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PTSD and the cultural brain: a review of Erin P. Findley’s War and Dislocation: A Neuroanthropological Model of Trauma Among American Veterans with Combat PTSD

3/23/2016

23 Comments

 

by Mirjam Holleman

​In this excellent chapter, Erin P. Findley describes the intersectionality between (post-traumatic) stress, the brain, and the cultural environment.  She highlights four key elements of the PTSD experience  - stress and horror, dislocation and grief - and unpacks their neurological, psychological, and cultural underpinnings.
 
In an environment of prolonged and/or intense stress and danger, the brain undergoes a “neurobiological reshuffling” (p. 269) and is left with an “altered architecture” (p. 274). This shift signifies an activation of survival mode, in which humans react more quickly and more strongly/definitively, yet at the expense of an ability to focus, learn, or retain information not related to a direct threat (p. 269), as well as the ability to filter out relevant from irrelevant stimuli or information (p.270).  In other words, the brain interprets everything as danger or a potential threat, without ‘wasting time’ on cognitive task (such as focusing and accurately interpreting a situation) that are of lower priority in a situation where danger is ever present and unpredictable.  One feels threatened by everything, and (re)acts accordingly.“Rockstroh & Elbert have observed that repeatedly stressed brains appear to use what they call a ‘low-road’ for sensory processing that speeds up the ability configure a threat responses [i.e. react to stressors] by bypassing the prefrontal cortex’s [….] ability to analyze complex data and regulate emotion accordingly” (p. 274)
 
This response may be adaptive and necessary in a combat zone.  However, this ‘hyper-vigilance’ and fast and strong reactions to anything that might be a threat – bypassing all rational thinking processes and cognitive filters to determine whether something actually is a relevant threat and how to respond appropriately, in the interests of responding quickly – may not be appreciated or rewarded in other contexts or environments.  For example, the PTSD brain is frequently met with considerable repercussions when this ‘low-road’ response carries over into everyday social interactions.
One old veteran sheepishly recalled loosing his cool at the grocery store – not as a result of any direct threat, but because he felt the cashier had been rude to the elderly women ahead of him in line. He perceived that the young cashier had failed to show proper respect to a vulnerable elder. The source of his anger, therefore, was entirely justified within the cultural setting, although his means of expressing it – in this case, by yelling at the cashier - was not, and provoked considerable disapproval from his wife, who witnessed the exchange (p. 275).
Thus the neurological architecture that may trigger an adaptive response in an environment of actual danger may simply be interpreted as ‘overreacting’ when the danger is gone, but the ‘altered architecture’ remains.
 
This brings us to the next theme in the PTSD experience- the experience of ‘dislocation,’ referring to a sense of “uncomfortable distance” from others in their lives, from feeling at home and safe in the world, from earlier modes of perceptions and ways of reacting, or from some prior, preferred, sense of self.
​
While it is becoming increasingly known that prolonged and/or severe stress may lead to an ‘altered architecture of the brain,’ it is important to consider how this altered state interacts with prior personal experiences and societal expectations of self. “For example, if a veteran has always prided himself on being a calm and easy going guy, then finding himself continually on edge and on guard may prompt a crisis of identity” (p. 275).  And as the above anecdote of the man in the grocery story illustrates, the neurological experience of PTSD is further mediated by cultural expectations and social reactions of others. Is the veterans’ change in behavior interpreted as: ‘he’s overreacting because the PTSD is affecting his brain’ or ‘he’s being a baby or a jerk?’  As noted earlier, the individuals themselves frequently struggle greatly with these changes in themselves; this distress at a sense dislocation from self may be compounded greatly by an additional sense of dislocation from other people when “friends and family members who are not well acquainted with PTSD may blame the veteran rather than the illness for unpleasant changes in behavior and attitude, often resulting in damaged relationships” (p. 275).  It is these personal, social, and cultural dislocations, rather than the stress and horror associated with trauma alone, that lead to the third aspect of combat trauma: Grief. “Grief, then, results from veterans’ internal and external dislocations; bereavement and interpersonal loss; being rent from a previously cherished view of self; overwhelming distress at finding the world can be without order, sense, or safety; and gaps in experience and understanding that lead to feeling distant from loved ones” (p. 279).
 
