Summary
Chapter 11—Uncovering Secrets: The Problem of Traumatic Memory
Van der Kolk was tasked with discerning whether a young man's resurfaced memories of childhood sexual abuse were credible. The man, whom van der Kolk calls Julian, was so affected by fragmented memories that it hindered his career. The passage of time, the fact that personal narratives can influence memory, and the level of arousal one experienced during the catalyst event are three factors that van der Kolk takes into account when considering the complexity of psychological assessments in legal cases. Humans are wired to remember negative events more than positive ones, and this negativity bias has helped our species survive by recognizing and responding to potential threats. Van der Kolk explains our likelihood to "remember insults and injuries best" from a neurochemical perspective: we secrete adrenaline in the face of threats. However, this doesn't always apply to traumatic experiences, which can overwhelm and fracture memories.
Chapter 12—The Unbearable Heaviness of Remembering
Van der Kolk recounts some of the overall trends in scientific interest in trauma in the past 150 years. A fierce debate and political storm over the term "shell shock" raged during and after the First World War. The World Wars, new technologies, and sociopolitical events influenced the political and medical understandings of trauma. Van der Kolk states that widespread denial of trauma in Germany set the stage for the rise of Nazism. Around the Western World, the scientific consensus was generally that severe disturbances in veterans were actually character defects. A larger debate surrounding memory loss and what was known as False Memory Syndrome ensued. Van der Kolk points out that the Diagnostic and Statistical Manual of Mental Disorders recognizes the existence of memory loss for traumatic events in the diagnostic criteria for dissociative amnesia.
The chapter ends with the story of a woman named Nancy who was given insufficient anesthesia during a laparoscopic tubal ligation. Nancy's marriage, home life, and grip on the present moment began to unravel. Eventually, she sought support from a psychodynamic psychiatrist and began practicing Pilates. These contributed to her healing.
Analysis
In Chapter 11, van der Kolk broaches the complexity of psychological assessments in legal cases involving child abuse. In legal contexts, it is not just professional psychologists and psychiatrists who evaluate defendants or contribute to the case. Witnesses provide firsthand accounts or expert opinions relevant to a case. Jurors are expected to be impartial and unbiased when they analyze the evidence and deliver a verdict. But new research has challenged the possibility of truly unbiased interpretations. According to psychologist, researcher, and educator Dr. Lisa Feldman Barrett, "Every perception, no matter how objective it seems to the witness, is infused with personal beliefs" (Barrett). In addition, she argues that emotions are not universally expressed or recognized, which means that jurors cannot reliably discern a defendant's real feelings. This has serious implications for the equitable administration of justice.
Van der Kolk identifies large-scale examples of what happens when trauma is denied on a societal level. For instance, he argues that the "intolerance of 'weakness' played an important role in the rise of fascism and militarism around the world in the 1930s" (Chapter 12). German society's humiliation following the First World War, coupled with the rejection of traumatized war veterans, helped set the stage for the rise of Nazism. Social stigma, disillusionment, and the appeal of radical right-wing paramilitary groups also contributed to the "Stab-in-the-Back" Myth, which was a conspiracy theory that claimed that the German army did not actually lose the war on the battlefield. Instead, the myth purports that the army was betrayed by civilians and politicians on the home front. In his book The Great War and German Memory: Society, Politics and Psychological Trauma, 1914–1945, historian Jason Crouthamel writes that "conservative doctors and political groups...believed that 'war neurosis' was not a real wound, but only a cover for men trying to shirk their duty at the front."
In one sense, storytelling plays an important role in the therapeutic treatment of trauma. Van der Kolk describes his goal with his patients as helping them associate and integrate the fragments of trauma into the ongoing narratives of life. This would help their brains mark a clear distinction between the past and the present. However, forming and sharing a coherent narrative alone does not always resolve the trauma. Though Part 5 goes into the need for physical approaches to dealing with trauma, van der Kolk ends Part 4 by describing a particular patient of his who succeeded in dealing with her trauma through a "combination of core strengthening—psychological, social, and physical" (Chapter 12). This shows that a top-down approach (which primarily focuses on changing a person's thoughts and beliefs) is not always enough. Instead, a holistic method that engages the body, mind, and brain cultivates healing and resilience.
Van der Kolk briefly mentions the role of literature and art in memorializing the horrors of World War I, a time "when politics and medicine turned their backs on the returning soldiers" (Chapter 12). Literature and art have always offered unique avenues for representing trauma when other types of discourses fail or attempt to suppress. Visual art parallels the way that trauma initially transcends verbal language. Van der Kolk writes several times about the speechless horror of traumatic experiences in which a person's capacity for language is overwhelmed by intense sensations, emotions, and survival instincts. There are numerous artistic examples of this, but perhaps one of the most iconic is "Edvard Munch's "The Scream." In the painting, a figure covers its ears and tries to block out a piercing scream sweeping through the landscape. The striking color palette conveys emotional intensity, and the swirling brushstrokes exude a sense of chaos. The painting articulates turmoil and isolation. While its scope is not limited to trauma, "The Scream" does parallel the speechless horror that traumatized individuals often experience.
These chapters demonstrate that van der Kolk aims not just to help individuals struggling with the devastating impacts of trauma, but also to change wider cultural understandings. By providing an overview of the fluctuations of scientific interest in trauma over the last 150 years, van der Kolk demonstrates the way that culture shapes both the expression and treatment of traumatic stress. Factors like stigma, meaning-making processes, and acceptable coping mechanisms are interconnected in terms of establishing the norms surrounding mental health challenges.
