The trauma of genocide
2007; Taylor & Francis; Volume: 9; Issue: 4 Linguagem: Inglês
10.1080/14623520701643327
ISSN1469-9494
Autores Tópico(s)Migration, Health and Trauma
ResumoClick to increase image sizeClick to decrease image size Notes 1. Michele Bedard, Jennifer L. Greif and Todd C. Buckley, "International publication trends in the traumatic stress literature," Journal of Traumatic Stress, Vol 17, 2004, pp 97–101. On the origins of trauma research, see Mark S. Micale and Paul Lerner, eds, Traumatic Pasts: History, Psychiatry, and Trauma in the Modern Age, 1870–1930 (Cambridge: Cambridge University Press, 2001). 2. Project 1 Billion, Mental Health Action Plan (Rome: International Congress of Ministers of Health for Mental Health and Post-Conflict Recovery, 2004). 3. More generally, see Marcelo M. Suarez-Orozco and Antonius C. G. M. Robben, "Interdisciplinary perspectives on violence and trauma," in Antonius C. G. M. Robben and Marcelo M. Suarez-Orozco, eds, Cultures under Siege: Collective Violence and Trauma (Cambridge: Cambridge University Press, 2000), pp 1–41. 4. Robben and Suarez-Orozco, eds, Cultures under Siege, pp 1–2. See also: Bessel A. van der Kolk and Alexander C. McFarlane, "The black hole of trauma," in Bessel A. van der Kolk, Alexander C. McFarlane and Lars Weisaeth, eds, Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society (New York: Guilford, 1996), pp 3–23; and Micale and Lerner, eds, Traumatic Pasts. 5. Florence Baingana and Ian Bannon, Integrating Mental Health and Psychosocial Interventions into World-Bank Lending for Conflict-Affected Populations: A Toolkit (Washington, DC: World Bank, 2004), p i. 6. I use the term "medical sciences" in a broad, ideal-typical sense, and take it to include also those responders in the therapeutic community—whether psychologists, psychiatrists, or psychoanalysts—who might eschew the medical treatment of trauma patients. The common denominator among those categorized as members of the medical sciences is the belief in the existence of psychological trauma at the level of the individual. Most, albeit not all, of those who can be characterized as such favour the treatment of individuals and are either agnostic regarding, or worse, opposed to, the diagnosis and treatment of collectivities. 7. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th edn (Washington, DC: American Psychiatric Association, 1994). More generally, see also: Bessel van der Kolk, Lars Weisaeth and Onno van der Hart, "History of trauma in psychiatry," in Bessel A. van der Kolk, Alexander C. McFarlane and Lars Weisaeth, eds, Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society (New York: Guilford, 1996), pp 47–74; and Ruth Leys, Trauma: A Genealogy (Chicago: University of Chicago Press, 2000). 8. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, p 424. 9. Gordon H. Bower and Heidi Sivers, "Cognitive impact of traumatic events," Development and Psychopathology, Vol 10, 1998, p 626. For a quantitative data analysis, see Paul P. Schnurr, Carole A. Lunney and Anjana Sengupta, "Risk factors for the development versus maintenance of posttraumatic stress disorder," Journal of Traumatic Stress, Vol 17, 2004, pp 83–95. For a discussion of diagnostic issues in the application of PTSD, see L. Stephen O'Brien, Traumatic Events and Mental Health (Cambridge: Cambridge University Press, 1998). 10. Allan Young, The Harmony of Illusions: Inventing Post-Traumatic Stress Disorder (Princeton: Princeton University Press, 1997); Chris Brewin, Posttraumatic Stress Disorder: Malady or Myth? (New Haven: Yale University Press, 2003). 11. Patrick J. Bracken, Joan E. Giller and Derek Summerfield, "Psychological responses to war and atrocity: the limitations of current concepts," Social Science and Medicine, Vol 40, 1995, pp 1073–1082. See also: Rachel Yehuda and Alexander C. McFarlane, "Conflict between current knowledge about posttraumatic stress disorder and its original conceptual basis," American Journal of Psychiatry, Vol 152, 1995, pp 1705–1713. 