Reviewed by:

• Trauma by Lucy Bond and Stef Craps
• Lewis Kirshner (bio)

This concise and informative treatment of the history and changing uses of the term "trauma" covers a broad range of topics, from clinical to popular social contexts. While the book's intended audience encompasses mainly literary and cultural scholars, students in mental health disciplines and social sciences can find much here of relevance for their own fields. Trauma, as the Bond and Craps observe, has become a thriving subject of political and social discourse, applied widely and sometimes loosely to an enormous variety of situations. As such, it has expanded our understanding of forms of human suffering, both the psychological effects of personal and social violence, and the more subtle influence of global events like environmental and technological changes on our lives. At the same time, the prevalent focus on trauma risks becoming a master narrative that obscures important political and economic issues. The authors tread a careful path between an appreciative, receptive approach to the expanding applications of the concept of trauma and a critical skepticism about its relevance.

Chapter One introduces the history of the trauma concept with the 19th century's concern with physical injuries resulting from the changed conditions of modern industrial life. Puzzling medical complaints following railway and work accidents created legal and financial problems with which European societies increasingly had to wrestle. Not the least of these was the status of non-organic afflictions that raised medical suspicions of malingering, character weakness, and the validity of diagnoses like hysteria or neurasthenia. Freud, of course, adapted the term trauma to the impact of life events on similar patients who consulted him for various mental and behavioral complaints. Under the influence of the French neurologists Charcot and Bernheim, he redefined hysteria as a post-traumatic state characterized by problems of memory of unassimilable experiences, perhaps with an organic basis. In the place of recollection, the patients displayed sometimes dramatic physical and emotional symptoms, whose origins could be reconstructed. Freud pursued a psychological explanation [End Page 800] for these conditions, at first emphasizing the delayed effect of childhood sexual abuse, which awaited puberty to achieve its full significance. Out of this work came his important notion of an unmanageable level of excitation that breaks through protective barriers (as a property of the nervous system) and the consequent splitting or fragmentation of the mind into dissociated parts.

Beginning with Studies on Hysteria (1895), Freud pointed to the importance of sexual repression in contemporary culture for the formation of neuroses. In his classic case reports, he argued that symptoms could be understood as indirect expressions of the conflict between forbidden wishes and prohibitions that could be discovered by interview methods. Although he began his investigations in a medical context, scholars now view these historical phenomena in social terms related to the changing status of women and the role of sexuality in bourgeois European life, rather than as purely individual disorders. The suffering person represents the product both of a unique private history and of complex developments in the wider society. Freud himself wrote throughout his life about these intertwined levels of trauma, but his major psychoanalytic theories gradually focused on the inner workings of the mind. In so doing, his attention turned from the causal importance of sexual abuse to the role of subjective sexual fantasies in neurosis.

World War I brought a heightened awareness of post-traumatic illnesses to psychiatrists confronted with the numerous military victims of shell-shock and combat stress. While the devastating consequences of combat on soldiers may have formerly been taken as implicit in the normativity of war or accepted as inevitable aspects of the presence of evil in human life, suddenly the human effects of military trauma became a pressing medical and social issue. Despite persistent resistance to the medical validity of post-traumatic conditions, the extent of the problem could not be ignored. Freud himself was forced to extend his explanations of trauma from the fate of sexual arousal and repression to the consequences of actual violence. His hypothesis of a pleasure principle governing mental...

审核人：

• 露西·邦德（Lucy Bond）和Stef Craps拍摄的创伤
• 刘易斯·科什纳（生物）

这种对“创伤”一词的历史和不断变化的用法的简明扼要的对待涵盖了从临床到流行的社会环境的广泛主题。尽管本书的目标读者主要是文学和文化学者，但心理健康学科和社会科学领域的学生可以在这里找到与其各自领域相关的许多知识。正如邦德和胡扯所观察到的那样，创伤已经成为政治和社会话语中蓬勃发展的主题，广泛地适用于某些情况，有时甚至是松散地适用于各种情况。因此，它扩大了我们对人类苦难形式的理解，既包括人身和社会暴力的心理影响，也包括环境和技术变化等全球性事件对我们生活的更为微妙的影响。同时，对创伤的普遍关注使人们难以理解重要的政治和经济问题。作者在宽泛地应用创伤概念的欣赏性，接受性方法和对其相关性的批判怀疑之间走了一条谨慎的道路。

第一章介绍了创伤概念的历史以及19世纪对现代工业生活条件变化导致的身体伤害的关注。铁路和工作事故后令人不解的医疗投诉造成了法律和财务问题，欧洲社会越来越不得不与之搏斗。其中最重要的是非有机疾病的状况，这种疾病引起医学界的误诊，性格虚弱以及歇斯底里症或神经衰弱等诊断方法的怀疑。当然，弗洛伊德将“创伤”一词改编为适应生活事件对类似患者的影响，这些患者向他咨询了各种心理和行为投诉。在法国神经学家Charcot和Bernheim的影响下，他将歇斯底里症重新定义为一种创伤后的状态，其特征是无法记忆的记忆问题，也许具有有机基础。在回忆的地方，患者有时表现出剧烈的身体和情绪症状，其起源可以被重建。弗洛伊德追求一种心理解释[End Page 800]针对这些情况，首先强调了儿童期性虐待的延迟影响，这种等待性青春期正要充分发挥其作用。在这项工作中，他提出了一个重要的观念，即无法控制的兴奋程度会突破保护性障碍（作为神经系统的属性），从而使大脑分裂或分裂成相互分离的部分。

从歇斯底里研究开始（1895），弗洛伊德指出，在现代文化中，性压制对于神经症形成的重要性。在他的经典案例报告中，他认为症状可以理解为禁忌意愿和禁忌之间冲突的间接表达，可以通过访谈方法发现。尽管他是在医学背景下开始研究的，但现在，学者们从社会角度来看这些历史现象，这些现象与妇女地位的变化和性在欧洲资产阶级生活中的作用有关，而不是纯粹的个体疾病。受苦的人既代表着独特的私人历史，又代表着整个社会复杂发展的产物。弗洛伊德本人一生都在写这些相互交织的创伤，但是他的主要心理分析理论逐渐集中在头脑的内部运作上。这样做的时候，他的注意力从对性虐待的因果重要性转向对主观性幻想在神经症中的作用。

第一次世界大战给精神病医生带来了更多的关于创伤后疾病的认识，这些精神病医生面对的是许多遭受炮击和战斗压力的军事受害者。尽管战争对士兵的毁灭性后果以前可能被认为是战争规范中所隐含的，或者被认为是人类生活中邪恶存在的必然方面，但军事创伤对人类的影响突然变成了紧迫的医学和社会问题。尽管对创伤后疾病的医学有效性一直存在抵触情绪，但问题的严重性仍然不可忽视。弗洛伊德本人被迫将对创伤的解释从性唤起和压抑的命运延伸到实际暴力的后果。他的假说是控制精神疾病的享乐原则。