Thus, Findley offers a holistic view in which PTSD, or the pathways through which traumatic experiences and the accompanying stress are experienced, is presented as simultaneously neurological (caused by a “neurological reshuffling”), psychological (related to past experiences, individual disposition, and sense of self), social (tied in with the immediate reactions of others) and cultural (a desire to conform to expected socio-cultural norms of behavior and managing emotions).   In this way, the model that Findley presents does an excellent job of capturing the neuroanthropological consideration of  “how culture, experience, and biology come together” (p. 282).  I would further like to emphasis that from an anthropological perspective, ‘the biological,’ ‘the psychological,’ ‘the social and the cultural’ are of course not stand-alone factors that each contribute to the experience of PTSD, but each also shapes the other. For instance, personal expectations of self are closely linked social cues of what kind of dispositions are rewarded in ones’ environment, and these social expectations are in turn embedded within broader cultural norms and values regarding proper conduct and management of emotions and impulses.
 
Such an understanding of the interplay between the neurological, psychological, social, and cultural aspects of a phenomenon such as PTSD ought to encourage (mental) health care providers to take a holistic approach in their treatment plans, and “look beyond the psychological symptoms […] to imagine responses that go beyond clinical treatment” (p. 285). I imagine such an approach would be useful not just in the treatment of PTSD, but in any kind of treatment or intervention.
 
 
Findley, Erin, P. 2014. “War and Dislocation: A Neuroanthropological Model of Trauma Among American Veterans with Combat PTSD.”  In The Encultured Brain: An Introduction to Neuroanthropology, eds. Daniel H. Lende, & Greg Downey, 263-290, Cambridge, Massachusets: MIT Press.
23 Comments
Edward Quinn
3/29/2016 08:22:48 am

I'd like to expand on your last sentence, Mirjam. A holistic approach to health is consistently taken by medical anthropologists because it allows us to see the full picture of all the different factors (cultural, political-economic, psychological, etc.) that drive differential well-being. It is argued that this allows for better understanding. At the end of her chapter, Finley makes the argument that we can do more for veterans using the model of PTSD that she describes, which is a more holistic model than the traditional model of PTSD. To me, the obvious next step is to test this proposition, but I wonder how realistic it would be to actually do this. How many clinical psychologists would be willing to sit down and listen to Finley, learn about her model for PTSD, and then incorporate the model into their treatment of the disorder? Could a study be set up in which PTSD treatment in one group (traditional treatment) is compared to a second group (treatment based on Finley's model), the dependent variable being veteran PTSD treatment outcomes? Such tests might strengthen the case medical anthropologists make for more holistic views on well-being.

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Issac
3/29/2016 04:10:23 pm

Furthermore, I think the author fails to explain the necessity to integrate this model of PTSD. Of course as anthropologists we would prefer a more holistic model in any case, but what is wrong with the traditional model? What are the problems and weaknesses of the current and past methods of treatment of our veterans? I think this chapter lacks a strong critique of the current/ traditional model of PTSD. Neglecting to critique the methods that the author wishes to change or advance weakens the authors argument in supporting a need for this more holistic model.

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Issac 2nd post
5/4/2016 01:46:29 pm

This is an example of one of the cases that I was referencing when I said that neuroanthropology , in my opinion, has good potential because it is studying things that need our attention. Addiction, depression, autism and PTSD are all serious topics. PTSD and the treatment of our veterans is even part of the platform of at least two presidential candidates this year. By focusing on things like PTSD I think neuroanthropology will gather more support and interest from the public.

Edward Quinn (2nd Response)
4/28/2016 07:16:28 pm

After further reading in neuroanthropology, Finley's model of how PTSD occurs seems like a particularly good model for future studies in neuroanthropology to follow. Lende and Downey make this point in the final chapter, and I couldn't agree more with them. Studies following Finley will focus on processes rather than static analyses. Culturally mediated processes can be explored using ethnographic methods. A deep anthropological understanding will be informed not only by emic perspectives, but also by historical, political-economic, and critical perspectives as well. Finley's model seems to easily lend itself to these types of analyses, which move up and down scales of analysis, from cells to society.

