3.2.2 Traumatic Billy Pilgrim47 Billy’s Difficulty to Fall Asleep 47 Billy’s Difficulty of Concentration 49
3.3 Intrusion Elements: A Psychoanalytical Reading of Slaughterhouse-Five51
3.3.1 Traumatic Narrator 51
3.3.2 Traumatic Billy Pilgrim 53
3.4 Constriction Elements: A Psychoanalytical Reading of Slaughterhouse- Five 55

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3.4.1 Traumatic Narrator 56 The Narrator’s Inability to Recall Traumatic Events56 The Narrator’s Reluctance to Traumatic Memories56 The Narrator’s Tendency towards Alcohols 58
3.4.2 Traumatic Billy Pilgrim 59 Billy’s State of Numbness 59 Billy’s Avoidance to Recall Traumatic Memories 61 Billy’s Tendency towards Alcohol63
3.5 Concluding Remarks 64
Chapter Four: A Psychoanalytical Reading of Slaughterhouse-Five: Recovery of Billy Pilgrim and the Narrator65
4.1 Introduction 66
4.2 Recovery of Billy Pilgrim 67
4.2.1 Establishing Safety for Billy Pilgrim67
4.2.2 Remembrance and Mourning of Billy Pilgrim72
4.2.3 Reconnection of Billy Pilgrim76
4.3 Recovery of the Narrator 80
4.3.1 Establishing Safety for the Narrator 80
4.3.2 Remembrance and Mourning of the Narrator81
4.3.3 Reconnection of the Narrator83
4.4 Concluding Remarks 85
Chapter Five: Discussions and Conclusion87
5.1 Summing up88
5.2 Findings91
5.3 Suggestions for further Readings95
Chapter One:
The Problem, Argument, and Framework: An Introduction:
1.1 General Background
Kurt Vonnegut (November 11, 1922- April 11, 2007), American novelist, is considered as one of the most influential writers of the twentieth century. He created his own world by blending science fiction with literature, a world that was partly the result of his service at the army during World War II. In 1944, he was captured and imprisoned in Dresden, Germany, where he witnessed an attack in an underground slaughterhouse meat locker used by the Germans as an ad hoc detention. This experience inspired him a lot in his famous novel, Slaughterhouse-Five (1969). He also wrote such works as Player Piano (1952), Cat’s Cradle (1963), andBreakfast of Champions (1973).
Slaughterhouse-Five or The Children’s Crusade: A Duty-Dance with Death is generally recognized as Vonnegut’s significantand autobiographical work. The narrator of the first chapter attended World War II and was imprisoned in Dresden; there he had witnessed the bombardment of the city. Twenty years after this incident he makes a visit to his buddy at war to share some memories of war for his novel. Themain character of his novel, Billy Pilgrim, goes through experiences that are highlysimilar tothose happened to him. Billy is a veteran that was captured by the Germans during a battle in World War II. He and his fellow prisoners were kept in a slaughterhouse in Dresden where they witnessed bombing of the city and became some of its few survivors. Now he is a wealthy man and successful in optometry business but “has come unstuck in time” (Vonnegut 15). He travels between periods of his life, experiences past and future events out of sequence and repetitively. He is kidnapped by extraterrestrial aliens from the planet Tralfamadore. He spends time on Tralfamadore, in Dresden, in the War, in his post-war married life in the U.S.A. of the 1950s and early 1960s. He also predicts his death and makes a tape recording of his account of it.
The presentstudy intends to examine the concept of psychological trauma and the process of its healing inVonnegut’s Slaughterhouse-Five. Billy Pilgrim has been traumatized as the result of attending in war and witnessing the bombarding of Dresden city. His being “unstuck” in time and his going backward and forward in time arethe result of the turbulence of his mind and his visit to Tralfamadore planet is not irrelevant. During the novel,he takes a long process to get rid of his unpleasant situation, to deny it at times and to banish it from his unconscious. As a matter of factBilly’s story is the story of the narrator’s life and his attempt to write a novel about it, is indeed a struggle to heal his wounds.
