McKinney - Best Reference... Teaches About Trauma Collective Violence

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BREAKING THE CONSPIRACY OF SILENCE 265
“Breaking the Conspiracy of

Silence”: Testimony, Traumatic
Memory, and Psychotherapy
with Survivors of Political
Violence
Kelly McKinney
Abstract In this discussion, I examine ways the “trauma story” is elicited and structured
in the context of psychotherapy with survivors of political violence. Data from two
ethnographic case studies are presented. One is based on the activities at a rehabili-
tation program for survivors of torture and refugee trauma in New York, where I was
a participant-observer. This case deals with the themes of countertransference and the
“conspiracy of silence.” The other is based on interviews I conducted with clinicians
and discursive materials that address the topic of a therapeutic approach called the
“testimony method.” Through these examples and an analysis of several ethical, nor-
mative, and epistemological assumptions related to traumatic memory and the
memory work of testimony and witnessing, I will demonstrate how an ideology may
form that works against restoring the full agency of clients. Conclusions of this study have
relevance for anthropologists who act as “witnessing professionals.” [Trauma, testimony,
witnessing, memory, psychotherapy]
In late-20th-century Western culture, trauma emerged as a paradigmatic

discourse for defining the catastrophic, calamitous, or otherwise injurious, for
attributing blame and accountability, and for organizing subjectivity and iden-
tity. The traumatic has also become a metaphor for characterizing the
historical epoch of the present (Douglass and Vogler 2003). Constituted with
the discourse of trauma has been an intensification of a therapeutic ethos that
registers distress in a psychological idiom. In this idiom, suffering is located in
individual psyches and social interventions focus on the domain of the self and
ETHOS Vol. 35, Issue 3, pp. 265–299, ISSN 0091-2131 online ISSN 1548-1352. © 2007 by the American
Anthropological Association. All rights reserved. Please direct all requests for permission to photocopy or
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http://www.ucpressjournals.com/reprintInfo.asp. DOI: 10.1525/ETH.2007.35.3.265.
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the interpersonal (Pupavac 2004). A new mental health specialty devoted to

helping survivors of collective violence, including torture and war, address the
psychological effects of their traumatic experiences was born out of this context
thirty years ago and has uniquely contributed to its elaboration. My discussion
centers on this mental health specialty.
In Allan Young’s masterful study of trauma, memory, and psychiatry, he included

a description of how the clinical protocol of an inpatient treatment program for
Vietnam Veterans with Post Traumatic Stress Disorder (PTSD) was formed
around the presumption “that every patient conceals a narrative, his pathogenic
secret” (1995:227). The goal for patients to disclose that secret drove much of
the therapeutic activity in that setting. In the present discussion, I will examine
that “pathogenic secret,” otherwise known as the “trauma story” (or sometimes
as the “story”), where it also plays an important role in therapies for survivors of
collective violence, particularly when professionals define the therapeutic
process as both a political and a healing event. Data from two ethnographic case
studies are presented to form my analysis. The first is based on a staff meeting at
an U.S. psychosocial program for survivors of torture and refugee trauma where
I was a participant observer. This staff meeting included an in-service training
that dealt with the themes of countertransference and the “conspiracy of
silence.” The second case study is based on primary sources and on interviews I
conducted with U.S. and Danish clinicians that involve a therapeutic approach
called the “testimony method.” This is a special, highly structured technique in
which the trauma story is drawn out over a series of sessions and shaped explic-
itly into a prescribed form by the clinician with the consent and participation of
the client. After the story is audiotaped and transcribed, a copy may be kept by
clients to do with it as they wish or copies are disseminated into the wider social
and political arena. Other forms of psychotherapy also invite the telling of the
trauma story, but not with the same degree of coordination toward producing a
specific narrative form and a written document.
Through these case studies and an analysis of several ethical, normative and
epistemological assumptions about the nature of traumatic memory and narra-
tive as “memory-work” (Kidron 2003), I will demonstrate how particular
responses to client needs may form and the consequences of such: clinicians
may subordinate social needs of clients to the ethical call to bear witness, neg-
lect to acknowledge the nuanced moral complexity of political violence, and
lose sight of the understanding that traumatic memories are politically and
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culturally mediated. As a result, an ideology may crystallize that casts clients as

innocent victims, paradoxically denying a sense of their full moral and psycho-
logical agency rather than restoring it (Haaken 1994, 1998).
Methods and Settings