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Jessica Muzzo
3/29/2016 12:19:10 pm

Combining a few of our readings, I am interested to know how genetics and biology might play a part in the experience of PTSD.

Dressler's article, which we have also been assigned to read this week, discusses the role genotypes (specifically coding for serotonin uptake regulation) play in the impact of cultural consonance on depressive affect. The idea of cultural consonance--adherence to perceived cultural values--as it relates to mental distress ties in well with the 'loss of identity' soldiers experience when their ideas of war-time action don't match up with real happenstance. They have an idea of what the "normal soldier" does, heroic images gathered from hollywood movies and trumped-up locker-room talks with guys who have (probably) never been in battle themselves. When they get into a war-zone, however, and their fight-or-flight reflexes prevent them from saving the whole battalion and single-handedly winning the war, their ideas about themselves crumble. They do not fit their former image of themselves, and they don't fit their image of what they should be. If this concept of cultural consonance relating to depression is demonstrable in Brazilian social salience, then it may be exponentially more so in a war-type situation (considering the effects heightened emotions have on memory and meaning-making). If serotonin pathways do, indeed, affect the impact of cultural consonance on mental wellbeing, how does this come into play in soldiers' experiences of PTSD?

Earlier in the year, we discussed innate 'temperament' as defined by Worthman, and how child 'reactivity' is a decent indicator of behavioral problems erupting in a negative developmental environment. Could this temperament discussion, then, be tied into a study of cultural consonance and serotonin?

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Paige Ridley
3/30/2016 07:23:54 am

I thought Finley’s article was very interesting by starting out her article with how she was first introduced to PTSD for the very first time. It is has been said that pictures are worth a thousand words. As the soldier moved from one image to the next it was clear to see through his emotions and body language that he was reliving parts of his terrifying past of the war environment. Finley defines trauma as “the direct result of social environment, reflecting structural inequalities and political economic conditions as much as one individual’s stress” (Pg 265).

The environment, the structure of routine and the current political standings are the foundations that stress begins to build on. I thought it was very interesting that a parent with PTSD can pass along certain behavior patterns and attitudes about society to a child. When I first read this statement I was shocked but then I began to realize that it was part of the structure that an individual grows up in. I instantly linked this to racism as babies we do not differentiate between children who are African American and White. But as we get older our parents have engrained it in our minds that we should not associate with others who are not like us or even in our social classes. Society has created this structure that is hard to differentiate from when you have grown up in the same household and family structure for the last 18 years. It too can be noted as a monster of society.

The soldier then recalls comparing himself to an “action movie- like image of the perfect warrior” (Pg. 271). When under heavy amounts of stress it is hard to see the reality of the situation. He recalls the event to be humiliating personal failure but then is quick to make the comparison above. In the end when want to remember being a hero and not a failure even in the lines of battle.

I agree with Isaac what is wrong with the old model. It might have been just as easy to take the old model and manipulate it to have a more holistic approach rather than create an entirely new one. I wish Finely would have brought in more insight into how the older model was used less efficiently than hers.

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Paige Ridley
4/26/2016 10:01:49 pm

This entire discussion really had very valid points. In order for an individual who is suffering from PTSD to be diagnosed properly it is important that our health departments improve. It is also very beneficiary to see the struggles and understand what an individual is going through. PTSD is not a group diagnosis but should be diagnosed as an individual. In order to make sure that the studies that are being conducted it is important to meet the patient in their environment so the anthropologist can see how each person reacts and why

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Nick Roy
3/30/2016 07:24:45 am

I find the interaction between culture, brain, and mental illness to be very fascinating coming from my background in psychology. Furthermore, I am interested in applying this idea beyond PTSD and other trauma-related illnesses. In clinical psychology, there is an entire class of disorders that, though their etiologies are much different than PTSD, are similar in that they are often life-long chronic illnesses that consist of deeply integrated mental systems and are highly resistant to therapy. These are called personality disorders.

