Dealing with Trauma

MARCH 23, 2017

EXCERPT FROM MUSALAHA’S A CURRICULUM OF RECONCILIATION 

The Bible is full of stories of humans interacting with God. Among these interactions, we see hurting people turning to God: asking why, asking for healing or mercy, and pouring out their hearts to God in their confusion and pain. Hannah, David, Solomon, Jeremiah, Peter, Jonah, and even Jesus expressed strong feelings to God and those around them. Psalm 32:3 says “When I kept silent, my bones wasted away through my groaning all day long.” Part of dealing with strong emotions of pain and hurt is letting it out, and expressing it to God and trusted friends.                  

Expressing a lament, or pain, is the first step in dealing with the emotional and physical effects of trauma. Learning to do this will help you deal with your own pain, and help you understand others’ pain as well.                    

Conflicts often beget situations where individuals and communities suffer from trauma. There are those who have been physically traumatized through injury or shock due to a violent encounter, and then, more commonly, there are those who have suffered psychological trauma which is an “experience that is emotionally painful, distressful, or shocking, which often results in lasting mental, spiritual and physical effects.” Trauma has different effects on people depending on how close an individual was to the event: whether the traumatic act happened directly to you, whether you witnessed a traumatic act, whether it happened to someone close to you, and how close in proximity you were to the occurrence.

When people are traumatized, in addition to possibly suffering physical wounds, they suffer heart wounds. Like a physical wound, a heart wound must be taken seriously and requires treatment for healing to take place. These emotional wounds express themselves through grief defined as “intense emotional suffering and a sense of sorrow and deep sadness.” Grief is a natural outcome of trauma, and individuals often go through the cycle of grief and need a support system provided by their religious community, family, and/or friends. The grief or loss cycle looks something like this:

We have all suffered some sort of trauma due to our conflict, and often we try and manage it through our normal emotional capacities. However, sometimes what we have seen, heard, or experienced is too much for us to handle, and our normal coping mechanisms shut down. When this happens, trauma counseling can help us deal with the situation and aid in providing a healthy perspective on what we are going through. When these emotional wounds are ignored or handled improperly, victims of trauma can withdraw from their friends, family and previously enjoyed activities, and begin engaging in dangerous behavior, cease taking care of themselves, and possibly become angry or violent.

As we at Musalaha are not specially trained in dealing with trauma, when we need to address this topic, we bring in professional trauma counselors. If handled by someone unequipped for the task, we can do more harm than good. We are not seeking to train reconciliation leaders or participants in trauma counseling or therapy. Instead, we hope to make participants and leaders aware of what trauma is, and encourage you to seek proper and professional assistance if and when necessary.

Intergenerational Trauma – Defining the Issues

When we discuss the issue of trauma in our Israeli-Palestinian context, we must address the trauma our peoples carry due to the conflict and our respective histories. When it comes to the Jewish people, there is the Holocaust, and the trauma the Israelis faced from the birth of their state until the present. For the Palestinian people, there is the suffering they faced at the hands of outside forces deciding their fate, from the Ottomans and British, and the Nakba of 1948. The clash between the Jewish residents and immigrants of Palestine and the local Arab Palestinians now has a long history of perpetuating the cycle of violence. Long-term historical traumas that resurface in subsequent generations due to continued conflict or remembered suffering are often referred to as intergenerational trauma.

Extensive research on the subject of intergenerational trauma raises a number of relevant and related terms, some of which are used interchangeably. Collective trauma, historical trauma, ancestral trauma, generational trauma, transgenerational trauma, and multigenerational trauma are all terms psychologists, psychiatrists and other social scientists use when describing this phenomenon. To begin with, collective trauma is an emotional, physical or psychological injury or shock that is inflicted on a group of people due to their location, political, cultural, racial or religious beliefs; this can be accidental or random (such as a natural disaster), anticipated but not necessarily intended (such as collateral damage in war), or intentional (such as direct infliction of war or genocide on a population).8 While trauma can result from natural occurrences, it has been noted that traumatic effects are more pronounced when other people are the perpetrators. Collective trauma from a specific occurrence can become intergenerational trauma when a collective trauma is not resolved in the first generation, and consequently is passed on to subsequent generations. Collective trauma becomes historical or intergenerational trauma when the emotional and psychological suffering of a group continues over the course of more than one generation. When traumatic events are 1) widespread and affect many individuals, 2) result in distress and group mourning in present-day communities, and 3) are “perpetrated by out-group members with purposeful and often destructive intent,” they are likely to result in a historical trauma response. Researcher Alan Young argues that trauma is a disease of time, where the “past invad[es] the present in re-experiences and re-enactments” and a person attempts to “defend himself from the consequences;” we are shaped not only by our memories, but by our “present interpretations of events that can continue to impact our lives.”