This discussion is based on fieldwork I conducted in 1999 and 2000 in the
United States and Copenhagen, Denmark, interviewing clinicians at several
rehabilitation centers for survivors of collective violence. Data was also col-
lected from lectures, workshops, and conferences for these professionals that I
attended. I also interviewed other service providers for refugees such as lawyers.
My study took me to Copenhagen to interview clinicians there who were key
influences in shaping the landscape of expert knowledge and practices in the
field internationally.
My primary fieldwork setting was at the “Haven,” a small psychosocial program

for survivors of political violence located in a large urban area in the United
States. After gaining IRB approval from my university and institutional approval
from the field site, I began my research as a participant-observer. This involved
occasionally helping with minor administrative tasks, attending staff meetings
and workshops, and observing and talking with the counselors as they carried
out their everyday routines. One of my research goals—to gain an understand-
ing of the practices and expert knowledge of clinicians—was partly determined
by the fact that clinicians at this and other programs I visited were protective of
clients and concerned about the consequences of permitting observation of
counselor–client encounters. I was told this was a particularly sensitive issue in
these types of programs because much of the therapeutic work was about
rebuilding a sense of trust and safety with clients for whom these basic elements
of being-in-the-world had been stolen or destroyed. It was explained that an
outside researcher could be experienced as a violating and undermining pres-
ence in the therapeutic process. In addition, there were issues of confidentiality
at stake for some clients whose lives or the lives of their families continued to be
in real and present danger. Although I was able to interview ten Haven clients
who were introduced to me by their counselors and were aware of my status as a
researcher, my overall approach involved studying-up, with a focus on profes-
sionals. I audiotaped most interviews and staff meetings, but many conversations
and observations were recorded through handwritten notes as they happened
spontaneously or because tape-recording seemed inappropriate.
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The Haven staffed an Anglo-American director and a Serbian–Bosnian clinical

director. Additionally, there were four refugee bicultural counselors: two from
the Former Yugoslavia, one from Latin America, and the other from Africa, as
well as a French social work intern. Approximately 70 clients were seen at the
Haven during 1999 and 2000. The clients represented a wide range of national
and ethnic backgrounds and included Kosovar Albanians, Iraqis, Kurds,
Tibetans, Moroccans, Colombians, Haitians, and Sri Lankans. Clients at the
Haven received social services (referrals for housing, legal aid, medical care,
employment, and English classes) and psychological services (supportive coun-
seling and, if deemed necessary, referrals for more intensive psychotherapy and
medication).
The Narrative Imperative

At one rehabilitation program for torture victims founded in Denmark in the
early 1980s—renowned because it was one of the first centers of its kind and
for its significant financial and institutional support, professional training, and
network building with over one hundred rehabilitation programs across the
world—the goal to get clients to tell their trauma stories was institutionalized
as the cornerstone for all psychotherapeutic practices (Ortmann et al.
1987:165). Today, this legacy continues, as the most thoroughly investigated
and scientifically validated treatment for PTSD involves cognitive-behavioral
techniques, including exposure therapy and anxiety management, which
require patients to activate their traumatic memories through images and
words, repeatedly, until these memories lose their power to cause fear, anxiety
and other distress in the patient (Rothbaum and Foa 1996).
However, in recent years, several critiques have been put forth challenging the
orthodoxy of the notion that survivors must tell their stories for recovery, lead-
ing to changes in the therapeutic practices at this and other programs. Several
of these critiques have accompanied those leveled at psychiatric responses to
political violence more generally for their medicalizing and colonizing effects
(see Pupavac 2004; Summerfield 1999). It has been suggested, for instance, that
psychotherapy is a culturally specific healing modality and should not be
applied universally, and that many survivors prioritize their needs or under-
stand their distress in political or social terms and may not consider therapeutic
memory work a pressing and necessary condition for managing their suffering
and rebuilding their lives (Elsass 1997; Summerfield 2003; Zarowsky 2004).
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Clinicians have also questioned whether verbalizing traumatic memories

toward the goal of integrating them psychically is even possible because, as
these critics maintain, trauma impairs nonverbal domains of the body (Levine
and Frederick 1997; van der Kolk 1994).
This perspective assumes a common model of trauma that defines troubling

traumatic memories as psychically unassimilated or unmetabolized (hence,
their repetition or their production of symptoms) but departs from it by sug-
gesting that the therapeutic aim to verbalize and, hence, assimilate and
integrate these memories may fail because trauma has an impact on neurologi-
cal levels of the body that may not be directly accessible to verbal and symbolic
meaning-making domains of the brain. Critics have also argued that they have
seen successful psychotherapeutic outcomes where the trauma story remained
unspoken or at least was not the focus of apparently successful treatment.
Finally, a slowly accumulating body of scientific evidence suggests that thera-
pies such as debriefing that rely on verbalizing traumatic memory may actually
exacerbate traumatic stress or have negligible therapeutic efficacy (see Sommer
and Satel 2005 for review).
Yet, and this point is important, even as a diverse range of therapeutic interven-
tions have become mainstream in this young field, including those that do not
include techniques for eliciting the narrativization of traumatic memories, psy-
chological experts continue to turn to the trauma story—as testimony and
bearing witness—for politicizing the therapeutic process and redemption. As
this discussion will demonstrate, certain confessional practices that are about
harnessing, mobilizing, and circulating traumatic memory have particular
investments and meanings ascribed to them by clinicians who work with sur-
vivors of political violence with wider implications worthy of exploration.
These clinical discourses significantly contribute to a globally expanding net-
work of remembrance practices, reinforcing what Allen Feldman refers to as
our “post-Holocaust world of anamnesis” (2004:166).
Politicizing Therapy: The Trauma Story,