The most commonly known personality disorders are likely paranoid, borderline, antisocial, and dependent personality disorders but there are many more. While nebulous and hard to classify, each is characterized by a certain set of personality traits that cause dysfunction. This dysfunction is often framed in terms of interpersonal relationships as, unlike many other mental illnesses, many personality disorders do not directly harm the patient. I think understanding the link between mental illness and culture can greatly assist in both how we understand personality disorders and how we distinguish what is dysfunctional from what is not.

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Nick Roy
5/4/2016 11:09:49 am

One of the reasons why anthropology was so appealing to me was the incorporation of culture into the social sciences. Psychology has had a problem in incorporating culture into its theories for reasons that have already been discussed in class. When psychology doesn't take culture into account in studying mental illness, it loses a key component of human experience that could help in understanding how mental illness is caused and how it develops.

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Kelly Likos
3/30/2016 08:34:46 am

I found the call for a holistic approach to PTSD treatment interesting.

One part of this subject that is important to remember is that the “combat zone” of a PTSD patient is not uniform. There can be different types of “combat zones” from various traumatic events. Taking note of these fluctuations is important to the holistic treatment of PTSD. The individual experience should be taken into account when approaching a treatment method for PTSD patients. The biological reactions of the body, along with the psychological reactions of the brain must be treated together.

Those who experience PTSD develop a sense of “hyper-vigilance”. This vigilance is an excellent example of embodiment as it becomes acquired without much self intervention. There is an unconscious adaptation to the PTSD reactions.

This is a tough mold to break once the “combat zone” has been left. Those with PTSD struggle to control the signals of PTSD in their daily lives.

This chapter is highly relative to our culture today. We are attempting to change the preconceived notions surrounding mental health. PTSD provides an example of how mental illness can be integrated into our everyday lives, or the everyday lives of those around us. I hope that by learning more about PTSD and holistic treatment would allow our society to better understand mental illness.

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Kelly Likos
4/26/2016 09:08:48 pm

In review, I would still like to see more modern works surrounding this subject. We should try to better integrate mental health into our lives. There is so much we miss by not doing so. A holistic treatment approach would not only provide a better understanding of mental illness (like I said above), but could help those who do not yet understand that they need help as well. This is a problem that we can't afford to ignore.

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Olivia Davis
3/30/2016 09:48:23 am

Much like the beginning of your post, Miriam, I found this chapter to reiterate that PTSD can be seen as the mind's own sort of protection and an adaptation to a highly volatile situations. Unfortunately, the mind almost goes into 'auto-pilot' and uses the mechanisms that it applied to the original trauma or traumatic states as a mechanism for all high-energy or emotional situations. I found myself thinking that a body's response to a high energy stimulus is like a small child doing something by accident, getting praise for stumbling across a useful solution, but then applying that accidental solution to everything and in every situation, which we know can and does cause problems eventually. My exact thought in regards to Combat PTSD was, "..maybe our neural processes have gotten so 'smart' by both consciously and unconsciously adapting us to our traumatic environment without a conscious effort that it doesn't think it needs reason to function any longer even after one's perception and senses are back to normal.."

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Olivia Davis
5/5/2016 09:29:05 am

After reading more about culture and how it acts as it's own adaptation, the more I am convinced that PTSD is an adaptation to a high stress environment in which the neural processes required for it to take place have difficulty returning to their previous function. With this being said, there could be a potential predisposition to PTSD in the form of a genetic trigger that makes certain people more susceptible to this type of one-way neural process.

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Myra
3/30/2016 09:54:27 am

Finley describes “a fear that may not have risen to consciousness” in recounting the experience of one soldier. Does this mean that traumatic events don’t necessarily need to be consciously registered to trigger PTSD? If so, the implication is that emotional response can happen before the individual realizes what their response even is directly. Conversely, could this potentially be an extension of the fight or flight response? The chapter explained how the brain is able to adjust to the intensely stressful environment during war combat. Could PTSD be a kind of acclimation the brain goes through as it adjusts to the pre-deployment environment?