12. Judith Lewis Herman, Trauma and Recovery (New York: Basic Books, 1997), p 50. 13. Richard F. Mollica, "Invisible wounds," Scientific American, Vol 282, 2000, p 55. 14. William H. Sack, Chanrithy Him and Dan Dickason, "Twelve-year follow-up study of Khmer youths who suffered massive war trauma as children," Journal of the American Academy of Child and Adolescent Psychiatry, Vol 38, 1999, p 1175. 15. Mollica, "Invisible wounds," p 55. 16. Ibid. 17. Hans Thulesius and Anders Håkansson, "Screening for posttraumatic stress disorder symptoms among Bosnian refugees," Journal of Traumatic Stress, Vol 12, 1999, p 172. For further trauma data from the former Yugoslavia, see Matt Porter and Nick Haslam, "Forced displacement in Yugoslavia: a meta-analysis of psychological consequences and their moderators," Journal of Traumatic Stress, Vol 14, 2001, pp 817–834; Patrick Smith, Sean Perrin, William Yule, Berima Hacam and Rune Stuvland, "War exposure among children from Bosnia-Hercegovina: psychological adjustment in a community sample," Journal of Traumatic Stress, Vol 15, 2002, pp 147–156; Kenneth E. Miller, Stevan M. Weine, Alma Ramic, Nenad Brkic, Zvezdana Djuric Bjedic, Amer Smajkic, Easd Boskailo and Greg Worthington, "The relative contribution of war experiences and exile-related stressors to levels of psychological distress among Bosnian refugees," Journal of Traumatic Stress, Vol 15, 2002, pp 377–387; and Stevan Weine, Daniel F. Becker, Dolores Vojvoda, Emir Hodzic, Marie Sawyer, Leslie Hyman, Dori Laub and Thomas H. McGlashan, "Individual change after genocide in Bosnian survivors of 'ethnic cleansing': assessing personality dysfunction," Journal of Traumatic Stress, Vol 11, 1998, pp 147–153. On the trauma of "ethnic cleansing" in Kosovo, see Amy L. Ali, Christopher Peterson and David Ubelhor, "War-related trauma and symptoms of posttraumatic stress disorder among adult Kosovar refugees," Journal of Traumatic Stress, Vol 15, 2002, pp 157–160. 18. Yehuda and McFarlane, "Conflict between current knowledge," p 11. 19. Mollica, "Invisible wounds," p 57. 20. Yehuda and McFarlane, "Conflict between current knowledge," p 11. 21. Jeffrey C. Alexander, "Toward a theory of cultural trauma," in Jeffrey C. Alexander, Ron Eyerman, Bernhard Giesen, Neil J. Smelser and Piotr Sztompka, eds, Cultural Trauma and Collective Identity (Berkeley: University of California Press, 2004), p 8. See also: Veena Das, Arthur Kleinman, Margaret Lock, Mamphela Ramphele and Pamela Reynolds, eds, Remaking a World: Violence, Social Suffering, and Recovery (Berkeley: University of California Press, 2001); Arthur Kleinman, Veena Das and Margaret Lock, eds, Social Suffering (Berkeley: University of California Press, 1997). 22. Alexander, "Toward a theory of cultural trauma," p 1. 23. Neil J. Smelser, "Psychological trauma and cultural trauma," in Jeffrey C. Alexander, Ron Eyerman, Bernhard Giesen, Neil J. Smelser and Piotr Sztompka, eds, Cultural Trauma and Collective Identity (Berkeley: University of California Press, 2004), p 44. 24. Sigmund Freud, Civilization and Its Discontents, translated and edited by James Strachey with a biographical introduction by Peter Gay (New York: Norton, 1961/1989); Emile Durkheim, The Elementary Forms of Religious Life, translated with an introduction by Karen E. Fields (New York: The Free Press, 1995). 25. Florence Baingana, Ian Bannon and Rachel Thomas, Mental Health and Conflict: Conceptual Framework and Approaches (Washington, DC: World Bank, 2005). 26. The literature on social capital is burgeoning—Nan Lin, Social Capital: A Theory of Social Structure and Action (Cambridge: Cambridge University Press, 2002)—remains the most sophisticated analysis. 27. Baingana et al., Mental Health and Conflict, p 10. 