Narrativity, and Identity
Many clinicians in this field take an activist position in their work with sur-
vivors of genocide, ethnic conflict, forced migration, and torture, rejecting
standards of therapeutic neutrality. Some would argue that beyond symptom
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reduction, the therapeutic process has important moral and political dimen-
sions and redemptive value that should be acknowledged and emphasized.
From their perspective, the dialogical process of narrativizing traumatic mem-
ory is itself constitutive of redemptive self and social reconstruction for
survivors, and through this activity the identities of client–patients and psycho-
logical experts may be remade into testifying survivors and witnesses of history.
Further, the traumatic memory emergent within psychomedical contexts may
be transformed through the special medium of memory-as-testimony from a
medicalized and, therefore, depoliticized recollection into an artifact enabled
to circulate in a new moral economy and a political register (Feldman 2004).
On the outgoing telephone message of the Haven program, the voice of the
Haven director, whom I will call “Ed,”1 greeted potential and current clients with
this invitation, “We want to hear your story.” The “story” to which Ed referred
could mean the story of the clients’ situation, their circumstances, needs, and so
forth, in other words, the story of who the clients are in terms of services they are
interested in receiving. However, there is another story implied in this message:
the “trauma story.”
Assumed in clinical practice with trauma survivors is the notion that every
client holds some sort of traumatic memory, a memory that by definition dis-
rupts the continuity of identity or self (the trauma as discontinuity) but can
also ground the survivor’s identity or self (part of who I am is the trauma I
remember and the trauma story I may tell). Each person has a unique story, a
story of memories that both construct and represent the self at reflected and
unreflected levels. Narratives of first-person experience are the stuff of psy-
chotherapy and valued for their power to counter totalizing collective
historical narratives (Young 2007). A particular kind of truth (distinct from the
truths found in other forms of historical data) is thought to reside in the sub-
jective experience of each person. Yet the individualized personal narrative of
memory, or autobiographical memory, is thought to have only latent political
and redemptive value until it is somehow performed and communicated in a
social context. These stories of traumatic memories simultaneously make pos-
sible and are made possible by collective practices of memory work and
identity construction. Many clinicians believe that it is their duty to take client
memories outside the therapeutic relationship for social justice, by doing
things such as instituting oral history projects. However, some clinicians would
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take the more radical view that some form of politicization and redemption
are possible when traumatic memories are articulated and received within the
therapeutic dyad.
Both in clinical settings where individual therapeutic transformation is the goal

and in larger social domains where survivor identity is culturally valorized and
the demonstration of traumatic injury has become a resource for gaining polit-
ical, economic, and symbolic capital on both individual and collective levels
(Kleinman and Kleinman 1991), it is commonly believed that the trauma story
has an important function in the formation of what is a particular kind of iden-
tity. Such an identity is constituted with what is considered the irreducibility or
indelibility of the traumatic past. As Kidron has beautifully demonstrated in
her case study of identity-making practices in a support group for descendants
of Holocaust survivors in Israel, when this narrative is produced in a context in
which particular cultural grand narratives, paradigms of memory, and “cultural
and social structural identity-making practices are present,” the trauma sur-
vivor narrative can come to serve as an “irrevocable master identity” (Kidron
2003:538).
Michael Lambek and Paul Antze have foregrounded the memory embedded in
“confessional” practices by making it central to their analysis of narrative and
identity (1996). They suggest that “Foucault’s study of the history of sexuality
might well have been about the discourses of memory: the substance of confes-
sion, after all, is memory, and the technique of memory is frequently
confession” (1996:xx). Ian Hacking, in describing the genealogy of what he has
called “memoro-politics,” remarks how humanist, antiscientific ideology shifted
“sciences of memory” from their associations with neurology, anatomy, and so
on, to the “doctrine that memory should be thought of as narrative.” He claims,
in fact, that “the metaphor for memory is narrative” (1995:251). Genealogies of
memory such as those provided by Antze, Lambek, Young, and Hacking are
important for problematizing the ethical and normative privilege given to what
analytic philosopher Galen Strawson has called “narrativity” (2004). In the pres-
ent study, narrativity is closely linked to a politics of emancipation and social
justice, and in some discourses these are thought to be inherently connected.
Lambek and Antze have rightly cautioned about this tendency by pointing out
that “there is nothing liberating in narrative per se” (1996:xix). This is an
important point that I will return to at the end of the discussion.
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The Haven: Case Study 1

Intake Interview—Introducing Trauma Story Ideology
At the Haven, the intake interview for clients included a section that asked the
clinicians to rate clients’ “functioning” based on their “ability to discuss
trauma history with their counselor.” Clients were given a score at intake,
which, if low, presumably would (and should) improve through the course of
service provision. This measure inscribes the normative expectation that dis-
closing the trauma story is a requisite for healthy functioning.
The Haven counselors were instructed not to “retraumatize” clients by coerc-

ing them into revealing their traumatic memories. Patience, flexibility, and
sensitivity were of the utmost importance: it was “up to the client” to reveal his
or her past. This was stressed both to the counselors when they were trained to
conduct the intake interview and to the client before the intake process began.
Nonetheless, the measure of functioning based on clients’ abilities to speak
about their traumatic pasts illustrates how the trauma story’s potential and
expectation for its production were explicitly structured into care from the very
beginning of the therapeutic process.
The intake interview was just one point at which the underlying ideology about
the need for the narration of the trauma story was made explicit at the Haven.
Other situations, such as staff meetings in which the counselors and directors
discussed clinical issues, also presented opportunities for producing and con-
testing trauma story ideology as I will now illustrate with a case study of a staff
meeting at the Haven.
A Haven Staff Meeting: Resistance and Countertransference