Also discussed in this chapter is the dislocation these veterans experience after returning home. I found it quite interesting that traumatic stress can so drastically reshape the brain. I think it would be worthwhile to study these changes more in depth. Finley describes how a significant number of people, even loved ones of veterans, don’t always associate the emotional responses of veterans with a disorder, but think it has more to do with the individual’s own inability to control their emotions. It seems that more studies on exactly how and why the brain reshapes itself in these environments would not only help families and friends of those returning from war combat to understand what is going on psychologically, but also give more insight into the extent of neuroplasticity in highly stressful environments.

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Myra
5/4/2016 02:41:35 pm

We also discussed a kind of second-hand PTSD that can happen with friends and family of a veteran. I feel like there is not really a lot of data out there that explains this phenomenon. Do their brains also exhibit an exaggerated fight or flight? Does developing this disorder after a person close to you goes through a traumatic event imply that our brains are/can be reliant on our relationships with others. Since the brain actually changes after experiencing a trauma, do loved one's brains change similarly to the veterans?

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Michelle Bird
3/30/2016 10:20:02 am

I was intrigued by this chapter, and upon reading, I felt grateful that so many people are striving for the acquisition of a holistic approach to medical conditions. Understanding how and why a condition arises and manifests itself is integral to determining effective treatment, and can help a person deal with the stress that having that condition brings. Holistic medicine also shifts the focus off of the treatment provider and onto the patient, allowing them a sense of control over their illness that wasn't present before (I've experienced this a bit myself, with my illness - it's not the same on a psychological level, but I can say I experience a similar feeling of physical hypervigilance that PTSD patients do, and it can manifest itself in numerous ways with varying affects on a person's life). Learning how and why certain reactions are elicited in a person is one of the most important steps in coping with any issue, and it would appear that the only effective way of treating it is for the patient to recognize specific triggers and work to reestablish a new form of normalcy.

I do think a lot of the deeper issues surrounding PTSD stem from cultural values - we tend to view people who misbehave in a public setting as inferior somehow, but, as cliché as it sounds, a person can never know what it happening inside of another person's body, or how what they have been through has changed them - a person who has been abused may flinch when a hand is raised near their face the same way a vet may tense and prepare to confront danger when turning a corner. The person has experienced a situation so traumatic that they cannot shake the physical reaction embedded in their psyche, and intolerance of "immature" behavior may just make the situation worse. Taking a holistic approach to medical conditions seems to lessen the chance of other people unnecessarily exacerbating the patient's problem through ignorance.

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Michelle Bird 2nd post
5/5/2016 08:42:25 pm

While pondering more on the problems surrounding PTSD and speaking with a few of the vets I know, I’ve found that another large issue is the stigma surrounding therapy itself. For whatever reason, there was a recurring sentiment that those who had to attend therapy after being in combat were somehow weaker than the others, and that if they couldn’t “flip the switch” then they shouldn’t have become soldiers to begin with. Even knowing that someone has been diagnosed with PTSD earns the person the label of “unstable”, and people end up treating the patient too differently (either because of what they think they know, or a general lack of knowledge of the condition) and it makes it difficult to create those new bonds with people which can ultimately help the patient redefine what is normal for them.

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Molly Jaworski
3/30/2016 10:23:09 am

As a person who has had family and friends diagnosed with PTSD, I found this chapter to provide an interesting holistic approach to the subject. This idea of the "big picture" comes to mind from our previous PTSD reading where, PTSD must be examined within multiple interdisciplinary studies making it a prime topic for neuroanthropological study; combining neurological, psychological, social, and cultural experiences as factors to PTSD as stated by Miriam.

It is interesting to view PTSD as a brains survival adaption to trauma or stress , one that reroutes the response to stimulus to a faster more immediate one. In this sense we can view this as a road system where those without PTSD take the 'scenic route' and process the incoming information before responding to stimulus where as those with PTSD take the "interstate or highway" with the quickest route from point A to point B or stimulus to reaction in the quickest method which inhibits the processing of the information. In this same analogy when those exposed to trauma or stress may find it difficult to find an exit on the highway and their adapted response system back to the scenic route to where they can once again take the time to process incoming information. Maybe not the best analogy but it can work for the broad discussion of the topic.

