In May 2003, ISTSS joined the VIII ECOTS, organized by ISTSS sister society, the European Society for Traumatic Stress Studies, in Berlin, Germany. On May 20, during that meeting, the ISTSS board of directors held a productive annual midyear meeting. Board members in attendance concentrated a great deal of time during the meeting following up on strategic planning that began in the summer of 2000. It was then that the society’s long-term priorities were formulated: 1) fiscal resources, 2) membership, 3) structure and governance, 4) programs, products and services, and 5) advocacy for the traumatic stress field. In the past year, ISTSS has made great progress in most of these areas, and I will give details about these issues in relation to strategic planning in the fall issue of StressPoints. I attribute the success of the board meeting and the progress made toward strategy to the dedication of members of the board, committees and task forces, and headquarters staff.
With more than 1,000 participants from 50 countries, the VIII ECOTS was a great success. ISTSS board members presented premeeting institutes and participated in symposia. To mention one example, ISTSS’s president elect, Paula Schnurr, chaired a parallel plenary discussion together with ESTSS board member Berthold Gersons on how to move toward making progress appropriately in trauma research and therapy, with Chris Brewin, Andreas Maercker and Stuart Turner as discussants. While all emphasized the need to take cultural and political conditions (diversity) into account as much as possible, they were a bit embarrassed that they were speaking on this issue as white professionals from North America and Western Europe to a predominantly white North American and Western European audience. Stuart Turner, ISTSS treasurer, presented figures to put this into perspective. For instance, each year, disasters kill 50,000 people, seriously injure 74,000, displace 5 million from their homes and affect 80 million in some other way; in 2001 the United Nations High Commissioner for Refugees, or UNHCR, was concerned for 21,793,300 people, among them 12,071,700 refugees and 914,100 asylum seekers. The vast majority of these survivors live in developing countries. Such findings highlight our need as a society to broaden membership in terms of diversity.
A Look at Berlin’s History
Berlin has long been branded as a city of many symbolic meanings and contrasting connotations. While it lags in industrial and financial strength, Berlin now is the vivacious capital of a country that has offered many riches to the arts, sciences and humanities, but it also has contributed to and suffered its share of massive oppression and traumatization. It was a symbol for Prussia—i.e., discipline and organization, but also culture; and it was the center of Nazi power. With the erection of the Berlin Wall in post-World War II, Berlin became the symbol of a divided Germany and political fragmentation. And when the wall came down in 1989, Berlin began to symbolize the unification of a new Germany—an ongoing process that still continues after nearly 15 years.
Nowhere is this more apparent than in the former “Todeszone” of the wall, where an artificial city, like an artificial heart, is being constructed. One can see wonderful architectural achievements there, but many side streets remain uninhabited, like a ghost town. Still, we can literally watch “the growing together of what belongs together” (Es wächst zusammen, was zusammen gehört), to use a phrase from former German Chancellor Willy Brandt on the day the wall came down. And contributing to this growth are many politically traumatized people who found asylum in a city that wants to be a place of peace and hope. May we all, in many ways, become inspired by this rejuvenating city. Above all, let it help us to realize that healing—even though it may take a long time—is possible after the worst of experiences.
Germany has wrestled intensely with the blackest pages of its past and—increasingly during the last decade—has not shied away from the extremely difficult task of integrating its painful past rather than burying it. For me, this is symbolized by a small statue that stands in front of a cathedral in the eastern part of Berlin that I visited during a break from the conference. This statue honors the members of the Herbert Baum Gruppe—a Berlin-based Jewish resistance group, most of whom were murdered during the Nazi era. My mother-in-law is one of the few surviving members of this group. Constructed while East Berlin was still part of the Deutsche Democratic Republic (DDR), the statue depicts the organization, in accordance with the DDR ideology, as a “workers” resistance group. Following the unification of the city, a glass plate was placed in front of the text. It allows the original words to be read while adding the names of those murdered and recognizing the Jewish identity of this group. Many other such plaques and statues in Berlin have “layered” text, signifying affirmation of past meanings to trauma and oppression as well as acknowledgment of previously denied or new meanings. I know of no other city that has taken such heed of the warning that those who forget the past will be condemned to repeat it.
Psychotraumatology’s Past Has Had Its Ups and Downs
When preparing for my trip to Berlin, thinking about the city’s history also made me think about the history of our field of psychotraumatology, with periods of high and low—high when there is consciousness about trauma and its sequelae and low when there is ignorance and denial. I have learned that delving into our origins is well worth the dig. Not only do we learn about the constellation of political, cultural, medical and military factors that contribute to or affect society’s interest in trauma and trauma treatment, but we also can discover treasures of clinical and theoretical wisdom that remain unsurpassed.
Therefore, I am pleased that scholars from various disciplines increasingly are showing interest in the historical roots of the trauma field. Apart from the Swiss psychiatrist Esther Fischer-Homberger who published the classic work, Die traumatische Neurose: Vom somatischen zum sozialen Leiden (1975), within our own field Judith Herman has paid the most attention to history in her book Trauma and Recovery (1992). In addition, the French military psychiatrist Louis Crocq wrote a large work on Les Traumatismes Psychiques de Guerre (1999). Various textbooks on trauma contain chapters on the history of traumatology, and recently Lars Weisaeth published a fine and interesting article on the European history of trauma in the Journal of Traumatic Stress (Dec. 2000). Professionals with backgrounds in history and anthropology have criticized trauma professionals’ attempts to write about our own history, suggesting that we would be able to write only historical fiction and that writing history should best be left to historians. Historians and allied professionals do make excellent contributions to the history of psychotraumatology—for example, Traumatic Pasts: History, Psychiatry, and Trauma in the Modern Age, 1870–1930, edited by Mark Micale and Paul Lerner (2001). But such disciplines may have their own biases, too. They can be strikingly naïve and incorrect in their dealings with clinical diagnostic issues or with the nature of traumatic memories. For instance, they may falsely believe that Dissociative Identity Disorder (DID) is merely a mental disorder suggested by therapists to susceptible patients, or that trauma-processing techniques are invariably harmful, or that trauma survivors by definition always have voluntary access to their traumatic memories and that therefore dissociative amnesia does not exist. Instead of an either/or approach to our history, we could make major steps forward if historians and traumatologists joined forces. I believe that this would be enormously helpful not only in the study of specific types of trauma—war trauma is now receiving major attention in terms of its history—but also in attempts to integrate the history of trauma across various situations.
The trauma field has a long history, and new chapters are being written continually. Other professionals and the media also are actively defining our struggles with clinical understanding as they relate to their own needs and political agendas. At times, various segments of our field have been under attack, particularly those dealing with the sequelae of childhood maltreatment, especially childhood sexual abuse. It saddens me to say that as a whole, traumatologists have not always been sufficiently supportive of the besieged among us. And however sound our research and effective our treatments, any of us could become the next target. Many in the field are trying to strengthen the scientific foundations, but still there are attacks: Recently the field of traumatology was depicted in a trauma book review as the “Church of Traumatology.” It would be interesting and enlightening to study the current forces that influence how society views trauma and those who try to help trauma survivors.
E-mail o.vanderhart@fss.uu.nl or istss@istss.org.