At one Haven staff meeting, Emil, the clinical director, conducted an in-
service training on “resistance” and “countertransference” to further
educate the counselors about the clinical aspects of their work at the Haven,
although to my mind there was little specific evidence indicating that the
counselors were negligent or lacking in this area. In-services like this were
fairly routine, but this particular one stands out for a number of reasons,
some of which would take this discussion out on tangents that must be left
unexplored in this article. However, I will note that underlying the stated
purpose of the in-service was an unspoken agenda to get the counselors
more in line with the evolving professionalization of the program. This implicit
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message was heard by the counselors and added even greater emotional
intensity to the meeting.
The in-service training centered on an article, “Psychotherapists’ Participation

in the Conspiracy of Silence about the Holocaust” (Danieli 1984), that all the
staff were assigned to read prior to the meeting, which presented the results of a
study conducted with a group of therapists who had worked with Holocaust sur-
vivors. The author of the article, Yael Danieli, a well-known trauma therapist,
found that many of the therapists in her study experienced countertransference
reactions that prevented them from productively acknowledging and therapeu-
tically working with their clients’ traumatic pasts. Danieli has said she believes
these forms of “resistance” contribute to what she and others refer to as the
“conspiracy of silence.” Emil, Ed, and the counselors and I were all quite famil-
iar with Danieli as she was a fixture in the local trauma community. Furthermore,
as Emil and the counselors had recently attended an experiential workshop
held at a university trauma studies program in which Danieli had been the
guest instructor, they were freshly reminded of Danieli’s mission to make clini-
cians fully recognize their “resistance” to trauma by aggressively confronting
them.
Emil opened his presentation by explaining to staff that “transference are feel-
ings that a client has toward a therapist, social worker, or case manager,” and
“countertransference are the feelings that a therapist has toward her client.”
Countertransference feelings are not just “compassion” but “feelings that are
unhelpful and harmful to the client.” Ed added that “these feelings are not nec-
essarily based in reality, but may be images, fantasies from your past, and your
history.” A clinician’s countertransference reactions with clients who have been
exposed to violence, explained Emil, are highly prone to defensive types of
resistance with respect to their clients’ trauma. These reactions include “indif-
ference, avoidance, and denial.”
The following are excerpts from Emil’s presentation as he continued to

describe what happens when countertransference becomes resistance:
It is important to get back to the story of the survivor. It must be told to be

integrated. For the therapist not to listen is a secondary traumatization. It
is very important to listen. I would like to read one short quotation from
Terence Des Pres: “to hear him is met by the need to ignore him”—to
join the “conspiracy of silence.” Mourning, grief, and loss are all part of
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recovery and without integration, healing is impossible. We need to

encourage and incorporate healing, mourning, grief, and loss. Each per-
son has an internal need to be heard and to tell his story. It’s not only their
material needs so we want to have a holistic approach here. Ignoring sig-
nificant aspects of a client’s trauma is hurtful and disrespectful. We need
to create a holding environment, and I hope we can go in that direction in
the future.
[Resistance would include] if the therapist forgot something the client

told them, if they switched to another theme, if they felt bored with the
same story over and over. The therapist may feel guilt also because they
didn’t suffer like the client. This could lead to a dysfunctional position
where the client would be encouraged to call at anytime, where the
boundaries would get blurred.
the powerfulness of the evil and tragedy that happened to the survivor,
perhaps talking about it could be potentially shameful for the client. The
survivor has the fear that the therapist will somehow not respond, or that
they cannot bear the evil of the event that was experienced, and in different
ways the therapist conveys that message.
If we see the person as a victim rather than a survivor, victim implies that
nothing can be done or changed, and it denies the capacity of survival and
the pre- and postexperiences of the person. This is just another way of
avoiding reality.
And pain, if people did not feel pain or suffering, or didn’t need help, they
wouldn’t come for help. To not address their pain would be not only
disrespectful to them but also to those who have died.
A heated discussion followed Emil’s presentation, with the counselors arguing

with Emil and Ed that they were not denying their clients’ pain or otherwise
silencing their clients. On the contrary, as Claire (French social work intern)
said after Emil spoke, “if anything, we have provided a very conducive climate
for the clients to open up. It is genuine and comes from the heart.” Meseret
(African counselor) also argued, “I picked him [a client] up at the train station,
and provided him with a good quiet place to speak and feel comfortable. This is
what we have been doing throughout . . . We don’t want to tell them we know
they have feelings.” The meeting eventually ended, with the counselors feeling
somewhat stunned and misunderstood by the whole notion that they were
denying their clients’ pain and joining the “conspiracy of silence” if the clients
didn’t talk about their “feelings” or tell their “stories.”
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Trauma, Memory, Narrative, and the Conspiracy of Silence

