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Communication Around, About, and of Psychological Trauma and Its Subjects Has Been Approved for the Department of Communication

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Communication Around, About, and of Psychological Trauma and Its Subjects Has Been Approved for the Department of Communication IN SEARCH OF THE REAL: COMMUNICATION around, about, and of PSYCHOLOGICAL TRAUMA AND ITS SUBJECTS By LISA R. IRVIN B.S., Appalachian State University, 1994 M.A., University of Denver, 1999 A thesis submitted to the Faculty of the Graduate School of the University of Colorado in partial fulfillment of the requirement for the degree of Doctor of Philosophy Department of Communication 2014 This thesis entitled: In Search of the Real: Communication around, about, and of Psychological Trauma and its Subjects has been approved for the Department of Communication __________________________________ Professor Gerard Hauser ___________________________________ Professor Bryan Taylor Date_________ The final copy of this thesis has been examined by the signatories, and we find that both the context and the form meet acceptable presentation standards of Scholarly work in the above mentioned discipline. Irvin, Lisa Renee (Ph.D., Communication) In Search of the Real: Communication around, about, and of Psychological Trauma and its Subjects Thesis directed by Professor Emeritus Gerard Hauser As social readjustment and recovery efforts among military populations suffering from Posttraumatic Stress Disorder (PTSD) continue to perplex researchers, mental health professionals, and veterans, dynamics of social stigma are increasingly problematized and targeted as sites of intervention in public health campaigns and inter-disciplinary research inquiries. In response to these problems and attributions of stigma, this research investigates historical, theoretical, and institutional sources of stigmatization in the diagnosis and treatment of psychiatric casualties suffering from the condition now known as PTSD. Through archaeological analysis of this history, the research identifies pivotal scientific controversies, competing theoretical perspectives, and shifts in psychiatric treatment that display on-going tensions characterizing psychiatric science in relation to changes in socio-political sensitivities implicating dynamics of social stigmatization. Close analytic attention is directed towards examining the politics and practices involved in the instantiation of a Therapeutic Community experimental model of post-combat treatment in a U.S. Naval Hospital conducted by Dr. Harry A. Wilmer with Korean War Veterans in 1955 designed explicitly to intervene in stigmatizing institutional configurations and socio-cultural attitudes. Research findings reveal that discourses highlighting the role of psychological trauma, overwhelming stress, and sexual or physical domination emerged as counter-discourses that challenged dominant neuro-psychiatric theories which purported neurological inferiority, genetic susceptibility, and moral weakness as conventional explanations of post-traumatic iii reactions. These reductive explanations are further argued to predispose psychiatric diagnostic discourse to stigmatize survivors of trauma through the instantiation of discursive suspicion in association with malingering and interiorized pre-conditions that politically diffract attention away from the concrete events productive of traumatic injury. Analysis also reveals a lineage of counter-theories that underscore the role that interpersonal, doctor-patient, and public communication has for not only in producing self stigma and identity altering interactions, but also in sustaining and recovering from post- traumatic reactions. Findings demonstrate how interventions in systemic cycles of stigmatization and patterns of pathological communication in treatment contexts can be facilitated by organization culture alterations encouraging staff discursive reflexivity of transference communication, and patient social support encouraging narrative reconstructions of self and others through utilization of meta-communicative techniques. iv Dedication This thesis is dedicated to the late Dr. Harry A. Wilmer and an enduring lineage of like- hearted military psychiatrists, mental health professionals, and citizens whose work is guided by conscience, dedication to maintaining human integrity, and belief in the power of human connection for restoring life after death, loss, and war v Acknowledgements I am indebted to the guidance, support, and incredible patience of my advisor and supervisor of this thesis, Professor Emeritus Jerry Hauser. I cannot adequately express my gratitude and respect for the depth of his understanding and wisdom of his narrative ways that will always provide a source of intellectual and spiritual guidance for me in my life and career path. I would also like to acknowledge the support and participation of Professor