tle of Investigating Post-traumatic Stress Disorder Symptoms and Recovery in Kurt Vonnegut’s Novel: A Psychoanalytical Reading of Slaughterhouse-Five consists of five chapters: The first chapter presents the problem, the framework, and the argument which includes the following sections: General Overview, Statement of the Problem, Objectives and Significance of the Study, Review of Literature, Materials and Methodology, Organization of the Study, and the last section, Works Cited. Objectives and Significance of the Study consists of four parts: Hypothesis, Significance of the Study, Purpose of the Study, and Research Questions. Materials and Methodology is also divided into two parts: Definition of Key Terms, Motivation and Delimitation.
The second chapter, entitled “Trauma Theory: A Critical Introduction,” critically investigatesJudith Herman’s theories of trauma and its recovery. Chapter Three is a practical reading of the novel, Slaughterhouse-Five while examining thetraumatic narrator as well astraumatic Billy Pilgrim.
The fourth chapter seeks to demonstrate Signs of Recovery in Slaughterhouse Five. The novel will be studied according to Herman’s main keywords in this field and its practice on the narrator and Billy.
ChapterFiveis the conclusion of the study. The proposedquestions and discussionsshall be settled in this chapter, which also contains some suggestions for further readings. Finally Bibliography of the research including the primary and secondary sources, presents thefinal section of this dissertation.
Trauma Theory: A Critical Introduction
The present chapter seeks to closely address the major definitions, theories, and steps for treatments of traumatic experiences in terms of the psychoanalytical approaches and more specifically based on the theories of Judith Herman. It consists of the following sections: first, Trauma: Definitions and Subcategories which gives definitions of the term and its diagnostic criteria since its emergence in the American Psychiatric Association, APA, as a new illness. The next part, discusses how these events vary on many different dimensions apart from personality factors which are also closely associated with an increased likelihood of developing the PTSD. Part four gives some historical accounts of the illness from diaries in the seventeenth and nineteenth centuries to the explosion of literature and interest in the concept by development of workmen’s compensation acts in the late nineteenth century and also the wartime experiences of the two World Wars and the Vietnam War. The last part introduces some influential figures in this field who were in way pioneers. However the main focus is on the theories of Judith Herman.
2.2 Trauma: Definitions and Sub-Categories
The notion of trauma has no straightforward definition. It has been used in a variety of ways by researchers. The origin of the term is derived from the Greek traumatizo, meaning to wound, which signified a blow or shock to the bodily tissues which let to injury or disturbance. This medical concept was later extended to encompass the structures of the mind, developing a more psychological and social reference (Trauma and Life Stories, 2)
In 1980, the American Psychiatric Association, APA, included in the new edition of its official diagnostic manual the symptom indicators for a new illness, Post Traumatic Stress Disorder (Roger Luckhurst, 1). This was an attempt to describe the clinical characteristics exhibited by survivals of traumatic events. Although there have been several revisions to the criteria, much debate remains over the architecture of PTSD symptomatology and in particular the definition of trauma (Joseph, Williams, and Yule, 33).
In the diagnostic criteria of the American Psychiatric Association, a person is exposed to a traumatic event in which both of the following were present “(1) the person experienced, witnessed, or was confronted with an event or events that involved actual threatened death or serious injury, or a threat to the physical integrity of self or others. (2) The person’s response involved intense fear, helplessness, or horror” (APA, 467). To be classified as traumatic, an event must be perceived and processed as serious enough to challenge basic assumptions of safety, predictability, justness, and fairness (Handbook of Post –Traumatic Therapy xiii)
Individuals who experience extreme ‘stressor’ events such as accidents, natural disasters, technological disasters, combat, criminal victimization, sexual assault, childhood sexual abuse, political violence refugees, event factors, seem to produce certain identifiable somatic or psycho-somatic disturbances (Joseph, Williams, and Yule, 52). Aside from myriad physical symptoms, trauma disturbs memory, and therefore identity, in peculiar ways (Roger Luckhurst, 1).
