Neuroanthropology

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Archive for June 22nd, 2008

Cultural Aspects of PTSD, Part II: Narrative and Healing

Posted by epfinley on June 22, 2008

Bremner et al. 2000.  MRI showing decreased hippocampal volume in Vietnam veterans diagnosed with PTSD.

Narrative and memory are interwoven in our consciousness, and thus explorations into trauma from both humanities and social science perspectives almost invariably discuss narrative in one form or another. An ongoing debate within psychological research, for example, ponders whether the coherence of trauma stories is correlated to the amount of emotional distress associated with a given traumatic memory. It is hypothesized that the greater the distress, the less organized the narrative. If this were the case, we might expect that the coherence with which an individual is able to talk about the trauma would increase as the memory is processed and resolved, a finding for which we have some evidence.

We do know – when it comes to Post-Traumatic Stress Disorder (PTSD) – that narrative matters. As I wrote in an earlier post, the most effective therapies yet proven for reducing PTSD symptoms are the exposure therapies, particularly Prolonged Exposure (PE) therapy. These therapies are more effective for reducing the full range of PTSD symptoms than any pharmaceutical yet identified. And the crux of these therapies rests on telling the story of the trauma, sometimes over and over again. This simple practice, this process of speaking, has been reliably demonstrated to result in an improvement of PTSD symptoms for many patients.

But for all its clinical benefit, this extraordinary observation tells us very little about the mechanisms of psychic healing after trauma. Instead, it points to a growing body of evidence that suggests it is not just narrative that matters in PTSD, but, more intriguingly, that it is the type of narrative that matters. Unstructured psychodynamic therapies, for example, have not been demonstrated to lessen the severity of PTSD, even among patients who continue in therapy for years. And yet certain ways of narrating memory do make a difference, and this phenomenon once again points to a role for anthropologists and other culturally-minded researchers in exploring the cultural-emotional-physiological-environmental interactions at play in post-traumatic processing.

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Posted in Brain imaging, general, Language, Neural plasticity, Psychological anthropology, Stress | 9 Comments »

 
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