Certain assumptions that guided the Haven’s clinical activities were articulated
through Danieli’s work but, more significantly, through the work of Judith
Herman. Herman was not mentioned in the fragments I provided from the
Haven staff meeting but came up later in the group discussion. Her ground-
breaking work on trauma, published in 1992, has been described as being at the
“center of the contemporary trauma mental health movement, as a thoughtful
and compelling synthesis of disparate knowledge and experience” (Larrabee
et al. 2003:354). Many clinicians in the trauma field, including Emil, would
acknowledge that Herman’s contributions be read not only for their clinical
applications but also as a political manifesto informing their own sense of pro-
fessional mission and methods.
What Emil made clear in his presentation is that the trauma story in the thera-
peutic process “must be told to be integrated.” For Herman, too, telling the
trauma is essential to the healing process: “in the second stage of recovery, the
survivor tells the story of the trauma. She tells it completely, in depth and in
detail” (1992:174). Yet the articulation of the trauma story in a therapeutic set-
ting is not just about an individual processing his traumatic memory but,
instead, is about breaking “the conspiracy of silence,” a collective silence that,
according to Danieli, is complicit with violence. Therefore, the therapists’ role
with survivors of political violence is above all moral and political, and not simply
therapeutic. As Herman writes:
the therapist is called upon to bear witness to a crime. She must affirm a
position of solidarity with the victim. This does not mean a simplistic
notion that the victim can do no wrong; rather, it involves an understand-
ing of the fundamental injustice of the traumatic experience and the need
for a resolution that restores some sense of justice. This affirmation
expresses itself in the therapist’s daily practice, in her language, and above
all her truth-telling without invasion or disguise. [1992:135]
For the conspiracy of silence to be broken, the survivor must tell the story to
someone who, through perceptive listening, bears witness to both the trauma
of the survivor and the traumatic historical event. In Emil’s opinion, when the
Haven counselors focus too much on meeting the social needs of clients, it is at
the potential cost of the client not telling the trauma story; this amounts to par-
ticipating in an act of collusion with evil, insofar as the counselors are not
performing their ethical duty to bear witness. The counselors are not just being
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“hurtful and disrespectful” or showing a lack of clinical competence but are

subjecting the clients to “secondary traumatization” and participating in the
“conspiracy of silence.” They join history in denying the truth of violence and
the truth of human suffering. Denying the truth in this way not only harms the
living, “but also . . . those who have died.” In this regard, the responsibility of
the counselor to “bear witness” is rather extraordinary.
According to these clinical discourses, added to this responsibility are the many
dangers of “countertransference.” Emil explained that while treating survivors
of political violence, the clinician must exercise extreme vigilance over coun-
tertransferential reactions because all kinds of “resistance” on the clinicians’
part to the “powerfulness of the evil and tragedy that happened to the survivor”
may arise. This is especially so because, according to Herman and others,
“Trauma is contagious. In the role of witness to disaster or atrocity, the thera-
pist at times is emotionally overwhelmed. She experiences, to a lesser degree,
the same terror, rage, and despair as the patient.” This phenomenon is known
as “traumatic countertransference” or “vicarious traumatization” (Herman
1992:140; see Young 2002 for views on these “neuroses”). Traumatic counter-
transference can lead to the therapist unwittingly identifying with the
perpetrator by sadistically reenacting the victimization of the client, smother-
ing and placating the client with kindness, taking on the role of rescuer, losing
confidence and feeling helpless, or becoming overwhelmed by anguish and
despair (Herman 1992:140–147). According to Herman, “traumatic transfer-
ence and countertransference reactions are inevitable. Inevitably, too, these
reactions interfere with the development of a good working relationship. Certain
protections are required for the safety of both participants” (1992:147).
Søren Jensen, a Danish psychiatrist and internationally recognized figure in the

treatment of survivors of political violence whom I interviewed and heard lec-
ture several times, explained at a workshop he gave in New York in March 2000
that no matter how much clinical training and experience one has, working
with trauma survivors “will affect you. You will have nightmares, flashbacks and
all that, but this is part of life.” What can make the “contagion” more bearable,
he offers, is the understanding that what you are doing is “not just a job and
that you are working in a context of human rights work.”
According to trauma therapists, key protections from destructive counter-

transferential reactions include an ongoing clinical supervision relationship in
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which the counselor can analyze her feelings and reactions toward her clients, a
regime of self-care practices (“caring for the caretaker,” as they say), and estab-
lishing what are called “good boundaries” with clients, which would include set
appointment times and rules about calling the therapist (Herman
1992:140–147). Advanced training including Emil’s in-service workshop would
be considered another countertransference management technique. Finding
greater purpose and transcendent meaning in the clinical work, as Jensen
proposed, is also thought to protect clinicians from destructive counter
transference.
Although inevitable, if left unmanaged, countertransferential reactions repre-

