Intrapsychic or Interpersonal Influences on Trauma

Trauma studies have made a strong resurgence even though Freud departed from his initial recognition of the extraordinary impact of external intrusions on the psyche instead, refocusing his attention on understanding intrapsychic workings. For this, we owe him a debt of gratitude. However, turning inward instead of outward may have come at the expense of equally appreciating the potency of interpersonal-relational influences on personality development. Some, like Masson, imputed nefarious motives to Freud, raising suspicions that “the professor’s” inward turn was the result of “playing politics” with the data (patients’ reports of molestation). We now know that some patients provided false memories, supporting Freud’s prescient distinction between real and fantasized experiences, so roundly criticized by Masson and others as Freud’s falsification of the “facts” that resulted in Masson’s (self-) exile to a land “down-under.”

In his erudite essay, “Reliving with Freud,” Binion revisits the trauma issue in detailed historical perspective. He cites compelling cases showing that traumatized individuals episodically and repeatedly relive their traumatizing experiences, as opposed to “merely” re-enacting episodes or symbolically representing the traumatic experience. For example, amidst a psychoanalytic transference, a traumatized patient may confront an analyst by pointedly asking, “why did you just spit in my face?” Although patient and analyst

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both know that the analyst did not literally spit at the patient, the patient has the felt (re-) experience of having been spat on. This is reminiscent of Freud’s patient referred to by Binion, who, when feeling rebuked, experienced it as an actual “slap in the face.”

While both the literal and figurative exist simultaneously, only the literal is experienced. The actual occurrence (which pre-dated the analytic encounter by a substantial amount of time) never achieved symbolic representation simply because the ego could not wrap itself around certain horrific experience(s) in view of the fact that the emotional impact was just too great and too overwhelming for it. What could overwhelm the ego? For one thing, it may be overwhelmed by the simultaneous bombardment of massive amounts of stimuli that require immediate processing, a requirement which the individual may be hard-pressed or unable to meet. For another, the accumulation of stimuli may add up to an unmanageable totality. One could also argue the reverse, in which a dearth of stimulation (as in sensory deprivation) is traumatic. The latter are readily apparent in a child who has experienced abandonment. This supports Freud’s notion of the ascendancy of primacy over recency (i.e., excessive emotionally-laden material occurring too early in child development may be overwhelming for the rudimentary ego, and may represent an important pre-condition for the subsequent emergence of trauma). This is essentially Freud’s claim regarding premature “sexual enlightenment” that Binion refers to as Freud’s “need for a pre-pubertal sexual original of the precipitating cause in each case.”

Binion argues that Freud super-imposed his theory of the sexual origin of neurosis in childhood and subsequent trauma onto the material, often inserting it into and letting it dictate the shape of his treatment procedure. It is here that Binion makes his most strident assertions that Freud created a theory as opposed to his happening upon objective infor-

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mation based on careful observations of patients; that it was the theory which drove the treatment, instead of the other way around. Whether this is precisely what happened is not clear, although Binion poses a legitimate question and provides an interesting argument on behalf of this contention.

Similarly, the lineage of the multi-versions of the Diagnostic and Statistical Manual of Mental Disorders (DSMs) owe their bent for making diagnoses and subsequently promulgating treatments for those diagnoses, in contrast with viewing the diagnostic category as an inherent abstraction not necessarily reflective of a patient’s phenomenological reality, or learning who the patient is and finding ways of working with the patient as a unique individual.

Professor Binion contends that Freud’s use of the phrase “repetition compulsion” is not equivalent to “episodic traumatic reliving,” which Binion describes as “Contriving unknowingly to repeat an especially painful experience in disguise, and more than once as circumstances permit, is a pattern of human behavior sufficiently distinct to deserve a technical name: “episodic traumatic living.” His distinction is no minor quibble. Allowing for the conceptual existence of episodic traumatic reliving, space is thus rendered available for an emendation to Freud’s trauma theory. Binion suggests that Freud’s theory may explain aspects of traumatic neurosis, but not trauma that imposes itself on individuals at random ages (i.e., war, assault, starvation, torture, rape, etc.). While Freudian canon may help us understand how a possibly “neutral” stimulus may instigate a traumatic reaction by invoking the “deferred action” rationale, it is hard-pressed to provide a fully adequate explanation of recent traumatic reactions lacking an infantile origin.

Freud, lone pioneer in a vast psychological wilderness, found or blazed trails through emotional jungles, but, even trailblazers occasionally deviate from course. Binion

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points to instances of failed treatment outcomes as proof that Freud is incorrect. While there is truth to Binion’s observation that Freud made treatment errors, to say that the trail is entirely inaccurate because Freud went off track in his treatment procedures may equally mislead us. I suggest four alternative reasons for this: (1) Freud over-estimated his patients’ level of “health,” (2) Freud was an average to mediocre therapist, (3) Freud was just learning, and (4) Freud did not always practice what he preached. I for one am just not ready to throw out the baby with the bathwater, nor do I truly believe is Dr. Binion.

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