When we experience a trauma and we do not address it, we can begin to see our changed behavior and reactions as “normal.” We can then pass this “psychological baggage” onto our own children, who can continue to pass it on so long as it remains unaddressed and unresolved. For example, if we experience physical abuse as children, we can pass this abuse or unresolved grief on to our own children if we fail to address the trauma we experience. While there is no single trauma response, there are a number of resulting maladaptive social disorders that manifest themselves in a group. A collective trauma can cause disintegration and fragmentation of a society through changing social norms and values, and can result in poor leadership which has a profound effect on the future of a community.            

Those that Show Resilience

Considering these social, cultural, psychological and biological channels of trauma transmission from one generation to the next, it is important to note that many individuals and groups show resilience when exposed to trauma, and do not develop the trauma symptoms of their parents or community. Researchers suggest that this resilience comes from parenting, age, education, individual temperament, and social and community support. While heredity does play a role in collective memory, environment does so as well.

Manifestations of Historical Trauma Transmission

Some manifestations of intergenerational trauma (historical trauma responses) are:                        

  • Addictions
  • Anger
  • Anxiety
  • Avoidance of problems
  • Cultural cohort effect                         
  • Depression                     
  • Domestic Violence                         
  • Entitlement                         
  • Health Problems
  • Learned helplessness                         
  • Low self-esteem (also a feature of self-destructive behavior)
  • Post-Traumatic Stress Disorder (PTSD) and Complex Post-Traumatic Stress Disorder (C-PTSD)  
  • Self-destructive behavior
  • Social Disintegration
  • Suicidal thoughts/attempts
  • Victimization, Secondary Victimization and Victimhood (or Victim Mentality)

Models for Healing

Spiritual Recovery

Christian institutions like Open Doors International work with groups who have suffered from trauma, and when addressing the spiritual aspect of recovery, they discuss God’s desire for his children to have peace, acceptance, confidence, love, comfort, restoration and healing.                  

God’s Plan for Spiritual Recovery from Trauma and Persecution                            

According to Revelation 12:11, the believers countered the accusations of Satan. “They overcame him by the blood of the Lamb and by the word of their testimony; they did not love their lives so much as to shrink from death.”

We are cleansed by faith in Christ’s blood. His saving grace and a willingness to receive us as sinners saved by grace is the key, not our feelings of worthiness.

The believers declared Christ’s love and forgiveness aloud to themselves, to Satan, and to the world (Romans 8:31-39 declares the same).

God “comforts us in all our troubles, so that we can comfort those in any trouble with the comfort we ourselves have received from God” (2 Corinthians 1:4).           

“If the world hates you, keep in mind that it hated me first…for they do not know the one who sent me” (John 15:18-21).

Confidence instead of intimidation

There will be a time for speaking out forcefully (advocacy) against injustice and sin. “For God did not give us a spirit of timidity, but a spirit of power, of love and of self-discipline” (2 Timothy 1:7).

Intimidation is a first step that often comes when people hate you for what you believe or want what you have. They want to derail your hope and vision of what God has planned for you. But, the truth is that God has given us each a unique and wonderful plan for our lives.

Revelation in the midst of destruction and conflict

“When the storm has swept by, the wicked are gone, but the righteous stand firm forever” (Proverbs 10:25).

God always brings good from evil (Romans 8:28). As Joseph told his brothers, “What man plans for evil, God can turn into good” (Genesis 50:20).

For those who grieve, God will “bestow on them a crown of beauty instead of ashes, the oil of gladness instead of mourning, and a garment of praise instead of a spirit of despair. Instead of their shame my people will receive a double portion, and instead of disgrace they will rejoice in their inheritance” (Isaiah 61:3).

