Fink Ann E
a Lehigh University.
AJOB Neurosci. 2019 Jul-Sep;10(3):137-144. doi: 10.1080/21507740.2019.1632970.
Frantz Fanon practiced psychiatry in a colonized Algeria during its struggle for independence. In his 1961 work , Fanon described cases from his treatment of Algerian nationalists and French colonists. I present one of Fanon's cases as an ethical inquiry into posttraumatic stress disorder (PTSD). A French police inspector, who is employed in torture, visits Fanon with symptoms of PTSD after escalating domestic violence. The patient asks Fanon "to help him torture … with a total peace of mind." Is it possible to treat the inspector in a meaningful way? More broadly, how might researchers and clinicians balance collective responsibilities to individual symptoms and social conditions? The answer depends on how trauma is framed: as disorder of meaning-making or circuit dysfunction, as individual illness or social rupture, as potentially gendered and racialized. These framings can reveal different views on the allocation of responsibility for the causation, expression and management of PTSD. I do not propose that it is inherently immoral to modify traumatic memories; nor do I question the efficacy of individual interventions. Rather, I ask whether PTSD has a social meaning that transcends individual comfort in decision making about erasure. What do individual interventions accomplish in the absence of concurrent political and social transformations? I argue that a holistic understanding of PTSD entails a set of social obligations: to address at its root political, gendered, and racialized violence, to repudiate occupations centered on exploitative manipulation of individuals and cultures, and to social change that prioritizes these commitments.
弗朗茨·法农在阿尔及利亚为争取独立而斗争期间,在被殖民的阿尔及利亚从事精神病学工作。在他1961年的著作中,法农描述了他治疗阿尔及利亚民族主义者和法国殖民者的案例。我呈现法农的一个案例,作为对创伤后应激障碍(PTSD)的伦理探究。一名参与酷刑的法国警察督察,在家庭暴力升级后出现了创伤后应激障碍的症状,前来找法农看病。这位病人要求法农“帮他毫无心理负担地实施酷刑”。有没有可能以有意义的方式治疗这位督察呢?更广泛地说,研究人员和临床医生如何在对个体症状和社会状况的集体责任之间取得平衡?答案取决于对创伤的界定方式:是作为意义构建的障碍还是神经回路功能障碍,是个体疾病还是社会破裂,是否可能存在性别化和种族化。这些界定方式可以揭示对创伤后应激障碍的成因、表现和管理责任分配的不同观点。我并不是说修改创伤记忆本身就是不道德的;我也不质疑个体干预的有效性。相反,我想问的是,创伤后应激障碍是否有一种社会意义,这种意义超越了在关于消除记忆的决策中个体的舒适度。在没有同时进行的政治和社会变革的情况下,个体干预能取得什么成果?我认为,对创伤后应激障碍的全面理解需要一系列社会义务:从根本上解决政治、性别化和种族化的暴力问题,摒弃以对个人和文化的剥削性操纵为中心的占领行为,以及优先考虑这些承诺的社会变革。