Judith Herman( born 1942), a psychiatrist, researcher, teacher, and author of the books Trauma and Recovery(1997) and Father-Daughter Incest (1981), is one of the prominent figures in the field of trauma and its recovery in recent years who has mostly focused on the understanding and treatment of incest and traumatic stress. Her book Trauma and Recoveryoffered a profound insight into the nature of trauma and the process of healing it. Herman contends that psychological trauma is the affliction of the powerless that is rendered helpless by the overwhelming power. The ordinary response to this situation is to banish it from the unconscious. Atrocities, however, deny beingburied and the conviction that denial does not work is as powerful as the denial(Herman12).Thereforeshe introduces a process of recovery that is the result of a twenty-year practice at a mental health clinic.
1.2 Statement of the Problem
This study seeks to argue that both the narrator and the protagonist of his story, Billy Pilgrim, were traumatized in the Second World War. Thus the symptoms of post-traumatic stress disorder can be traced in both characters. However each seek for recovery in their own way, Billy’s time travel to the planet Talfamadore and talking about it on a radio show and the narrator’sattempt to write a book about the massacre in Dresden.His will to keep in touch with his old war buddyforsharing memories of past,demonstrateshis struggle to prevail his outrage at the cruelties of war. It is an effort to put an end to his suffering from post-traumatic stress disorder as the result of witnessing the cruelties of war. Although twenty three years have passed and the narrator is, at least apparently, living a secure life with a good job and a family, yet he is still suffering from the consequences of the traumatic event. His insomnia and involvement inalcohols and telephones late at nights, the way he narrates his life events, the people around him and his experiences at war could be considered as clear examples in this regard. Indeed, it is him that is “unstuck” in timeand his narration of Billy Pilgrim’s life story is a reflection of his internal conflicts.
1.3 Objectives and Significance of the Study
1.3.1 Hypothesis
The major assumption in this study is tracing the symptoms of trauma and evaluating its treatment in Kurt Vonnegut’snovel Slaughterhouse-Five. Psychological trauma is a type of damage to the psyche. This damage is the result of a traumatic event that might be a single experience, an enduring or a repeating one.According to Judith Herman the significance of traumatic events originally goes back to this fact that they overwhelm human adaptations to life, when neither resistance nor escape is possible since these events produce profound and enduring changes in physiological arousal, emotion, cognition, and memory (Herman 24).
However,people’s reactions to traumatic events are widely different. Onemight suffer from anexperience while the other is not affected at all. On the other hand, the severity of the symptoms depends on the person, the type of trauma, and the emotional support received from others. In the first part of the book Trauma and Recovery,Judith Herman introduces syndromesof this mental disorder; in the second part, she offers stages of recovery as establishing safety, reconstructing the trauma story and restoring the connection between survivors and their community.
1.3.2 Significance of the Study
By reading this project, the reader is going to feel more tangibly how atrocities can influence every aspect of an individual’s life. Thus an accurate understanding of the past is required to reclaim the present and future of a traumatized person who has been cut off from the knowledge of his or her past life.People who are suffering from disasters might behave in a way that seem odd to those surrounding them; thereforerecognition of post traumatic symptoms, could be vital to the patient’s fragile sobriety.
Slaughterhouse-Five is not only Vonnegut’s masterpiece but also one of the most powerful anti-war novels written since 1945. What makes it more distinguishable from other anti-war novels is thatit fashions experiences in the Second World War into an eloquent and deeply funny plea against butchery in the service of authority and its consequences on the people involved. It is an account of Vonnegut’s imprisonment,which according to Randal Withers is his reactionto overlooking the destruction of Dresden in America (Withers 64).
Since World War II, many anti-war books have been written depicting the cruelties and injustices of the event, its destructive consequences on different aspects of the life of the people involved and their disgust toward it, yet little have been said about the effects of war on the veterans, not only during the war but also in the years following. The significance of this study is its psychological reading of the main character of the novel during World War II, and a close analysis of the consequences of the event on him in the following twenty three years.
1.3.3 Purpose of the Study
This study is going to focus on the novel Slaughterhouse-Five by Kurt Vonnegut under the light of Judith Herman’s theories on trauma and its discovery. She arguesthat the ordinary response to atrocities is to banish them from consciousness. Atrocities, however, refuse to be buried. Just as powerful as the desire to deny atrocities is the conviction that the denial does not work. The conflict between the will to deny and horrible events and the will to proclaim them aloud is the central dialectic of psychological trauma (Herman 43).
This is what happens with the narrator of the novel who is the main focus of this study. His struggle to denythe unpleasant experiences of warfrom his consciousness is unsuccessful. His amnesia at nights, his obsession with drinks and telephoning and his divagation while speaking are all the result of his unsuccessful attempt for denial. He bears a secret within that is unpleasant to be spoken and at the same time impossible to deny.