28. Alexander, "Toward a theory of cultural trauma," p 27. 29. Derek Summerfield, "Effects of war: moral knowledge, revenge, reconciliation, and medicalised concepts of 'recovery'," British Medical Journal, Vol 325, 2002, p 1105. 30. Luc Chauvin, James Mugaju and Jondoh Comlavi, "Evaluation of the psychosocial trauma recovery programme in Rwanda," Evaluation and Program Planning, Vol 21, 1998, p 385. 31. Chauvin et al., p 385. 32. Atle Dyregrov, Leila Gupta, Rolf Gjestad and Eugenie Mukanoheli, "Trauma exposure and psychological reactions to genocide among Rwandan children," Journal of Traumatic Stress, Vol 13, 2000, pp 3–21; see also: Human Rights Watch, Rwanda's Lasting Wounds: Consequences of Genocide and War for Rwanda's Children (New York: Human Rights Watch, 2003). 33. Dyregrov et al., "Trauma exposure," p 14. 34. Ibid, p 11. 35. Ibid, p 14. 36. Phuong N. Pham, Harvey M. Weinstein and Timothy Longman, "Trauma and PTSD symptoms in Rwanda: implications for attitudes toward justice and reconciliation," Journal of the American Medical Association, Vol 292, 2004, p 606. 37. Pham et al., "Trauma and PTSD symptoms in Rwanda," p 608. 38. Ervin Staub, Laurie Anne Pearlman and Vachel Miller, "Healing the roots of genocide in Rwanda," Peace Review, Vol 15, 2003, pp 287–294. See also: David C. Thomasma and David N. Weisstub, "Forgiving and forgetting: a post-Holocaust dialogue on the possibility of healing," Cambridge Quarterly of Healthcare Ethics, Vol 9, 2000, pp 542–561. 39. Ervin Staub, "Preventing violence and generating humane values: healing and reconciliation in Rwanda," International Review of the Red Cross, Vol 85, 2003, p 798. See also: Ervin Staub, "Genocide and mass killing: origins, prevention, healing and reconciliation," Political Psychology, Vol 21, 2000, pp 367–382. 40. Marten W. DeVries, "Trauma in cultural perspective," in Bessel A. van der Kolk, Alexander C. McFarlane and Lars Weisaeth, eds, Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society (New York: Guilford, 1996), p 407. 41. Dyregrov et al., "Trauma exposure," p 4. 42. Ibid, pp 4–5. 43. Project 1 Billion, p 12. 44. Ibid, p 12. 45. Vanessa Pupavac, "Pathologizing populations and colonizing minds: international psychosocial programs in Kosovo," Alternatives, Vol 27, 2002, p 489. 46. British Red Cross, Response to the International Federation Draft Assessment of April (London: British Red Cross, 1999). 47. Atle et al., "Trauma exposure," p 15. 48. Jens Meierhenrich, "Presidential and parliamentary elections in Rwanda, 2003," Electoral Studies, Vol 25, 2006, pp 627–634. More comprehensively, see also: Johan Pottier, Re-imagining Rwanda: Conflict, Survival and Disinformation in the Late Twentieth Century (Cambridge: Cambridge University Press, 2002). 49. Timothy Longman and Théonèste Rutagenwa, "Memory, identity, and community in Rwanda," in Eric Stover and Harvey M. Weinstein, eds, My Neighbor, My Enemy: Justice and Community in the Aftermath of Mass Atrocity (Cambridge: Cambridge University Press, 2004), p 167. 50. Eugenia Zorbas, "Reconciliation in post-genocide Rwanda," African Journal of Legal Studies, Vol 1, 2004, p 41. 51. As quoted in Human Rights Watch, Killings in Eastern Rwanda (New York: Human Rights Watch, 2007), p 11. 52. Longman and Rutagenwa, "Memory, identity, and community," p 177. 53. Alexander, "Toward a theory of cultural trauma," p 10. 54. See also Pottier, Re-imagining Rwanda, p 48. On the "trauma process," see Alexander, "Toward a theory of cultural trauma," pp 10–22. 55. Neil J. Smelser, "September 11, 2001, as cultural trauma," in Jeffrey C. Alexander, Ron Eyerman, Bernhard Giesen, Neil J. Smelser and Piotr Sztompka, eds, Cultural Trauma and Collective Identity (Berkeley: University of California Press, 2004), pp 269–270. 56. Summerfield, "Effects of war," p 1106. 57. As quoted in Summerfield, "Effects of war," p 1106. 