sent not just clinical failures but also political failures of witnessing, according
to clinicians like Danieli and Emil. However, there is a high price to pay for
properly bearing witness. According to this logic, in the intersubjective space
created in the act of telling and witnessing, the therapist needs to allow for the
empathic transfer of the trauma (hence, flashbacks and nightmares). Bearing
witness to the trauma is an act of sacrifice because the trauma’s effects will then
be embodied by the therapist. However, this sacrifice elevates the clinical
encounter to a new moral and political plane; in empathically experiencing the
client’s suffering, clinicians renounce their individuality to become a conduit of
history, a necessary condition for transforming the patient’s testimony from
one of personal trauma to one voicing a call for historical truth.
Bearing witness is also the responsibility of the client, and to bear witness the
client must remember. Thus, the memory constituted within the therapeutic
construct of the trauma story plays an essential role in the witnessing process.
Trauma is thought to rupture both the continuity (in which continuity is asso-
ciated with identity) of the self and the community. The rupture is enlarged
both by a lack of acknowledgment or denial by others about what happened
and by the inability of the sufferers to acknowledge or bear witness to their
own suffering. Memory then becomes the vehicle through which identity can
be reinstated. Private trauma and personal memory are thus connected with
public and collective memory, simply in the act of telling and receiving, if there
is mutual awareness among the bearers of witness that the trauma occurred
within a historical and collective context. This exchange enables the client to
reclaim his own position as witness to the truth of what happened and achieve
membership within a collective of testifying “survivors” whose identity is
anchored in a discourse of remembrance (Laub 1995).
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Communities of survivorship are both imagined and realized through networks

of social practice (Murakami and Middleton 2006). One such community is a
survivor-based, grassroots activist group, Torture Abolition Survivors Support
Committee International (TASSC). Traumatic memories of political violence
are also narrated and circulated and identities of survivorship and witness
instated every year on June 26; this is the UN International Day in Support of
Victims of Torture, which was proposed to the UN General Assembly by
Denmark in the late 1990s. On this day commemorative activities are per-
formed internationally, with the participation of survivors, clinicians and other
service providers, and the general public. In the three commemorations I attended
in the United States and Denmark, clinicians took leading roles in organizing the
events. In all, several survivors provided testimony of their experiences.
The Trauma Story and Practice

Several clinicians I interviewed do not actively chase the trauma story in the
therapeutic relationship, but take their cues from the clients and go from there.
These clinicians are less interested in constituting memory and the trauma
story as political vehicles than as therapeutic ones and, thus, are not as moti-
vated by an ethics of remembrance. A Danish clinician, Dr. Eriksen, spoke in
2000 as a representative of this alternative position that nonetheless carries
with it certain ambivalences and doubts about the trauma story. He said to me,
I think it is the quality of the relationship, and because of your knowledge

of post-traumatic stress and of how ordinary human decency has been vio-
lated, you treat this person in a certain way. I think this is the most
common healing factor. And then on top of this may come, for some
people, the integrating of the trauma.
Dr. Eriksen went on to say,
The idea of needing to go to the trauma story was never an idea at our
program. You could go back but you should titrate it very carefully and
not overwhelm the person. So there is some principle that we do agree
upon in this house: don’t overwhelm the person with the traumatic mate-
rial. Go slow and sort of soft. The last thing does not necessarily mean it
has to be talked about. There has to be some process, in some way or
another, in some ways with words and in other ways on physical and expe-
riential levels, but some processing does have to take place. For these
people, their inner world is so chaotic and painful so to be successful you
need to help them modulate their inner states in a more efficient way so
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they can sleep more better, or whatever. A lot of work is helping clients
establish themselves here in a safe and secure way. That is the ground for
everything else. So you shouldn’t go into traumatic situation until you han-
dle that first. Sometimes we will never go back to the traumatic material.
Both Danish and U.S. clinicians reported that some clients talk almost exclu-
sively about their present life concerns, like worry about family members back
home who are still in danger, or about practical matters like finding gainful
employment. For some clinicians, this can be a satisfactory therapeutic course.
In this regard, if one insists on using the construct of “trauma,” trauma would
be considered “continuous” rather than “post” (Silove et al. 1991). At the
Haven, because the counselors’ work was simultaneously geared toward pro-
viding some sort of supportive counseling and helping their clients meet social
needs, there was less room for the possibility that the clients would tell their
trauma story. Nevertheless, the directors, Emil and Ed, would insist that there
should be room enough.
Thus, while the Haven maintained a critical view on practices that overem-
phasize the psychological aspects of individual functioning and staff tried to
follow the mandate that service provision is defined by what the clients say they
need, the trauma story was retained as an important potential facet of treat-
ment. Although the directors did not police the counselors about the trauma
story, the counselors nevertheless felt caught within a bind created by two
different ethical demands: one a call to respect the social narrative when it was
presented by a client and the other a call to ethically bear witness by eliciting
the trauma story. When I asked Isabela, the Latin American counselor, about
her thoughts on her work, one thing she explained to me was that many
clients came in wanting services for their asylum cases. These clients were
not interested in receiving “supportive counseling” when it was offered to
them, nor did they disclose their trauma stories in an emotionally invested way
that would be considered proper to a therapeutic relationship or to bearing
witness. After these types of clients received their asylum, in Isabela’s words,
they “walked away from the program and never looked back.” Like the other
counselors, Isabela had been taught to deliver the services asked for by clients,
at the same time it is possible that she may have failed to issue a proper thera-
peutic invitation to those clients who were not interested in “talking” and
supportive counseling. As I have described, it is believed that this failure
could signify an unconscious resistance to trauma and Isabela’s unwitting
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membership in the conspiracy of silence. This was something that Dr. Eriksen
worried about:
You can never be sure. You are always feeling that insecurity though that if
you don’t go back to the traumatic material, is that in the interest of the
client or yourself? You will always have the position of not knowing and
[to] try to be [as] open as possible to what you feel intuitively would be the
best path for the client and it’s more or less following after the client.
However, I feel that Isabel had slightly different concerns. I thought I heard
disappointment that some of the asylum-seeking clients were not interested in
a more intimate engagement with her and that although she availed herself to
bearing witness, she was unable fulfill her duty as the clients were not able or
did not want to tell their stories or talk about their feelings. Her tone also indi-
cated that she felt some clients used her instrumentally toward their own ends
(Fassin and d’Halluin 2005). I heard frustration, too. Isabela conveyed that the
ethical call to bear witness placed a heavy burden on the shoulders of coun-
selors when it often seemed that social needs of clients should be prioritized.
Case Study 2
The Testimony Method
This brings the discussion to my second case study, the testimony method. I
consider this method an extension and consolidation of the ideas that traumatic
memories should be narrated and that therapy should be politicized as dis-
cussed in the first case study. According to the official history of the testimony
method, in the 1970s, Chilean mental health professionals found that having a
torture victim recount his or her story for the legal and political purposes of
documenting torture had the added benefit of psychological improvement.
They formalized a therapeutic technique called the “testimony method”
because of this. At the time, this method found cultural resonance in the
Catholic confession and the testimonio tradition in Latin America.
In the testimony method, victims of political repression provide a “detailed