Herman believes the survivors can begin their recovery when they finally recognize the truth (54).In Slaughterhouse-Five, the narrator’s desire to meet his old buddy at war, Bernard O’Hare, after twenty three years, is the result of his recognition of the source of his torments. During all these long years that he has apparently lived a normal life, trying to forget or ignore the horrible events of war, the traumatic event was staying with him, and now it is the time to face the truth. The way he deals with his state of mind, the stages he takes and the methodology he chooses to utter the unspoken is the main prime of this research.
1.3.4 Research Questions
This essay attempts to deal with the following questions:
1. What is the narrator’s main motivation to write a book about his experiences in Dresdenand why did it take him more than twenty years to write it?
2. Why does he attempt to keep in touch with his old war buddy, Bernard O’Hare?
3. To what extent is his reunion with O’Hare influential in his recovery?
4. What are the role of children in this novel, specifically the narrator’s daughter and Billy’s daughter?
5. Why does Billy attend a radio program and what are the consequences of this action?
6. To what extent is recovery from traumatic stress disorder fulfilled in this novel, regarding both Billy and the narrator of the first chapter?
1.4 Review of Literature
Trauma and Recoveryis Judith Herman’s outstandingbook which consists of two parts: “Traumatic Disorders” and “Stages of Recovery”. “Traumatic Disorders” includes six chapters; the first of which addresses the curious history of studying psychological trauma; when periods of active investigation have alternated with periods of oblivion. To study psychological trauma means bearing witness to horrible events which makes it impossible to remain neutral in the conflict between the victim and the perpetrator. The next five chapters introduce the main symptoms of this mental disorder and its influence on different aspects of personal and social life of the victim;how the victim is rendered helpless and powerless by the traumatic event and how traumatic events call into question the basic human relationships. The second part mainly focuses on the stages of recovery. As the core experiences of psychological trauma are disempowerment and disconnection, recovery is based on the empowerment and the creation of new connections for the survivor. Therefore, the pivotal stages of recovery introduced by Herman are: establishing “Safety”, “Remembrance and Mourning”, “Reconnection and Commonality”. It is in the second stage, “Remembrance and Mourning” that the survivor makes the final choice to confront the horrors of the past and speak of the “unspeakable”, a stage that demands extraordinary courage supported by the therapist alongside the security established by those surrounding the victim.
Trauma and Life Stories, edited byKim Laky Rogers, Selma Leyesdorff and Graham Dawsonisacollection of studies in terms of the works of anthropologists, sociologists, psychologists, and oral historians. It focuses on a wide variety of social, political contexts in Africa, Europe, and the Americas. The life-long impact of traumatic experiences is the subject of the essays collected. The book is an attempt to explore the relationship between the experiences of terror, the ways survivors remember and the language and form which they use to retell their stories. All contributions are concerned with painful aspects of the past which may have consequences in the present as private nightmares or public conflicts:
“We believe that it is a crucial theme to address, not only intellectually but also because the legacy of trauma raises such immediate personal and political issues and dilemmas it is important for us to remember that all the words printed here can have little significant impact on the ultimate loneliness of those who suffer such psychic wounds from social dislocation and violence. (Rogers et al.23)
The Trauma Question by Roger Luckhurst is a historical genealogy of trauma which tracks its origin from the1860s to the present through industrialization and bureaucratization, law and psychology, military and government welfare policies. It draws upon a range of cultural practices from literature, memoirs and confessional journalism through to photography and film. The writer’s strong claim is that “cultural narratives have been integral not just in consolidating the idea of post-traumatic subjectivity, but have actively helped form it” (Luckhurst 15).At the end, the book suggests the ways in which the traumatic paradigm might meet its limits.
In his article entitled “New Wars, Old Battles: Contemporary Combat Fiction for the High School Canon” Randal W. Withers considers thenovels by Kurt Vonnegut as alternatives to established antiwar canon. He believes that the atomic strikes on Japan are widely discussed across America while the destruction of Dresden, Germany, is often quietly overlooked, even though the attack by Allied bombers on this peaceful city killed more than the Nagasaki and Hiroshima bombs. Hefinds this a motivation for Vonnegut to write his semi-autobiographical work, an account of his year as a prisoner of war in Dresden and how he survived the attack. Therefore, the main reason for Slaughterhouse-Five to be one of the most banned books in American high schools is its embarrassing portrayal of the atrocities committed by the United States.