58. Pupavac, "Pathologizing populations," pp 497, 498–499. See also: idem, "Therapeutic governance: psycho-social intervention and trauma risk management," Disasters, Vol 25, 2001, pp 358–372. 59. Jeffrey C. Alexander, "On the social construction of moral universals: the 'Holocaust' from war crime to trauma drama," in Jeffrey C. Alexander, Ron Eyerman, Bernhard Giesen, Neil J. Smelser and Piotr Sztompka, eds, Cultural Trauma and Collective Identity (Berkeley: University of California Press, 2004), p 201. 60. Stevan Weine, Yael Danielli, Derick Silove, Mark Van Ommeren, John A. Fairbank and Jack Saul, "Guidelines for international training in mental health and psychosocial interventions for trauma exposed populations in clinical and community settings," Psychiatry, Vol 65, 2002, p 157; Derek Summerfield, "Myths over the field of intervention," in Carson Becker, ed., Psychosocial and Trauma Response in War-Torn Societies: The Case of Kosovo (Geneva: International Organization for Migration, 2000), pp 45–52. On the limits of particular strategies, such as psychological debriefing, see generally the influential, so-called Cochran Report. See S. Rose, J. Bisson, R. Churchill and S. Wessely, "Psychological debriefing for preventing post traumatic stress disorder (PTSD)," Cochrane Database of Systematic Reviews, Vol 2, 2002, pp 1–32. For an exchange, see Simon Wessely and Martin Deahl, "Psychological debriefing is a waste of time," British Journal of Psychiatry, Vol 183, 2003, pp 12–14. 61. Derek Summerfield, "The social experience of war and some issues for the humanitarian field," in Patrick J. Bracken and Celia Petty, eds, Rethinking the Trauma of War (London: Free Association for Save the Children, 1998), p 34. 62. Summerfield, "The social experience of war," p 41. 63. Baingana et al., Mental Health, p 41. 64. S. Megan Berthold, "The effects of exposure to community violence on Khmer refugee adolescents," Journal of Traumatic Stress, Vol 12, 1999, p 467. 65. Berthold, "The effects of exposure," p 468. Emphasis added. 66. Daniel F. Becker, Stevan M. Weine, Dolores Vojvoda and Thomas H. McGlashan, "PTSD symptoms in adolescent survivors of 'ethnic cleansing': results from a 1-year follow-up study," Journal of the American Academy of Child and Adolescent Psychiatry, Vol 38, 1999, pp 775–781. 67. Becker et al., "PTSD symptoms," p 780. Emphases added. 68. Dyregrov et al., "Trauma exposure," p 18. More generally, see R. Ramsay, C. Gorst-Unsworth and S. Turner, "Psychiatric morbidity in survivors of organized state violence including torture," British Journal of Psychiatry, Vol 162, 1993, pp 55–59. 69. Van der Kolk and McFarlane, "The black hole of trauma," pp 16–17. 70. Florence Baingana and Ian Bannon, Integrating Mental Health and Psychosocial Interventions into World-Bank Lending for Conflict-Affected Populations: A Toolkit (Washington, DC: World Bank, 2004), p 7. 71. Mollica, "Invisible wounds," p 55. 72. Ibid, p 54. 73. Richard F. Mollica, "Mental Health 21: mental health policy and the recovery of conflict/post-conflict societies," unpublished manuscript, Harvard University, n.d., p 4. 74. Psychosocial Working Group, Psychosocial Intervention in Complex Emergencies: A Conceptual Framework (Edinburgh: Centre for International Health Studies, Queen Margaret University College, 2003). 75. Quantitative data on the consequences of trauma research for trauma victims suggest that participation for trauma survivors in such research is not harmful, and may even contribute to trauma recovery. See Michael G. Griffin, Patricia A. Resick, Angela E. Waldrop and Mindy B. Mechanic, "Participation in trauma research: is there evidence of harm?," Journal of Traumatic Stress, Vol 16, 2003, pp 221–227. 76. Derek Summerfield, "Debriefing after psychological trauma: inappropriate exporting of Western culture may cause additional harm," British Medical Journal, Vol 311, 1995, p 509. On the notion of the "techno-phenomenon," see Young, The Harmony of Illusions, p 10. 