Abstract
Following the growing critique of the use of Post-Traumatic Stress Disorder in post-disaster interventions, a new type of intervention aimed at building resilience in the face of traumatic events has been making its first steps in the social field. Drawing on fieldwork of a resilience-building program for pre-clinical populations in Israel, we analyze the paradoxes and ambiguities entailed in three inter-related aspects of this therapeutic project: The proposed clinical ideology aimed at immunizing against traumas; the discursive and non-discursive practices used by the mental-health professionals; and, participants’ difficulties to inhabit the new resilient subject. These contradictions revolve around the injunction to rationally handle emotions in response to disruptive traumatic events. Hence, the attempt to separate between a sovereign rational subject and a post-traumatic subject is troubled in the face of experiences of trauma and social suffering. Furthermore, we demonstrate how these difficulties reconstitute unresolved tensions between mimetic and anti-mimetic tendencies that have been pervading the understanding of trauma in the therapeutic professions. Finally, we discuss how the construction of the resilient subject challenges the expanding bio-medical and neoliberal self-management paradigm in mental health.
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Notes
These are public schools that roughly adhere to a Jewish Zionist-orthodox ideology. The intervention program was deployed in all kinds of schools, including the so called secular (‘mamlakhti’) schools.
All names of workshops facilitators and participants are pseudonyms.
Israel’s memorial day for fallen soldiers.
A Jewish mourning prayer.
In Hebrew, resilience (‘hosen’) and immunization (‘hisun’) share the same linguistic root, thus making the connection between these two concepts seem natural and necessary.
“National trauma” aligns the divergent discourses of the therapeutic and the national by "weaving together emotional symptoms of individual psychopathology with cultural markers of collective experience and identity" (Friedman-Peleg and Bilu 2011:418). This concept was introduced by mental health experts in Israel and is becoming popularized, as exemplified in this excerpt.
Our aim is descriptive and analytic. We do not offer a judgement on the intervention’s effectiveness or its potential benefits or risks for citizens that participate in these activities. Evaluating the intervention efficacy is well beyond the scope of this article, as it requires different methodological and disciplinary approaches.
On the suspicion paradigm and the role of military psychiatry in the construction of trauma see also Brunner 2002.
ICTP was one of ITC founding members, but left the organization in 2011.
An example was the wide distribution (for parents and teachers in thousands of schools all around Israel) during Operation Protective Edge of a special resilience e-booklet titled “An emotional protected space: From stress reactions to functioning in emergency situations.” The booklet was prepared by the Resilience Center (‘Merkaz Hosen’; similar, yet competing with the NGOs covered in this article). It included detailed emotional guidance and diverse practices aimed at better functioning in the face of the stressful events.
Young (2007) traces back this expansive logic to the emergence of a new form of trauma following 9/11 that he calls “PTSD of the virtual kind,” for it includes “distant PTSD” related to indirect exposure to traumatic events (like watching TV images of a terrorist attack), and the expansion of diagnosis to individuals with only some symptoms of the disorder (“partial PTSD”).
The blurring of the distinction between the normal and the pathological in the resilience paradigm has interesting moral underpinnings. Hence, the reluctance to label those who fail to cope with trauma as “abnormal” is probably due to the psy-professionals acknowledgment of the victims’ moral superior status (cf. Fassin and Rechtman 2009). This is especially the case in Israel, where victims of war and terrorism enjoy a special moral status that clears them from any liability for their physical or mental injuries (Lomsky-Feder and Ben-Ari 2007). While emphasizing resilient responses, the resilience experts are usually careful not to blame the victim or harshly criticize individuals for not being resourceful enough.
Warning alarm activated by the Home Front Command defense system before a missile hits the ground.
One of the pioneers in the Israeli emergency psychology field.
These are cards including abstract drawings which are widely-used by psy-professionals in Israel for projective exercises and for eliciting talk about different issues. In contrast to Rorschach or TAT, therapeutic cards are non-standardized tools and they can be used as therapists find suit. For some examples, refer to the following websites: http://www.en.itzikcards.co.il/site/index.asp?depart_id=113508&lat=en, http://nordcards.com/index_en.php?category_id=166, both last accessed July 23, 2016.
The seven days of mourning after the death of a family member.
In writings about the violent national conflict in India, Das (2007) argues that life is recovered through a “descent into the ordinary” (p. 7). In her view, the “ordinary” functions as a space in which victims of violence can re-become subjects.
This project also raises questions about subject formation and the desirability of being able to inhabit the coherent resilient self. For instance, a Lacanian psychoanalyst may find it actually mentally healthy not to be able to inhabit the ideal resilient self, and to "continue" living as a divided subject; the wound should be considered a crucial element that creates paths towards subject formation. The injunction to "be resilient" (before a trauma occurs, or in a country where everybody is potentially traumatized) deserves to be problematized and confronted then with a Lacanian model that insists on contradictions, discontinuities or breaks within the subjects, and with recent questions raised within the sociology of autonomy (see Ehrenberg 2010; 2014). We thank the reviewer of our manuscript for bringing up this point.
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Funding
This study was funded by the Shaine Center, Department of Sociology and Anthropology, Hebrew University of Jerusalem
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Authors Ariel Yankellevich and Yehuda C. Goodman declares that they have no conflict of interest.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Yankellevich, A., Goodman, Y.C. “You can’t choose these emotions… they simply jump up”: Ambiguities in Resilience-Building Interventions in Israel. Cult Med Psychiatry 41, 56–74 (2017). https://doi.org/10.1007/s11013-016-9504-9
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DOI: https://doi.org/10.1007/s11013-016-9504-9