A traumatic stress reaction is a normal reaction to the abnormal stressor events. If that reaction continues for a period of at least one month, whether that reaction occurs immediately after the event or at some point in the future, the reaction becomes a post-traumatic stress disorder (PTSD) if the required number of symptoms is present. The primary components of the reaction are re-experiencing, avoidance/withdrawal, and physiological arousal. Associated features of generalized anxiety, depression, grief, and guilt frequently coexist with the primary symptoms. (Handbook of Post –Traumatic Therapy, xiv)
Charles R. Figley in Trauma and Its Wake defines Post-Traumatic Stress Reactions as” a set of conscious and unconscious behaviors and emotions associated with dealing with the ‘memories’of the stressor of the catastrophe and immediately afterwards.” A Post-Traumatic Stress Disorder is “the clinical manifestation of the problems associated with trauma induced during the catastrophe and represented by the post-traumatic stress reactions”. He compares these terms with casting a pebble into a pond, the initial wake as Traumatic Stress Reaction, the subsequent ripples as Post-traumatic Stress Reaction, and the destruction resulting from the waves as the disorder (xviii-xix). According to the American Psychiatric Association those confronted with traumatic experience are diagnosed with PTSD (post-traumatic stress disorder) if they present certain clusters of symptoms:
A. Re-experiencing the traumatic event as indicated by one or more of the following ways: “(1) recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. (2) Recurrent distressing dreams of the event. (3) Acting or feeling as if the traumatic event were recurring (includes a sense of relieving the experience, illusion, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated). (4) Intense psychological distress at exposure to internal or external cues that symbolize or resemble as aspect of the traumatic event. (5) Physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of traumatic event” (APA, 468).
B. Avoidance of stimuli in three (or more) of the following:”(1) efforts to avoid thought, feelings, or conversations associated with the trauma (2) efforts to avoid activities, places, or people that arouse recollections of the trauma (3) inability to recall an important aspect of the trauma (4) markedly diminished interest or participation in significant activities (5) feeling of detachment or estrangement from others (6) restricted range of affect (e.g. unable to have love feelings) (7) sense of a foreshortened future (e.g. does not expect to have a career, marriage, children, or a normal life span)” (APA, 468).
C. Increase arousal by two or more of the following: “(1) difficulty falling or staying asleep (2) irritability or outbu
t of anger (3) difficulty concentrating (4) hyper vigilance (5) exaggerated startle response” (APA, 468).
According to this manual the onset and duration of symptoms are indicated by the following specifiers: acute, when duration of symptoms is less than 3 months; chronic, if the duration is 3 months or more; delayed onset, whenever the onset of symptoms is at least 6 months after the stressor. (APA, 468-469).
2.3 Dimensions and Personality Factors
Traumatic events differ on many different dimensions, identified as follows: the degree of life threat, bereavement or loss of significant others; the rate of onset and offset, the duration and severity of the stressors; the level of displacement or dislodging of persons from their community; the exposure to death, , injury, destruction, and social chaos; the degree of moral conflict inherent in the situation; the role in the trauma( agent, victim); the location of the trauma ( home or elsewhere); the complexity of the stressor; and the impact of the trauma in the community. Each of these stressor dimensions can be linked to the post-traumatic symptomatology independent of the personality traits of the person. Traumatic events can be experienced alone, with others, or in the context of a community-based experience. When the trauma is experienced alone, the individual may feel helpless, terrorized, fearful, vulnerable, and at the mercy of fate. In groups, the effects of a trauma may be different (Handbook of Post-Traumatic Therapy, 10).
Not all survivors of traumatic events go on to develop severe or chronic distress. The experience is not a sufficient cause; various psychosocial factors must either mediate or moderate. It would seem that personality factors (including previous mental history) are associated with an increased likelihood of developing PTSD (Joseph, Williams, and Yule, 107). However it does not seem that these factors are necessary for the development of the disorder. The personality variables in determining reactions to traumatic events include motives, traits, beliefs, values, abilities, cognitive structures, mood, and defensive and coping styles, as well as genetic propensities (Handbook of Post –Traumatic Therapy, 10).It is not just what happened that matters to people but also what it means to them in relation to their sense of who they are, the world they live in and what their expectations are for the future. Traumatic events can challenge the whole meaning of a person’s life. One person might interpret an event as a lucky escape, whereas another person might consider the same event as a catastrophic misfortune which proves that life is meaningless. (Joseph, Williams, and Yule, 3)
The importance of understanding the role of psychosocial factors in the development of the post-traumatic stress reactions is that, unlike the traumatic event itself, they are potentially modifiable and therefore they could be targets for therapeutic interventions. For example, techniques can be aimed at examining the way in which a person makes sense of the experience and how he or she copes with what has happened(Joseph, Williams, and Yule, 3).Indeed personality factors help to shape the specific cognition of the traumatic event which in turn helps to determine the nature and intensity of emotional states, such as guilt, shame, fear, or rage. Cognition of emotional states influence the choice of coping strategy and level of social support received which would seem to be useful in helping to explain the individual differences in the severity and chronicity of reaction of survivors to take into account the role of stimulus, appraisal, personality, state, and activity factors(Joseph, Williams, and Yule, 107).
2.4 Traumatic Experiences: Historical Accounts
It is apparent from historical accountsthat psychic effects of traumatic experience were by no means new. Samuel Pepys, writing his diary in 1667, outlines the progression of the fire toward his home, and his subsequent