Abstracts Anthropology

Contextualizing PTSD as Diagnosis and Intervention: Situating Trauma and the Subjective Experience of Suffering in Locally Meaningful Worlds

by Emilia Rose Orsted Holmbeck

This paper examines the diagnostic classification of PTSD in view of how traumatic experiences are perceived, articulated, and responded to in locally meaningful ways. Drawing on cases from Haiti (James 2016) and Indonesia (Lemelson, Kirmayer, and Barad 2007), two disparate social contexts that have both incurred deep suffering under acute political violence, I reflect on the applicability of the PTSD construct to cultural contexts that are different from the Western-scientific milieu from which it was born and became institutionalized. I argue that making sense of individual suffering requires close attention not only to the circumstances under which the traumatic experiences unfold but also to the ways in which individuals interpret and respond to their suffering. In this context, the PTSD category is but one of many cultural systems of meaning that provide a framework for understanding and responding to one’s pain. As such, uncritical and universal applications of Western notions of trauma that disregard locally situated experiences of suffering, its meanings, and culturally salient coping strategies run the risk of both misinterpreting behavior and prescribing treatment that conflicts with locally meaningful categories of understanding. Simultaneously, understanding traumatic experience necessitates a recognition of its critical relational dimension, not only because trauma often involves painful ruptures to social relations but also given the role that social relations play in healing processes. The implication of this is that psychiatric models that pathologize trauma and neglect the role that culture and social relationships can play in healing are insufficient for explaining and treating subjective suffering everywhere.