Other Models for Healing

When a community has faced trauma like genocide, colonization, imprisonment, forced assimilation and poor governance, it can result in the loss of culture, identity, and result in alcoholism, poverty and despair,62 among the other symptoms listed before. One approach for intervening in historical trauma suggests the following:                    

1. Confront the historical trauma

2. Understand the trauma

3. Release the pain of the historical trauma

4. Transcend the trauma

This method suggests a community go about this through educational initiatives to increase awareness; to allow for sharing the effects of trauma to allow victims relief; and to seek grief resolution through collective mourning which allows for positive group identity formation and exhibits community commitment.            

In order to regain control, communities can encourage trauma victims’ social efficacy (people’s belief in their ability to succeed) and social control through: completing a challenging task (such as finishing school, receiving a degree, obtaining a job); seeing others in similar situations overcome obstacles to achieve something; and social support.                    

Bibliography                    

“Addictions.” American Psychological Association Online. Accessed May 18, 2013. http://www.apa.org/topics/addiction/index.aspx

“Anger.” American Psychological Association Online. Accessed May 18, 2013. http://www.apa.org/topics/anger/index.aspx

“Anxiety Disorders.” U.S. Department of Health and Human Services, National Institute of Mental Health, 2009. 1-24. Accessed May 18, 2013. http://www.nimh.nih.gov/health/publications/anxiety- disorders/anxiety_disorders_en_ln.pdf

“Biderman’s Chart of Coercion” from Amnesty International in Report on Torture, New York, 1975. 

“Complex PTSD.” National Center for PTSD United States Department of Veterans Affairs, January 1, 2007. Accessed May 18, 2013. http://www.ptsd.va.gov/professional/pages/complex-ptsd.asp 

“Depression.” U.S. Department of Health and Human Services, National Institute of Mental Health, 2011. Accessed May 18, 2013. http://www.nimh.nih.gov/health/publications/depression/complete-index.shtml                    

“Hidden from History: The Canadian Holocaust.” Canadian Genocide Online. Accessed May 18, 2013. http://canadiangenocide.nativeweb.org/intro2.html

“Historical Trauma.” Historical Trauma Online. Accessed May 18, 2013. http://historicaltrauma.com

“International Day for the Prevention of Smoking.” Central Bureau of Statistics, Israel. May 29, 2011.                  

“Post-traumatic stress disorder.” PubMed Health, U.S. National Library of Medicine Online, March 8, 2013. Accessed May 18, 2013. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001923/           

“Prime Minister Harper offers full apology on behalf of Canadians for the Indian Residential Schools system.” Aboriginal Affairs and Northern Development Canada, June 11, 2008. Transcript accessed May 18, 2013. http://www.aadnc- aandc.gc.ca/eng/1100100015644/1100100015649            

“The Residential School System.” Indigenous Foundations site of the University of     British Columbia. Accessed May 18, 2004. http://indigenousfoundations.arts.ubc.ca/home/government-policy/the-residential- school-system.html         

Antze, Paul and Michael Lambek. Tense Past: Cultural Essays in Trauma and Memory (New York: Routledge, 1996).                 

Bandura, A. Social Learning Theory (Englewood Cliffs, NJ: Prentice Hall, 1977).                   

Banyard, V.L., L.M. Williams, and J.A. Siegel. “The long-term mental health consequences of child sexual abuse: An exploratory study of the impact of multiple traumas in a sample of women.” Journal of Traumatic Stress 14 (2001): 697-715.

Baranowsky, A.B., M. Young, S. Johnson-Douglas, L. Williams-Keeler and M. McCarrey. “PTSD Transmission: A review of secondary traumatization in Holocaust survivor families.” Canadian Psychology Vol. 39, No. 40 (1998): 247- 256.

Baumeister, Roy F., and Steven J. Scher. “                   

Bombay, A., K. Matheson and H. Anisman. “The Impact of Stressors on Second Generation Indian Residential School Survivors.” Poster presented at the annual meeting of the National Network for Aboriginal Mental Health Research, Montreal, Quebec, 2008.

Bombay, Amy, Kim Matheson, and Hymie Anisman. “Intergenerational Trauma: Convergence of Multiple Processes among First Nations peoples in Canada.” Journal de la santé autochtone, National Aboriginal Health Organization (November 2009): 6-47

Bonanno, G.A., and A.D. Mancini. “The human capacity to thrive in the face of potential trauma.” Pediatrics 121 (2008): 369-375.