In another articlecalled”Nothing’s Ever Final”: Vonnegut’s Concept of Time””, Philip M.RubensexploresVonnegut’s concept of time based on a quotation of him in an interview with New York Times”. He statesthat Vonnegut owes a debt for the crux of his ideas to several popular time theorists, the most considerable of all Henry Bergson who believes that man is not only free to move at random through time, but also able to experience a progressive interiorization into memory.
John R.Mayfocuses on the impact of the Tralfamadorians on Billy Pilgrim’s world view in his article”Vonnegut’s Humor and the Limits of Hope”. Billy’s famous phrase “so it goes” is taken from what the Tralfamadorians say about the dead. They have convinced Billy that if men are like bugs in amber and “all moments, past, present, future always have existed, always will exist” (Vonnegut 29); accordingly, when he hears that someone has died, he simply shrugs and repeats his famous phrase. He also adds that the sameness Billy notices in his unstuck pilgrimage is the universality of death and the unavoidability of war.

1.5 Materials and Methodology
1.5.1 Definition of Key Terms
Hyperarousal: Judith Herman introduces three main categories as symptoms of post-traumatic stress disorder. The first one of them is Hyperarousal in which the human system of self-preservation goes on permanent alert as if the danger might return at any moment. In this state, the physiological arousal continues, and the traumatized person startles easily, reacts irritably to small provocation and sleeps poorly (Herman 25).
Intrusion: This is the second cardinal symptom in which the traumatized person relives the event as though it were recurring in the present and as if time stops at the moment of trauma. Any insignificant reminder might remind memories with all the vividness and emotional force of the original event (Herman 26).
Constriction: The third symptom of post-traumatic stress disorder happens when any form of resistance is futile.The system of self-defense shuts down and the escape is not by action in the real world, but rather by altering the state of consciousness (Herman 31).
Disconnection: According to Herman, the damage to relational life is the primary effect of trauma since traumatic events affect not only psychological structures of the self but also the systems of attachment and meaning that link individuals and community. “They breach the attachments of family, friendship, love and community” (Herman 51).
Remembrance and Mourning: In the second stage of recovery, the traumatized person tells the story of the trauma completely, in depth and detail. This reconnection transforms the traumatic memory into the survivor’s life story (Herman 175).
1.5.2 Motivation and Delimitation
There is no shortage of novels and issues that have addressed war and its destructive consequences.However the story of survivors who have lived through concentration camps or bomb attacks is frequently overlooked. On their return home, they found themselves at best ignored at worst spurned; they may be praised and awarded medals for their heroism or blamed for lack of humanity in murdering their fellows and partaking in the brutal action. However, the psychologicalscars of the combat which they had endured brought them no sympathy. What interested the present researcher is neitherthe brevity nor the cowardliness of their actions,nor theiraction; however, the voices that address us to listen to their stories appear to be appealing; these are the stories of wounds that cry out to inform the world of the hell they had experienced. This is the hell of memories of the past, which, in an unsuccessful attempt to be buried and kept out of consciousness, have lived on in the present. It, therefore, takes courage and excessive effort to call to mind such memories and to make a narration out of it, andit also demands a particular sensitive kind of reading.
Consequently, this studycomprises the discussion of Kurt Vonnegut’s famous novel in the light of psychoanalysiswhile givinga considerablyremarkabledepiction of the unpleasant memories of a veteran who decides to face his nightmares after twenty-three years of unsuccessful struggle to burry and forget. Thus,through a psychological study of Slaughterhouse-Five, the researcher seeks to be carefully engagedin a narrator whose memories as a veteran have been denied by himself and the world surrounding him. As long as the telling stories of trauma continue to meet with resistance and denial, the psychic effects of the past remain to poison the present
1.6 Organization of the Study
This thesis by the title 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.

Chapter Two:

Trauma Theory: A Critical Introduction

2.1 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 outburst 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
2.4.1 Diaries
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 nightmares and lack of sleep six months after the incident, that how his sleep was still disturbed by recurrent memories and images: ‘it is strange to think how to this very day I cannot sleep a night without great terrors of fire, and this very night could not sleep till 2 in the morning through thoughts of fire’. (qtd. in Trauma and Life Stories, 3).He also referred to the sequel of the disaster for others, including attempted suicide (Charles R. Figley, 7).