description of the events leading to their present state of suffering” that is tape-
recorded, transcribed, and signed by the patient and his clinician–witness
(Cienfuegos and Monelli 1983:48). Testimonies usually contain “fragmented
chronological and affective sequences” detailing detention, torture and the vic-
tim’s pretrauma history, which need to be told over a series of sessions to create
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a coherent narrative, “so that the traumatic experience may be integrated and
understood in the context of the life of each individual” (Cienfuegos and
Monelli 1983:48).
The testimony method was originally intended to help patients regain a sense of
political commitment, to “create a document of historical value for future gen-
erations,” and to serve as a legal document.2 According to Ana Julia Cienfuegos
and Cristina Monelli, the actual written document can function as a portable
and transferable “memory” (1982:49). It was reported to me by clinicians who
use this method today that patients use the documents in different ways. Some
want to rewrite the document as their “narrative” changes, some keep it in a
drawer, and others may hand it to people and say, “This is my story.”3
In subsequent years, the testimony method was appropriated and its theoriza-
tion elaborated by Søren Jensen and his then wife, Danish social psychologist
Inger Agger (Agger 1993; Agger and Jensen 1990, 1996). Its use since has been
documented with survivors of the Mozambican and Bosnian wars, Holocaust
survivors, and asylum seekers and refugees in the Netherlands (Igreja et al.
2004; van Dijk et al. 2003). The testimony method is considered a legitimate
form of therapy in this field, and has been used within a repertoire of other psy-
chosocial interventions at several programs. However, the Haven did not
employ the testimony method, partly because it would have required more
clinical training, organizing, and supervision than the program could manage.
Besides the life of its own the document may take on outside the therapeutic
context, the method itself shares healing mechanisms with psychoanalytic and
cognitive–behavioral approaches to trauma including catharsis, cognitive reap-
praisal, and desensitization (van Dijk et al. 2003). Clinicians have also posited
that constructing a coherent story or narrative out of fragmented, incomplete,
and painful memories challenges defenses such as psychic numbing and allows
the survivor to create at least a provisional structure of meaning and intelligi-
bility for moving forward in life (van Dijk et al. 2003). As Jensen said, the
testimony method can work to “create order out of chaos.”
In separate interviews I conducted with Agger and Jensen in 2000, each

expressed the belief that the impulse to create a narrative out of suffering is a
common human response (“it’s deeply human,” said Agger), and that the testi-
mony method, used judiciously, with “proper guidelines” and in the context of
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an ongoing therapeutic relationship, can have definite therapeutic effects.