Catani, C., E. Schauer and F. Neuner. “Beyond individual war trauma: Domestic violence against children in Afghanistan and Sri Lanka.” Journal of Marital & Family    Therapy 34 (2008): 165-176.

Champagne, F. and M.J. Meaney. “Like mother, like daughter: Evidence for non- genomic transmission of parental behavior and stress responsivity.” Progress in Brain Research 133 (2001): 287-302.

Self-Defeating Behavior Patterns among Normal Individuals: Review and Analysis of Common Self-Destructive Tendencies.” American Psychological Association Vol. 104, No. 1 (1988): 3-22.

Chansonneuve, Deborah. Addictive Behaviors Among Aboriginal People in Canada, from The Aboriginal Healing Foundation Research Series (Aboriginal Healing Foundation: Ottawa, 2007). Accessed May 18, 2013. http://www.ahf.ca/downloads/addictive-behaviours.pdf

Commission for Historical Clarification [Comisión de Esclarecimiento Histórico]. Memory of Silence [Memoria del silencio] (Guatemala: CEH, 1999).

Daigneault, I., M. Hébert, and M. Tourigny. “Attributions and coping in sexually abused adolescents referred for group treatment.” Journal of Child Sexual Abuse 15 (2006): 35-59.

Danieli, Y. “Introduction: History and conceptual foundations.” In International handbook of multigenerational legacies of trauma, edited by Y. Danieli, 1-20. (New York: Plenum, 1998).          

Dempsey, M. “Negative coping as mediator in the relation between violence and outcomes: Inner-city African American youth.” American Journal of Orthopsychiatry 72 (2002): 102-109.                 

Duran, B., L.H. Malcoe, M. Sanders, H. Waitzkin, B. Skipper and J. Yager. “Child maltreatment prevalence and mental disorders outcomes among American Indian women in primary care.” Child Abuse and Neglect 28 (2004): 131-145       

Evans-Campbell, T. “Historical Trauma in American Indian/Native Alaska communities: A multilevel framework for exploring impacts on individuals, families, and communities.” Journal of Interpersonal Violence 23 (2008): 316-338.                   

Feiring, C., and C. Cleland. “Childhood sexual abuse and abusespecific attributions of blame over 6 years following discovery.” Child Abuse & Neglect 31 (2007): 1169-1186.

Figley, C.R. and R.J. Kleber. “Beyond the “Victim”: Secondary Traumatic Stress.” In Beyond Trauma: Cultural and Societal Dynamics, eds. R.J. Kleber, C.R. Figley and B.P.R. Gersons (New York and London: Plenum Press: 1995).

Foster, Roger. Helping Staff Survivors after Traumatic Event. To be published.

Frijda, N. “Commemorating.” In Collective Memory of Political Events, edited by J.W.

Pennebaker, D. Paez, and B. Rimé (Mahwah, NJ: Lawrence Erlbaum, 1997). Gabrielsen, A.E., and R.A. Good. “Chemical suppression of adaptive immunity.”

Advances in Immunology 6 (1967): 91-229.

Gewirtz, A., M. Forgatch, and E. Wieling. “Parenting practices as potential mechanisms for child adjustment following mass trauma.” Journal of Marital & Family Therapy 34 (2008): 177-192.

Gottlieb, G. “The psychobiological approach to developmental issues.” In Handbook of Child Psychology. In Infancy and Developmental Psychobiology, ed. P. Mussen, Vol. 2, 4th Edition, eds. M.M. Haith and J.J. Campos, 1-26 (New York: John Wiley and Sons, Inc., 1983).

 Greeson, Charlotte, Mary Hollingsowrth, and Michael Washburn. The Grief Adjustment Guide. Sisters, Oregon: Questar Publishers, Inc., 1990.

Hill, Margaret, Harriet Hill, Richard Bagge and Pat Miersma. “Healing the Wounds of Trauma: How the Church Can Help.” Kenya: Paulines Publications for Africa, 2007, Revised edition.

Hirsch, M. “Surviving images: Holocaust photographs and the work of postmemory.” The Yale Journal of Criticism 14 (2007): 5-37.

Horton, D.L. and C.B. Mills. “Human Learning and Memory.” Annual Review of Psychology 35 (1984): 361-394.