Bryan Taylor, Professor Emeritus Robert Craig, and Professor Karen Tracy who served as members of my thesis committee and provided meaningful touchstones during the arduous and regenerative process of education. Their scholarship and mindfulness remind me to honor traditions and leadership that maintain communities of understanding and respect. I am blessed to have the opportunity to acknowledge my friends who have listened ad infinitum and believed in my convictions about this project over the course of many years. I am grateful that there are too many to list, but they know who they are. Specifically, I acknowledge the patience and kindness of Cory Jacobs who assisted with some of the data collection and has endlessly, as well as, painstakingly provided a source of support and encouragement. I gratefully acknowledge the patience and commitment of Lander Harrison who helped with preparing this thesis and editing my record long sentences. There are several academic advisors throughout my graduate school career who have offered creative sources of inspiration and knowledge, Professor Roy Wood, Professor Stan Deetz, and the late Professor James McDaniel. Their presence and capacity to ignite passion for learning remains etched in the story of my academic career. Lastly, however not least, my parents have provided sources of wisdom, inspirational support, and humor that have proved invaluable for the resolution of this project. vi CONTENTS CHAPTER I. INTRODUCTION………………………………………………………….…….1 1.1 The Problem: Crises of Stigma and Limits of Understanding…….……...1 1.2 The Social Construction of Stigma: Historicizing and Recovering Key Concepts, Contexts, and Conversations……………………………...6 1.3 Stigma, History, and Contexts of Mental Health…………………….........8 1.4 Stigma and Communication………………………………………….…..11 1.5 Research Questions………………………………………………............12 1.6 Data Collection and Description of Texts…………………………..........15 1.7 Chapter Preview………………………………………………….........…17 II. IN SEARCH OF THE REAL: COMMUNICATION around, about, AND of PSYCHOLOGICAL TRAUMA AND ITS SUBJECTS……………………………………………...…………………….....22 2.1 The Problem with Trauma: Wakes, Waves, and Aftershocks….........…………………………………………………...22 2.2 Trauma’s resurgence: A new frontier of explanation, interpretation, and spectatorship………………………....……....…...………………25 2.3 PTSD: A History of Politics and Paradoxes of a Diagnosis………….30 Legal contexts and the Scientific Burden of Proofs…………..………..39 2.4 “Psychological” Trauma and the “Psychologization of Trauma”……..45 2.5 Communication around and about Psychological Trauma and its Subjects………………………………………………………..49 2.6 Trauma and Communication: Narratives, Dialectics, and Traumatic Constellations……………………………………...….53 Narrative Interruptions and Trauma……………………...………...…....54 The “Split-off” Symbol: Narrative and Dialectical Movements……...56 Constellations of Silence: Social Body of Trauma……………….......58 vii Identity: Traumatic Impacts and Imprints…………………………..…..59 Shattered Assumptions: Doxic Interruptions………………….…..61 A Meta-Communicative Theory of Psychiatric Disorder: Distortions of Double Binding…………………………………….....63 2.7 Conclusions………………………………………………………..…..69 III. ARCHAEOLOGICAL THEORY AS METHOD: AN ATTITUDE AND STRATEGY FOR APPROACHING HISTORY IN CONTEXT………….........72 3.1 Trauma and Stigma over Time: A Fragmented and “Underground” History…………………………………………………………………....73 3.2 Epistemological Connections and Theoretical Trajectories: Post-structuralism, Problems of Doxa, and Epistemic Rhetoric……….....79 Post-structuralism and the Role of Theory………………………………..79 Deconstructing Doxa and Epistemic Rhetoric……………….……….…..80 3.3 Articulation Theory: Applied and Political Archaeology…………….......84 3.4 Applications and Strategies of Archaeological Analysis……………...…..88 3.5 Archaeology: Recovery of new contexts to study old problems……….....98 Conclusions and Integration…………………………………………….....101 IV. HISTORICAL EXPLOSIONS AND INVENTIONS: HYSTERICAL ARTICULATIONS AND CONCEPTUAL TRAJECTORIES OF A STIGMATIZED DIAGNOSIS……………..……............................................…103 4.1 A New Name for an Old Story: Historical Baggage of Hysteria…...........103 4.2 Ancient and Pre-modern Formations of Hysteria: Wandering Wombs and Wicked Women…………………...………………………………….......107 4.3 From the Possessed to the Possessors: A Shift in the Ontology of Hysteria in the Trials of Mary Glover and Father Urbain Grandie...........................113 4.4 Discourses of Animality, the Passions, and the Humours: A Unique De- Stigmatizing Configuration of Alliances and Ancient Theories……..….119 viii 4.5 Conclusions………………………………..………………………..…....126 V. ORIGINS OF A DIAGNOSIS: QUESTIONS OF HYSTERIA AND TRAUMA IN THE BUDDING FIELDS OF NEUROSCIENCE, PSYCHOANALYSIS, AND MILITARY PSYCHIATRY…………………...……………………….....129 5.1 The Scientization of Hysteria: New Constellations, Old Characters, Inventive Configurations……………...…………………………….........129
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