2. Trauma Avoidance Vs. Trauma Transformation

I have argued elsewhere (Reisner 2003) that most responses to trauma, particularly group or social responses, are aimed at trauma avoidance. Circumstances which tend to produce international aid, such as war, political and ethnic violence, and natural disasters of a huge scale, are by their very nature, challenges to human beings' sense of safety and order. They are potentially traumatizing both to those who experience the tragic circumstance and those who offer help afterwards. Each group marshals, according to their capacity, trauma avoidance mechanisms. Often these mechanisms are at odds.

So, for example, after September 11th, Americans from outside of New York City, frightened by the events they had watched on television, responded with the particularly American cultural response to trauma: they sought to identify the innocent suffering children and to express sympathy and attempt to alleviate their suffering. One way this was done was evidenced by thousands of stuffed animals raining down on schoolchildren in downtown New York (so many, that there is, at this writing, still a warehouse full of the overflow of these toys and animals). This collective response can be understood as an attempt on the part of Americans to cope with their own feelings of vulnerability, terror, and helplessness, by focusing their attention on the fantasy of comforting these distant children. It may have given the senders some relief. But for the most part, these stuffed animals, with their comforting notes, served as constant reminders to the children that they were thought of as suffering and scared, reminders that something terrible had happened nearby. The children's own processes of coping and healing (and avoidance) were repeatedly interfered with by these intrusions, as they had to contend with the coping mechanisms of so many others.

To be fair, New Yorkers, too, imposed their fantasies of need and care onto these children; the professional community and the press collaborated to overwhelm them with therapy, assuming, without appropriate assessment, that more traditional mechanisms to help them cope with their loss and their fear were not up to the task. (Not surprisingly, older children made little use of this tidal wave of treatment, preferring more familiar processes to avoid dwelling on the fearful aspects of the loss.)

Similarly, many international psychosocial interventions in trauma, in Kosovo and elsewhere, overtly offer trauma treatment while covertly undermining traditional mechanisms for dealing with trauma.

Overtly, there is an attempt to treat the traumas of war, genocide, and exile using accumulated clinical knowledge. To accomplish this, creative mechanisms are being employed to allow the safe confrontation and working through of the traumatic experience and the repair to the functioning of the social system, which has been traumatized by the recent war, the exile, and the murder of so many non-combatants solely because of their ethnicity.

Yet simultaneously, and this is most often unacknowledged, there is the attempt to deter the survivors of traumatic circumstance from using their culturally familiar methods to avoid being traumatized by these circumstances when those methods clash with the values and fantasies of the therapists or the aid organization.

The therapists and aid organizations often bring with them an image of those they are trying to help, not unlike the image therapists and altruists from across the country projected onto the children of New York City. For example, it is not unusual for those who offer international aid and comfort to harbor the presumption that victims of political violence will welcome what the international community has to offer: the human rights perspective, which validates their experience of trauma and offers a forum for condemning the abuses they experienced. But the presumption that victims of such abuse would welcome the precepts of the Universal Declaration of Human Rights is often simply not the case, as many victims of political violence are no more interested in extending such rights to their enemies than their enemies were toward them. Nor are they eager to change traditional culture to suit the values of the international organizations that suddenly hold economic and often political power; in fact, it is not unusual for culturally familiar modes of coping with trauma to stand in opposition to those values.

Cultural mechanisms to avoid traumatization which are thus overtly or covertly frowned upon may include, but are not limited to: fantasizing or carrying out revenge strategies; strivings for an ethnically or religiously unified environment; sanctioning social models which are traditional and non-egalitarian; isolating certain segments of the population as cultural scapegoats; espousing a religious system which depicts the suffering as somehow holy or valuable, guaranteeing a better life in the next world.

These methods do not fit the Western image of the traumatized as innocent, isolated sufferers, whose lives are to be restored to their prior idealized state; nor do those who practice these methods make for useful objects of sympathy and narcissistic identification. If, as Losi (2001) has argued, the covert structure of Western international intervention is defined (by those who intervene) in tripartite terms: the foreign or political aggressor, the displaced, disenfranchised victim, and the international savior, most often those receiving foreign aid resent and resist the passive, grateful victim role that is offered them. However, their own culturally sanctioned responses to trauma (which in Kosovo, and elsewhere, include practices of revenge) are often a direct challenge to the position offered and paid for by the well-heeled aid organizations.[2]

The unfortunate result of the covert attempt to deter survivors from using familiar methods to avoid the traumatic effect of traumatic circumstances is that it supports a lack of understanding and communication between the parties. Experts in the field of international trauma intervention have long been puzzled by the fact that psychosocial treatment does not reduce the incidence of revenge or violence (Jensen, personal communication) following genocidal clashes. But this is not surprising, since most international trauma treatment covertly suppresses acknowledgement of such culturally sanctioned, collective modes of response, while, as in Kosovo, international military intervention suppresses organizations whose aim is to carry out such responses. In this way, trauma treatment, like much international intervention, becomes an unacknowledged struggle to influence the outcome of treatment according to the values and fantasies of the therapists.