Jorden, S., K. Matheson, K., and H. Anisman. “Supportive and unsupportive social interactions in relation to cultural adaptation and psychological distress among Somali refugees exposed to collective or interpersonal traumas.” Journal of Cross-Cultural Psychology, Vol. 40, No. 5 (September 2009): 853-874.

Kellerman, N.P.F. “Transmission of Holocaust trauma: An integrative view.” Psychiatry 64 (2001): 256-267.

Kellermann, Natan P.F. “Transmission of Holocaust Trauma.” AMCHA National Israeli Centre for Psychosocial Support of Survivors of the Holocaust and the Second Generation, 2000. Accessed May 20, 2013. http://www.yadvashem.org/yv/en/education/languages/dutch/pdf/kellermann.pdf    

Kemper, D. “Sociological models in the explanation of emotion.” In Handbook of Emotions, edited by M. Lewis and J.M. Havilland (New York: The Guilford Press, 1993).                  

Kinsfogel, K.M. and J. H. Grych. “Interparental conflict and adolescent dating relationships: Integrating cognitive, emotional, and peer influence.” Journal of Family Psychology 18 (2004): 505–515.            

Landau, J., M. Mittal, and E. Wieling. “Linking human systems: Strengthening individuals, families, and communities in the wake of mass trauma.” Journal of Marital and Family Therapy 34 (2008): 193-209.

Liu, Y. “The mediators between parenting and adolescent depressive symptoms: Dysfunctional attitudes and self-worth.” International Journal of Psychology 38 (2003): 91-100.

Lykes, B. “Terror, silencing and children: International, multidisciplinary collaboration with Guatemalan Maya communities.” Social Science and Medicine Vol. 38 (1994): 543-542.

Mannarino, A., and J. Cohen. “Abuse-related attributions and perceptions, general attributions, and locus of control in sexually abused girls.” Journal of Interpersonal Violence 11 (1996): 162-180.

 Maslow, A.H. Motivation and Personality (New York: Harper and Brothers, 1954). McLeod, Saul. “Low Self Esteem.” Simply Psychology Online, 2012. Accessed May 18,

2013. http://www.simplypsychology.org/self-esteem.html

Moretti, M.M., I. Obsuth, C. Odgers, and P. Reebye. “Exposure to maternal vs. paternal partner violence, PTSD, and aggression in adolescent girls and boys.” Aggressive Behavior 32 (2006): 385-395.

O’Connell, J., D.K. Novins, J. Beals, N. Whitsell, A.M. Libby, and H.D. Orton. “Childhood characteristics associated with stage of substance use of American Indians: Family background, traumatic experiences, and childhood behaviors.” Addictive Behaviors 32 (2007): 3142-3152.

Open Doors International. Lecture on Intergenerational Trauma. Handout “Collective and Intergenerational Trauma.” December 28-30, 2013.

Páez, D., N. Basabe and J.L. González. “Social processes and collective memory.” In Collective Memory of Political Events, edited by J.W. Pennebaker, D. Paez, and B. Rimé (Mahwah, NJ: Lawrence Erlbaum, 1997).

Pomerlau, O.F., and C.S. Pomerlau. “Neuroregulators and the reinforcement of smoking: Towards a biobehavioral explanation.” Neuroscience and Biobehavioral Reviews Vol. 8, No. 4 (1984): 503-513.                         

Neal, Arthur G. National Trauma and Collective Memory: Major Events in the American Century (New York: M.E. Sharpe Publishing, 1998).                

Prince, Robert. “Reflections on the Holocaust,” in Children Surviving Persecution: An International Study of Trauma and Healing (eds. J Kestenberg and C. Kahn; Westport, Ct: Praeger, 1998): pp. 43-53, here p. 46.

Rieckmann, T.R., M.F. Wadsworth and D. Deyhle. “Cultural identity, explanatory style, and depression in Navajo adolescents.” Cultural Diversity and Ethnic Minority Psychology Vol. 10 (2004): 365–382.

Rimé, B., C. Finkenauer, L. Olivier, Z. Emmanuelle, and P. Philippot. “Social sharing of emotion: New evidence and new questions.” In European Review of Social Psychology, edited by W. Stroebe and M. Hewstone, Vol. 9 (Chichester: Wiley, 1998): 146-189.

Rotter, J.B, “Generalized expectancies for internal versus external control of reinforcement.” Psychological Monographs, Vol. 80, No. 1 (1966).

