Review of War and Dislocation: A Neuroanthropological Model of Trauma among American Veterans with Combat PTSD (Erin Finley)
by Jennifer Fortunato
In chapter 10 of The Encultured Brain, the author of the chapter, Erin Finley, writes about how trauma evolves into post-traumatic stress disorder (PTSD) by focusing on six variables that are implicated in this experience: cultural environment, stress, horror, dislocation, grief, and cultural mediators. The author starts off the chapter by describing what trauma is. They describe trauma as beginning with sensory and perceptual experience of danger that may or may not come as a shock. To understand how trauma morphs into PTSD, the author states that we need to look not just at one aspect or use of definition of PTSD but integrate biological, social, physiological and cultural factors into our understanding of the disease.
Finley then starts to delve into the six variables of the PTSD experience. The first variable cultural experience which takes into account local social structure, patterns of kin relationships, historical and political context, physical environment and local worldviews and norms. Finley emphasizes that the cultural experience plays a critical role in the experience of trauma. PTSD is characterized by hyperarousal, reexperiencing, and avoidance or numbing all of which can be stigmatized by others.
The next variable of stress is discussed in the cultural context. Where soldiers who have extended combat experience have a rewiring of the stress experience due to time spent under intense and potentially life-threatening conditions. This is exemplified in veterans returning from deployment who describe their responses to stimuli as having unprecedented vigilance. Finley then describes research related to this and concludes that it is normal for those who experience a highly stressful environment for a long while to adapt to that way of living and for it to remain after returning to safety. Understanding cultural differences in the stress response might provide a way to understand how individuals respond to stressful events.
The third variable, horror, is the one that is most likely to reemerge as a recurrent nightmare and/or intrusive memories. Finley describes horror as an emotion so powerful that it can overwhelm an individual’s capacity for immediate sense-making or cognitive processing. Those with PTSD may not recover without intervention from outside help. Horror can be understood in the cultural context as a challenge to deeply held beliefs about the self and world that may pose a painful challenge to individual identity.
Dislocation, the fourth variable, is an estrangement from those around you, an earlier mode of perception, from feeling at home in the world or sense of self. Veterans can have an emotional flattening of their emotions where the way that they react to the world around them has diminished. Biologically, stressed brains will bypass cognitive thinking to go immediately to rapid action and response. This can be shaped by an individual’s personal history and cultural expectations of themselves. Veterans may respond in ways that are culturally appropriate, however, the way in which they do so may not be appropriate. This may in turn further alienate them from close friends and family. However, how the friends and family perceive these responses by veterans to stimuli can reduce this alienation.
The next variable, grief, is a part of a natural mourning process when losing someone close to you. Veterans may feel a sense of personal responsibility for the death of a fellow soldier or even for surviving the same event that killed another soldier. Grief can also result from a loss of self or norms after returning to civilian life. These losses whether tangible, like loss of a life, or intangible, like loss of the sense of self, can exacerbate senses of grief in veterans.
The last variable is cultural mediators. This is the role of cultural tools and processes to help mediate the relationship of the other trauma variables. This can be best understood through evidence-based cognitive behavioral therapy which has been proven to reduce trauma symptoms over a long period of time. Cognitive behavioral therapy can assist in helping veterans return to civilian life and manage symptoms of PTSD and the, often accompanying, symptoms of anxiety and depression. Having other ways to express emotion can help in reducing dislocation and stress. Also, social support is critical in helping reduce the experience of trauma. Social support can be found in kin relationships, support groups for survivors, and personal role models.
Finley ends the chapter with a section on the neuroanthropological view of trauma and how it can assist in understanding PTSD. Neuroanthropology can facilitate the comparison of trauma responses across cultural contexts to better understand the relationship between culture and trauma. It can also help us understand the relationship between cognitive and neurophysiological responses to trauma. Using neuroanthropology as an interdisciplinary framework for understanding PTSD and trauma can help us find more meaningful, focused, and effective ways for understanding PTSD.
My questions for the class are:
1. Early in the chapter, Finley mentions that this discussion is solely based on the experiences of male combat veterans and that the inclusion of female combat veterans is an important missing factor. Do you think the analysis of trauma and PTSD would change? How so?
2. How would you design a study to look at trauma from a neuroanthropological view? How would a more laboratory-focused and a more ethnographic-focused study differ?