, however, group members suddenly take notice, and everyone under the tent collectively becomes preoccupied with trying to make the tent strong again. At this point, rituals that maintain a balance between "us" and "them" become more prominent and more observable (Volkan, 1992).

Individuals can and do, of course, suffer trauma independent of their society as a consequence of accident, abuse, or other loss. When this occurs, the societal tent is not affected; it is not shaken. Although we do not know with any degree of precision what proportion of a particular culture need be affected before the cumulative effect begins to influence societal stability, we do know that a significant group may suffer serious localized trauma, as a result of natural disaster or a terrorist incident for example, without a discernible destabilization of society’s norms. Analysis and treatment of the individual or circumscribed group in such circumstances can proceed without reference to larger issues of societal norms and assumptions.

Individual and societal suffering merge when the shock or trauma is massive, overwhelming, and universal in the sense that it touches directly or indirectly every member of the large group. As Volkan(1992) has noted:

The individual suffers a two-fold loss, both personally and as a part of the corporate group. His or her individual identity is challenged at the same time that the encompassing societal stability is under attack, because all fellow members of the group are confronting analogous pain simultaneously.

It is not essential for all members of a society to endure the same intensity of trauma for the experience to become an ingrained aspect of group identity. Individuals who undergo imprisonment, torture, personal humiliation, and the loss of loved ones, close friends, and valued symbols are clearly most at risk of incapacitation, although some are able to develop coping mechanisms that allow them to function at some level. Where the traumatic episode is so pervasive and threatening to individual and societal survival, every member of the group shares fully in the intense feeling of loss. Those who may have escaped the more physical brutality of the event nevertheless share the awareness of loss, the sense of powerlessness, terror, and general anxiety associated with it. Their private suffering becomes interwoven indelibly with their ethnic or national identity. Personal experience becomes a part of societal "history."

When the individual and group cannot successfully mourn the tragedy that has befallen them, the trauma and feelings surrounding it are passed on to succeeding generations. They remain a dysfunctional part of the corporate identity, shaping attitudes and inspiring actions long after the actual events have faded in the society’s memory. To explain this phenomenon, CSMHI has developed the concept of the chosen trauma:

The alternative facing the victimized group appears to be a stark one: find culturally appropriate ways to "remember" and mourn its pain and loss, or allow the trauma to play a disproportionate role in shaping its sense of collective identity in unpredictable and potentially harmful ways.

The understanding and study of these phenomena in victimized groups is still in its early stages. The number of specific cases studied in depth remains small and, of course, is concentrated on instances where the group has not successfully mourned its feelings of victimization. While much more work needs to be done, we have reached a stage that permits us to suggest several possible "outcomes" of such failures. Stated briefly, these patterns seem to fall into at least five categories:

One can see such fragmentation in the states of the Old South after their defeat in the US Civil War. Scapegoating, segregation, and disenfranchisement of African Americans continued in varying degrees for nearly a century after their official emancipation in 1865, and some Southerners clung to anti-Washington and anti-government attitudes for decades.

It will be evident from the categories and descriptions above that societal maladaptations to trauma do not assume a chronic malignant form overnight. Many of the problems and conflicts apparent today trace their origins to traumas decades or even centuries old. Psychic trauma is as old as man and will remain with us always. Understanding its dynamics at an individual and societal level is the responsibility of all concerned with the treatment of emotional suffering and the prevention of perpetual cycles of trauma.

References