Rutter, M. “Implications of resilience concepts for scientific understanding.” Annals of the New York Academy of Sciences 1094 (2006): 1-12.

Sachar, Edward J. “Neuroendocrine Abnormalities in Depressive Illness.” In Topics in psychoendocrinology, edited by Edward J. Sacher, 135-156 (New York: Grune and Stratton, 1975).

Schmale, A. and H. Iker. “The Psychological Setting of Uterine Cervical Cancer.” Annals of the New York Academy of Sciences 125 (1966): 807-813.

Shelton, K.H. and G.T. Harold. “Marital conflict and children’s adjustment: The mediating and moderating role of children’s coping strategies.” Social Development 16 (2007): 497-512.

Skalar, L.S., and H. Anisman. “Stress and Cancer.” Psychological Bulletin 89 (1981): 369-406.

Somasundaram, D. “Collective trauma in northern Sri Lanka: a qualitative psychosocial- ecological study.” International Journal of Mental Health Systems Vol. 1, No. 5 (2007).

Spaccarelli, S. “Stress, appraisal, and coping in child sexual abuse: A theoretical and empirical review.” Psychological Bulletin 116 (1994): 340-362.

Stark, E. Coercive Control: The Entrapment of Women in Personal Life (Cary, NC: Oxford University Press, 2007).

Stark, K. D., K.L. Schmidt and T.E. Joiner. “Cognitive triad: Relationship to depressive symptoms, parents’ cognitive triad, and perceived parental messages.” Journal of Abnormal Child Psychology 24 (1996): 615–631.

Tait, Caroline L., Aboriginal Mental Health Research Team, National Network of Aboriginal Mental Health Research, Cultural and Mental Health Research Unit, and Sir Mortimer B. Davis-Jewish General Hospital. Fetal Alcohol Syndrome Among Aboriginal People in Canada: Review and Analysis of the Intergenerational Links to Residential Schools, from The Aboriginal Healing Foundation Research Series (Aboriginal Healing Foundation: Ottawa, 2003). Accessed May 18, 2013. http://www.ahf.ca/downloads/fetal-alcohol- syndrome.pdf

Thabet, A.A.M., V. Tischler and P. Vostanis. “Maltreatment and coping strategies among male adolescents living in the Gaza Strip.” Child Abuse & Neglect 28 (2004): 77- 91.

 Thoits, P.A. “Stress, coping, and social support processes: Where are we? What next?” Journal of Health and Social Behavior, extra issue (1995): 53-79.

Underwood, P.W. “Social support. The promise and reality.” In Handbook of Stress, Coping and Health, edited by B.H. Rice, 367-391 (Los Angeles, CA: Sage, 2000).

 Weine, S.M., D.F. Becker, T.H. McGlashan, D. Laub, S. Lazrove, D. Vojvoda and L. Hyman. “Psychiatric consequences of ‘ethnic cleansing’: clinical assessments and trauma testimonies of newly resettled Bosnian refugees.” The American Journal of Psychiatry 152 (1995): 536-542.

 Wesley-Esquimaux, Cynthia C. and Magdalena Smolewski. Historic Trauma and Aboriginal Healing, from The Aboriginal Healing Foundation Research Series (Aboriginal Healing Foundation: Ottawa, 2004).

 Wiseman, H., P. Barber, A. Raz, I. Yam, C. Foltz, and S. Livne-Snir. “Parental communication of Holocaust experiences and interpersonal patterns in offspring of Holocaust survivors.” International Journal of Behavioral Development 26 (2002): 371-381.

Yehuda, R., L.M. Bierer, J. Schmeidler, D.H. Aferiat, I. Breslau and S. Dolan. “Low Cortisol and Risk for PTSD in Adult Offspring of Holocaust Survivors.” The American Journal of Psychiatry Vol. 157, No. 8 (2000): 1252-1259.

Yellow Horse Brave Heart, Maria. “Oyate Ptayela: Rebuilding the Lakota Nation through addressing historical trauma among Lakota parents.” Journal of Human Behavior and the Social Environment Vol. 2, No. 1⁄2 (1999): 109-126.

Young, Alan. The Harmony of Illusions: Inventing Post-Traumatic Stress Disorder (New Jersey: Princeton University Press, 1995).