Stories of Trauma and Idioms of Distress: From Cultural Narratives to Clinical Assessment

Abstract

In the case of long-term major traumatic events such as the Cambodian tragedy there is a close relationship between the individual's clinical history and the collective history of his/her ethnic group. Most of the refugees who have survived a given historical event share the same history with nearly the same trauma, the same loss, the same flight to escape, the same difficult resettlement and so on. However, even if refugees have lived the same events, this does not mean that they have experienced the same trauma. Both trauma and culture shape human experience and may give the illusion of a common destiny that would flatten out varying individual fates, whereas in fact different destinies are contingently linked together. These questions pose a challenge to clinicians' knowledge of the relationship between trauma, culture and subjectivity and of course they challenge the concept of post-traumatic stress disorder as well. While knowledge of cultural differences is essential for clinicians, it is equally essential to be aware of how the individual's psyche may find hidden paths within the constraints imposed by culture, or even by trauma itself. To illustrate this issue, the article focuses on the case study of a Cambodian refugee to France.

Which Language Does PTSD Speak? The “Westernization” of Mr. Sánchez

“…Both trauma and culture shape human experience and may give the illusion of a common destiny flattening out varying individual fates, whereas different destinies are actually contingently linked together (Rechtman, 2000). Therefore, in addition to cultural differences, it is important to recognize within-group and individual differences.…”

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“…In this regard, it is also important for clinicians to "be aware of what they represent for their client" (Holder 2002) and also for their interpreter in terms of the power structures inherent in society. Thus working cross culturally, one needs to think about the way in which the racial and cultural biases of the past continue to impact on the ways in which services are set up and delivered and the way in which clients may believe they need to engage with services (Rechtman 2000). "Softening" clients for clinicians and clinicians for clients might then be seen as a way of negotiating power differentials reflecting the position of the interpreter as a bridge between two cultures, and two power positions, attempting to manage sometimes disparate worldviews and identities in a relationship in which their role is to "interpret" and their pay depends on making a coherent job of this.…”

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