77. Ian Palmer, "Psychosocial costs of war in Rwanda," Advances in Psychiatric Treatment, Vol 8, 2002, p 18. 78. Psychosocial Working Group, Research Agenda (Edinburgh: Centre for International Health Studies, Queen Margaret University College, 2002), p 3. 79. Mollica, "Invisible wounds," p 54. 80. Primo Levi, The Drowned and the Saved (New York: Vintage, 1989). 81. Claudia Card, The Atrocity Paradigm: A Theory of Evil (Oxford: Oxford University Press, 2002), p 225. 82. Patrick J. Bracken, "Hidden agendas: deconstructing post traumatic stress disorder," in Patrick J. Bracken and Celia Petty, eds, Rethinking the Trauma of War (London: Free Association for Save the Children, 1998), p 55. 83. Marten DeVries, "Trauma in cultural perspective," in Bessel A. van der Kolk, Alexander C. McFarlane and Lars Weisaeth, eds, Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society (New York: Guilford, 1996), p 403. See also: Arthur Kleinman, The Illness Narrative (New York: Basic Books, 1988). 84. Egbert Sondorp and Anthony B. Zwi, "Complex political emergencies: we can learn from previous crises," British Medical Journal, Vol 324, 2002, pp 310–311; on the "Sphere Project," see Oxfam, Sphere Project: Humanitarian Charter and Minimum Standards in Disaster Response (Oxford: Oxfam, 2002). 85. For a contending perspective, see Joop T. V. M. de Jong, Ivan H. Komproe, Joseph Spinazzola, Bessel A. van der Kolk and Mark H. Van Ommeren, "DESNOS in three postconflict settings: assessing cross-cultural construct equivalence," Journal of Traumatic Stress, Vol 18, 2005, pp 13–21. 86. Weine et al., "Guidelines for international training," p 159. 87. International Rescue Committee, IRC Kosovo Psychosocial Needs Assessment (New York: International Rescue, 1999), p 4. 88. Brewin, Posttraumatic Stress Disorder, p 205. 89. Psychosocial Working Group, p 2. 90. Ibid. 91. Sondorp and Zwi, "Complex political emergencies," p 311. 92. Lynne Jones, "What are the psychosocial domain and the role of the mental health professional in conflict and post-conflict situations?," in Carson Becker, ed., Psychosocial and Trauma Response in War-Torn Societies: The Case of Kosovo (Geneva: International Organization for Migration, 2000), p 69. 93. Alexander Wendt, "Anarchy is what states make of it: the social construction of power politics," International Organization, Vol 46, 1992, pp 391–425. 94. Young, The Harmony of Illusions, p 10. 95. Jones, "What are the psychosocial domain," p 69. 96. Edward Balke, "Trauma and conflict," Working Paper No 02-37, Development Studies Institute, London School of Economics and Political Science, 2002, p 21. 97. Summerfield, "Debriefing after psychological trauma," p 1107. 98. For initial evidence, see Sack et al., "Twelve-year follow-up study," p 14. 99. For evidence, see de Jong et al., "DESNOS in three postconflict settings." 100. I am grateful to an anonymous reviewer for highlighting this point. For a strong criticism of this point, see Pupavac, "Pathologizing populations." 101. See, for example: Anthony J. Marsella, Matthew J. Friedman, Ellen T. Gerrity and Raymond M. Scurfield, eds, Ethnocultural Aspects of Posttraumatic Stress Disorder (Washington, DC: American Psychological Association, 1996); de Jong et al., "DESNOS in three postconflict settings"; and Maurice Eisenbruch, Joop T. V. M. de Jong and Willem van de Put, "Bringing order out of chaos: a culturally competent approach to managing the problems of refugees and victims of organized violence," Journal of Traumatic Stress, Vol 17, 2004, pp 123–131. It is worthwhile to mention in this context also Judith Herman's work, Trauma and Recovery, in which she discusses early on the politics of trauma. 102. De Jong et al., "DESNOS in three postconflict settings." See also: DeVries, "Trauma in cultural perspective."
Referência(s)