Another testament has been left in Charles Dickens diaries. He was involved in a railway accident on June 9, 1865 which made him feel weak. He believes his state of mind and not feeling good is the result of the railway shaking; “I am not quite right within, but believe it to be an effect of the railway shaking”. He developed a phobia of railway traveling but summed up the sequel as: “I am curiously weak as if I were recovering from a long illness” (qtd. in Charles R. Figley, 7).
2.4.2 Railway Spine
Two important human activities led to an explosion of literature and interest in the concept of post- traumatic disorder, wartime experiences and development of workmen’s compensation acts in the late nineteenth century (Charles R. Figley, 7). The latter increased medical awareness of possible psychological and neurological effects of physical injuries, such as ‘railway spine’- a term coined to describe the experience of persistent severe back pain after train accidents, without any apparent injury to the back itself (Trauma and life Stories, 3).
In mid- nineteenth century, following an increase in invalidism reported after railway accidents in which the railway companies were seen as an easy target for compensation, physicians were called upon to examine potential litigants. John Eric Erichsen wrote an influential book entitled On Concussion of the Spinein 1882which made railway spine adiagnosis for the post-traumatic symptoms of passengers involved in railroad accidents. His little volume became a guide book to distinguish the dishonest plaintiffs who attempted to get a heavy verdict by dissimulation and imposture (Charles R. Figley, 7).
Not long, in 1885, a rebuttal of Erichsen’s ideas was published entitled Injuries of theSpine and Spinal Cord Without Apparent Mechanical Lesion by a surgeon to the London and North West Railway, Herbert Page. He used the term “nervous shock” as the subtitle of his book and considered it so common after railway collision. He also believed that the railway spine in the majority of the cases was psychological rather than an organic disorder. His views were supported by many but the central feature of many arguments was the extent which patients were malingering for personal gain, a subject that is a kernel found at the center of the whole issue of post-traumatic disorders in general(Charles R. Figley,7).
2.4.3 War
There has been a powerful social myth that heroes do not or should not have any problems; thus, it has been difficult for veterans to admit to themselves or to the others that they might be suffering from war zone experiences per se. The military view on acute psychiatric casualties until the 1980s was (1) temporary breakdown; (2) individual weakness; (3) poor leadership and weak unit cohesion. None of these perspectives let the possibility that war might be traumatic itself (Handbook of Post –Traumatic Therapy, 180). However, arguably the most important focus for the study of trauma from the mid-nineteenth to the mid-twentieth century was the soldier. The Crimean War (1854- 6) and the American Civil War (1861- 5) brought to the attention of doctors various stages of physical and mental exhaustion arising in soldiers exposed to combat (Trauma and life stories, 3).By the Second World War and specifically after Vietnam War further descriptions of post-traumatic stress reactions were provided by psychiatrists (Joseph, Williams, and Yule, 6). It was fifteen years after the withdrawing of U.S troops from Vietnam, that the United States conducted the National Vietnam Veterans Readjustment Study (NVVRS) that set out to determine shorter-and longer-term sequel of the war experience and other pre- and postwar factors (Handbook of Post –Traumatic Therapy, 180).
The effects of traumatic events on psychological health have been recognized under various names; most of these labels have been chosen in relation to combat, e.g., nervous shock, traumatic neurosis, anxiety neurosis, fight neuroses, and shellshock. Shell shock is perhaps the most well-known of these terms. Originally it referred to the belief that combat-related disorder was minute brain hemorrhages which resulted from the lodging of shrapnel in the brain during the explosions. But the observation that soldiers could develop shell shock even in the absence of explosions let to the belief that shell shock implied weakness of character with the consequence that many soldiers of the First World War, who today would be diagnosed as suffering from PTSD, were executed for cowardice on the part of military authorities (Joseph, Williams, and Yule, 6)
Frederick Walker Mott (1919) coined the term ‘’shell shock’’ and suggested that the condition was due to a physical lesion of the brain, brought about in some manner by carbon monoxide or changes in atmospheric pressure. It was Charles Samuel Myers (1940) with his research over 2000 cases of shell shock that divided the problem into shell concussion and shell shock. He believed that the term ‘’shell shock” was ill-chosen, since it could occur in soldiers not exposed to exploding missiles but subject to emotional stress, therefore the term gave rise to hysteria, neurasthenia, or even psychiatric illness(Charles R. Figley, 8)

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