Status Updates From Trauma and Recovery: The Af...

In Chapter 2 of Trauma and Recovery, Judith Herman connects Freud’s classic concept of the compulsion to repeat with psychiatrist Mardi Horowitz’s cognitive framework, the completion principle. Both concepts address the exact same psychological puzzle: Why do traumatized individuals continuously re-experience, re-enact, or relive terrifying experiences that cause them profound distress?

Three of the men died by suicide during the course of the study. Thus, the very “threat of annihilation" that defined the traumatic moment may pursue the survivor long after the danger has passed. No wonder that Freud found, in the traumatic neurosis, signs of a
"daemonic force at work." The terror, rage, and hatred of the traumatic moment live on in the dialectic of trauma.

Because post-traumatic symptoms are so persistent and so wide-ranging, they may be mistaken for enduring characteristics of the victim's
personality. This is a costly error, for the person with unrecognized post-traumatic stress disorder is
condemned to a diminished life, tormented by memory and bounded by helplessness and fear.

They lack drama; their significance lies in what is missing. For this reason, constrictive symptoms are not readily recognized, and their origins in a traumatic event are often lost. With the passage of time, as these negative symptoms become the most prominent feature of the post-traumatic disorder, the diagnosis becomes increasingly easy to overlook.

The psychiatrist Mardi Horowitz postulates a "completion principle" which "summarizes the human mind's intrinsic ability to process new information in order to bring up to date the inner schemata of the self and the world." …The trauma is resolved only when the survivor develops a new mental "schema" for understanding what has
happened.

In his use of language, Janet implicitly recognized that helplessness constitutes the essential insult of trauma, and that restitution requires the restoration of a sense of etticacy and power.

Because the repetition compulsion seemed to defy any conscious intent and to resist change so adamantly, Freud despaired of finding any adaptive, life-affirming explanation for it; rather, he was driven to invoke the concept of a "death instinct."

He first conceptualized it as an attempt to master the
traumatic event. But this explanation did not satisfy him. It somehow failed to capture what he called the
"daemonic" quality of reenactment.

There is something uncanny about reenactments
Everwhen they are consciously chosen, they have a feeling of involuntariness. Even when they are not dangerous, they have a driven, tenacious quality.
Freud named this recurrent intrusion of traumatic experience the "repetition compulsion."

“Post-traumatic play is so literal that if you spot it, you may be able to guess the trauma with few other clues." Adults as well as children often feel impelled to re-create the moment of terror, either in literal or in disguised form. Sometimes people reenact the traumatic moment with a fantasy of changing the outcome of the dangerous encounter.

Similarly, Roy Grinker and John Spiegel observed that traumatized soldiers of the Second World War "Eventually the soldier is removed from the environment of stress and after a time his subjective anxiety recedes. But the physiological phenomena persist and are now maladaptive to a life of safety and security."

“The many symptoms of post-traumatic stress disorder fall into three main categories. These are called "hyperarousal," "intrusion," and "constriction." Hyperarousal reflects the persistent expectation of danger; intrusion reflects the indelible imprint of the traumatic moment; constriction reflects the numbing response of surrender.”

“According to the Comprehensive
Textbook of Psychiatry, the common denominator of psychological trauma is a feeling of "intense fear, helplessness, loss of control, and threat of annihilation."

“Traumatic events are extraordinary, not because they occur rarely, but rather because they overwhelm the ordinary human adaptations to life. Unlike commonplace misfortunes, traumatic events generally involve threats to life or bodily integrity, or a close personal encounter with violence and death. They confront human beings with the extremities of helplessness & terror, and evoke the responses of catastrophe.“