Tuesday, August 24, 2010

Trauma and Recovery

I'm reading Judith Herman's fine book "Trauma and Recovery: The Aftermath of Violence - from Domestic Abuse to Political Terror" published in 1992 by Basic Books.

Here's an important quote from page 58: "Restoration of the breach between the traumatized person and the community depends first, upon public acknowledgement of the traumatized event and second, upon some form of community action."

Victims of crimes may get the public acknowledgement and community action they need through the legal process of apprehending the criminal and prosecuting him/her, but that alone is rarely adequate. They also need support from family and friends and many need opportunities to express themselves. Unfortunately those who are the victims of acts of violence that may not be criminal in the legal sense are often not granted any public acknowledgement or community action. This would include, but is not limited to, victims of warfare (since war is usually "legal"), sexual harassment and abuse and physical harassment and abuse since those behaviors are only infrequently publicized and prosecuted; bullying and mobbing, both at school and in the workplace; whistleblowers; plus any form of discrimination. It's true that there are laws and policies addressing some forms of harassment and also laws and policies protecting whistleblowers. Unfortunately these laws are very weak and designed to protect the companies and corporations who otherwise might be liable for what happens to people on their campuses.
Any student or employee taking legal action against an institution or company due to their failure to provide protectection from some form of discrimination, harassment, or abuse is taking a very risky step. Virtually no individual has access to the unlimited financial and legal resources possessed by a large company or educational institution. In my own experience of being the target of a workplace bully for over two and a half years at Saint Alphonsus Regional Medical Center, and injured with PTSD (See "Workplace Psychological Abuse" on this blog for more information), I've made numerous attempts to address the problem with those involved by requesting a professional mediated conflict resolution process. My requests have been denied even though such a process would have the following advantages over litigation:

1. Cheaper
2. Quicker
3. Access to more information
4. Everyone could come out a winner
5. Not a punitive process
6. Open communication
7. More possibility of preventing similar injuries in the future
8. Increased possibility of publicity, thereby increasing awareness which
would make the community and region safer
9. Financial and other resources directed toward prevention, not retaliation
10. Would include possibility of hearing everyone point of view,
not just those who were most directly involved.
11. Better educational opportunities
12. More flexible option
13. No gag rule

A few of these overlap, but the point remains. This would be a much more efficient and inexpensive way to resolve conflicts. In spite of these advantages, management at St. Als adamantly refuses to consider this option. The reasons are obvious. Selecting a venue or process for addressing a problem that does not utilize their legal department and is not a conflict they can win while inflicting a loss on the other party, is outside their comfort area. Also their legal department would advise against choosing such a resolution because it minimizes or eliminates the role attorneys play in resolving conflicts and thereby reduces their need for attorneys. Unfortunately the losers are the citizens of this region as well as all St. Alphonsus employees.

A medical center ignoring a request to be heard from a victim violates everything that a responsible health care employer represents. It blocks healing; it foolishly implies that the company cannot make mistakes and that it has no responsibility for those mistakes when they are made, and it also makes the leaders and members of upper management look very uncivilized in their unwillingness to acknowledge the trauma. I watched the film "Food, Inc." last evening and it includes the story of a small boy who died as a result of eating a Jack-in-the-Box burger contaminated with e-coli. The boy's mother expressed her grief and disdain at the appalling behavior of those individuals who were responsible for the contaminated meat that killed her son, and their refusal to listen to her grief, to apologize, or to in any way be personally accountable. Certainly the first lesson of Civilization 101 that we should have learned in kindergarten is the lesson that when we hurt someone, we offer a sincere, public, and official "I'm sorry." Are those who refuse to do that really civilized?

Herman writes on Page 8 and 9:

"The study of psychological trauma must constantly contend with this tendency to discredit the victim or to render her invisible. Throughout the history of the field, dispute has raged over whether patients with post-traumatic conditions are entitled to care and respect or deserving of contempt. whether they are genuinely suffering or malingering, whether their histories are true or false and, if false, whether imagined or maliciously fabricated. In spite of a vast literature documenting the phenomena of psychological trauma, debate still center on the basic question of whether these phenomena are credible and real. "

"It is not only the patients but also the investigators of post-traumatic condition whose credibility is repeatedly challenged. Clinicians who listen too long and too carefully to traumatized patient often become suspect among their colleagues, as though contaminated by contact. Investigators who pursue the field too far beyond the bounds of conventional belief are often subjected to a kind of professional isolation."

" To hold traumatic reality in consciousness requires a social context that affirms and protects the victim and that joins victim and witness in a common alliance. For the individual victim, this social context is by relationships with friends, lovers, and families. For the larger society, the social context is created by political movements that give voice to the disempowered."

"The systematic study of psychological trauma therefore depends on the support of a political movement. Indeed, whether such study can be pursued or discussed in public is itself a political question. The study of war trauma becomes legitimate only in a context that challenges the sacrifice of young men in war. The study of trauma in sexual and domestic life become legitimate only in a context that challenges the subordination of women and children..."

I would like to add here that the study of psychological trauma from bullying and mobbing in the workplace only becomes legitimate if discussed in the context of employees and customers/patients at a place of employment. Does management have the right to ignore their own standards? Do they have the right to threaten someone with termination for reporting an on-the-job disabling injury as the Employee Relations Manager did to me in July, 2005? It's about how management treats their employees - everything from refusing to enforce or even follow their own standards, to the absence of unions whose presence would help protect employees and patients from injury. It's a human rights issue as well as a safety and health problem.

Herman goes on to say: "Advances in the field occur only when they are supported by a political movement powerful enough to legitimate an alliance between investigators and patients and to counteract the ordinary social processes of silencing and denial. In the absence of strong political movements for human rights, the active process of bearing witness inevitably gives way to the active process of forgetting. Repression, dissociation, and denial are phenomena of social as well as individual consciousness."

"Three times over the past century, a particular form of psychological trauma has surfaced into public consciousness. Each time, the investigation of that trauma has flourished in affiliation with a political movement. The first to emerge was hysteria, the archetypal psychological disorder of women. Its study grew out of the republican, anticlerical political movement of the late nineteenth century in France. The second was shell shock or combat neurosis. Its study began in England and the United States after the First World War. and reached a peak after the Vietnam War. Its political context was the collapse of a cult of war and the growth of a antiwar movement. The last and most recent trauma to come into public awareness is sexual and domestic violence. Its political context is the feminist movement in Western Europe and North America. Our contemporary understanding of psychological trauma is built upon a synthesis of these three separate lines of investigation."

The next form of psychological trauma that needs to addressed by society and that also needs a political movement to support the actions taken, is the very common and serious problem of workplace psychological abuse, commonly called bullying or mobbing.

Leonard Nolt

1 comment:

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