Review of "Back from the edge of existence: A critical anthropology of trauma."

by Larry Monocello

​“The reality, of course, is that trauma happens within the flow of a person’s life—he or she did not simply come into being at the moment of the event” (755). In this article, Lester calls on researchers to remember that trauma is not a one-time event, nor is trauma experienced—or, re-experienced—the same way in all of the men and women who have been traumatized. Rather, a person’s psychophysiological response to both the “trauma-as-moment-of-injury” and “trauma-as-ongoing-lived-experience” (755) is individualized. One’s trauma is based in his or her own culturally, socially, and personally mediated beliefs about how the world works, as well as his or her own place within it; therefore, it would do a disservice to both future research on and treatment of trauma with anything less than that in mind.
 
The strengths of this article lie in Lester’s ability to deconstruct the ways in which we currently deal with trauma, but then—even more importantly—from that deconstruction suggest practical and socioculturally relevant suggestions for improvement. In discussing cross-cultural variation in the roles of (a) agency in the trauma-event, (b) the “developmental arc of trauma” as experienced, and (c) effective therapeutic strategies in treatment, she offers a different approach to trauma that understands it to be a socially, culturally, and personally mediated lifelong process rather than a bounded event. It requires understanding that denying wholly a victim’s agency in the experience of trauma can be constraining to coming to terms with it, especially cross-culturally. It requires recognizing that the trauma cannot be undone, but rather through the process of re-experience responses to the trauma can be changed (if not “healed”). Finally, it requires knowing that the most important facet of the treatment of trauma is repairing the victim’s social relationships
 
From a neuroanthropological perspective, then, there are implications for the study of trauma and PTSD. Trauma is not just an event but a chronic process through which the experience of trauma is not only re-experienced, but also re-fashioned and re-evaluated. It is a constant push and pull of beliefs and relationships shifting and shaping how each subsequent re-exposure is endured and understood. To the neuroanthropologist, this means that trauma should not be studied from the perspective of “before and after,” but rather as a continuous process of meaning-making and -re-making with implications for the types and degrees of stress experienced and the concomitant neurophysiological responses that affect overall well-being.
 
Lester’s work is notable for her ability to guide the reader beyond the immediately apparent (and, often, ethnocentric), and through layers of hidden meaning, to come to a much more nuanced understanding of phenomena. However, an obvious concern with this work is that the breadth of analysis it calls for does not lend itself to practicality. And while it is out of the scope of most psychological and psychiatric research, anthropologists are uniquely poised to address these questions, to synthesize large and disparate bodies of information into coherent exegeses of phenomena.
 
Lester, Rebecca. (2013). “Back from the edge of existence: A critical anthropology of trauma.” Transcultural Psychiatry, 50(5): 753-762.