This chapter in combination with the article “Post Traumatic Stress Disorder and Neuroanthropology: Stopping PTSD Before it Begins”, by Collura and Lende provides readers with a way to view PTSD on the different neuroanthropological levels and not just as a medical categorization of people who suffer from this. Findley discusses how PTSD can be studied and examined in these fields and Collura and Lende discuss the impact and the preventative measures that can be taken

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Molly Jaworski
5/5/2016 09:36:36 am

In comparing this article with the one Larry brought into class I find it interesting how PTSD is just viewed as effecting the individual who was exposed to the trauma. Instead PTSD seems to show a ripple affect causing secondary PTSD to those who are directly influenced by the individual with PTSD. I appreciate the direction this article took on enforcing the idea that preventative measures in military should be taken more seriously in order to lessen the affects of combat zone trauma or prevent them. I also agree that ones culture, upbringing, and biology are all factors in how the individual will respond or responds to trauma.

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Larry Monocello (2nd Post)
4/26/2016 04:50:23 pm

I thought it was so interesting how this article went hand-in-hand with the article by Rebecca Lester that I brought in. Lester underscores the importance of a sociocultural approach to healing that takes into account the social environment in which a person lives. It is important not just to treat the person as a bounded individual; rather, it is even more important to work with patients to redefine their traumatic experiences (since it can never be excised from their Self), and to repair their social relationships.

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رعاية مسنين بالمنزل link
1/25/2022 02:07:31 am

Thanks for providing valuable information

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Faraz
2/15/2023 08:51:54 am



This is an excellent review of Erin P. Findley's War and Dislocation: A Neuroanthropological Model of Trauma Among American Veterans with Combat PTSD. Findley uses a unique combination of neuroscience, anthropology, and cultural perspectives to explore the effects of PTSD on veterans. The article provides a comprehensive and insightful look into the ways in which culture shapes and influences the experience of PTSD, as well as how it can be treated. Findley's work provides a much needed examination of the complexity of PTSD and its impact on veterans. It is an important contribution to the literature and a must-read for anyone interested in understanding the psychological and physiological effects of PTSD.
https://yourmentalhealthpal.com/war-affects-on-mental-health/

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Eugene link
6/13/2023 07:05:58 am

Erin P. Findley's groundbreaking work, "War and Dislocation: A Neuroanthropological Model of Trauma Among American Veterans with Combat PTSD," sheds light on the complex relationship between PTSD and culture. This insightful review delves deep into the intersection of neuroscience, anthropology, and psychology to offer a comprehensive understanding of the effects of war-induced trauma on American veterans.

Findley's neuroanthropological approach provides a fresh perspective, highlighting how cultural factors intertwine with neurological processes in shaping the experiences of individuals with combat PTSD. By recognizing the influence of cultural context on trauma response and recovery, this model opens doors to more effective and culturally sensitive interventions.

The review presents a compelling analysis of Findley's work, showcasing its significance in bridging the gap between scientific research and lived experiences. By examining the impact of war-related dislocation, it underscores the urgent need to address not only the physiological aspects of trauma but also the social and cultural dimensions that shape veterans' recovery journeys.

Findley's research serves as a crucial reminder that combat PTSD is not solely an individual struggle but a multifaceted phenomenon rooted in broader societal and cultural dynamics. This review celebrates the author's pioneering work in bringing together neuroscience and anthropology, fostering a deeper understanding of the lived experiences of American veterans.

"War and Dislocation: A Neuroanthropological Model of Trauma Among American Veterans with Combat PTSD" is a significant contribution to the field, offering valuable insights that have the potential to shape future research, policy, and clinical practice. It highlights the importance of considering cultural factors when studying and addressing PTSD, ultimately paving the way for more holistic and inclusive approaches to supporting our veterans.

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    This blog is group authored by Dr. DeCaro and the students in his ANT 474/574: Neuroanthropology.

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