Agger seemed to think, more than Jensen, that the desire to provide testimony
(as trauma story) is a universal response to trauma, and that because of this she
said it “takes care of the cross-cultural issue.” By contrast, Jensen explained to
me that few people “have worked systematically to see if testimony works
cross-culturally. Political and more religious people seem to do better with tes-
timony because we have found that they are more alike across cultures than
compared to individuals within their culture.”
Importantly, Agger and Jensen both suggest that perhaps one of the most
important healing factors of this method was not necessarily the narrative pro-
duction but the ritualized “symbolic” activity of externalizing and concretizing
the memory on a piece of paper. The “memory” becomes an object under the
power of its owner. Jensen described this process as “putting the evil on paper
and getting rid of it. The person can then take the document under his arm,
hand it to people, and reframe what happened by deciding what he wants to do
with it.” For both Agger and Jensen, creating a special ritual space for the testi-
mony to be performed also gives it its potency (Agger 1993). Jensen also
explained that “telling the story by itself has no healing without the context”
and that for it to have benefits, the testimony must be produced in a context of
shared meaning. In this regard, Agger said that they join anthropologists such
as Arthur Kleinman (1988) by focusing on the ritual aspects of psychothera-
peutic healing rather than on the specifics of narrative production and the
content of memory.
The Testimony Method with Bosnian Refugees

A group of clinicians in Chicago who work with Bosnian Muslim refugees have
also employed the testimony method (Weine and Laub 1995; Weine et al.
1998). The leader of this team, Stevan Weine (1999), established an oral his-
tory project that archives the testimonies of Bosnian survivors in their program
and wrote a book based on these testimonies. I will now address an article that
Weine coauthored with Dori Laub, a Holocaust survivor, trauma theorist, and
psychiatrist at Yale, that is representative of certain discourses on trauma and
testimony that have come to dominate trauma theory in the humanities as well
as clinically. My aim is not to single out Weine or Laub but, instead, to use
their work as examples of larger tendencies that should be examined critically.
Their work is related to Jensen’s and Agger’s as they too want to demedicalize
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the therapeutic process by framing their work within a larger system of

meaning—human rights and social justice—and certainly in this small world of
expertise they all know each other and each other’s work. However, I perceive
that Weine and Laub’s sensibility has emerged more out of humanities and
Holocaust studies than Jensen’s and Agger’s.
In the article “Narrative Constructions of Historical Realities in Testimony

with Bosnian Survivors of ‘Ethnic Cleansing,’ ” Weine and Laub focus mostly
on the clinician’s important role in witnessing “historical reality” in the thera-
peutic domain. They are interested in how the clinician’s participation in the
activity of survivor testimony serves as a crucial link in connecting “an individ-
ual’s personal story and a collective’s history” (1999:259).4 According to these
authors,
mental health professionals working with these survivors should develop a

psychohistorical formulation that addresses: (1) the centrality of narrative
of historical realities in the survivors’ use of testimony; (2) the significance
of survivors’ narratives of historical realities as historical documentation;
(3) the clinician functioning as a witnessing professional. [1999:258]
Thus, clinicians should consider themselves moral and political agents in doc-
umenting history (and also in constructing history by preventing future
violence) and not just actors in the “narrowing prisms of individual psy-
chopathology and the psychotherapeutic dyad” (Weine et al. 1998:1724).
However, Weine and Laub explicitly disagree with Danieli’s position that
countertransferential reactions of “resistance” in effect deny the historical real-
ity of traumatic events or are about joining the conspiracy of silence. They
posit instead that “clinicians’ shortcomings in adequately bearing witness to
narratives . . . may be because they are not familiar enough with the therapeu-
tic problems to have developed an appropriate treatment approach,” that is, the
“psychohistorical” approach to therapeutic testimony they are promoting
(1999:258). Although these authors want to diminish the severity of Danieli’s
condemnation of therapists who exhibit resistance, a certain kind of moral
responsibility is nonetheless placed on the clinician; Weine and Laub prescribe
that the clinician should use “history” and professional authority as political
tools for the prevention of future violence. This would include educating and
working with other professionals outside the clinical domain, state actors, and
the general public. They share with Danieli, Herman, and Emil the belief that
bearing witness and transmitting the knowledge of historical reality to others
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has the redemptive capacity to halt future conflict and repression. This belief
resonates in the post-Holocaust mantra, “Never again.”
According to Weine and Laub, despite the testimony’s unique capacity for rep-
resenting historical truth, it is also subject to “distortions” and “myth,
revisionism and ignorance” (1999:251). For example, the authors describe how
Bosnian survivors spoke about “ancient ethnic hatreds” as the driving force
behind the war, to recommend that clinicians should be aware of their own
unquestioned acceptance of what Weine and Laub consider myths like this.
They offer that clinicians should consult other sources of historical documenta-
tion, such as journalistic and scholarly accounts and other testimonies, to gain a
more accurate description of historical reality. Weine and Laub suggest that cli-
nicians disabuse their clients of these distorted and erroneous notions, not just to
provide a “better” representation of history but also to intervene into the moral
worlds of clients. For the latter goal, it is important that the clinician reframe the
“survivors’ stories away from ethnic hatreds toward a perspective that values uni-
versal human rights above all else” during the testimony process (Weine et al.
1998:1724). Furthermore, clinicians also are to structure client’s stories into pre-
scribed themes and shape them into a chronological order, which potentially
“enforces the linearity of historical time and promotes history as a teleological
continuum without ruptures or alterity” (Feldman 2004:165). These interven-
tions thus have normativizing and moralizing functions, sculpting as they do
traumatic memories into “such master narratives as the idea of progress, collec-
tive reconciliation, or evolution to human rights equity” (Feldman 2004:165).
As a result of Laub’s prior work with Holocaust survivors and their families, he
has come to observe that “survivors did not only need to survive so that they
could tell their stories; they also needed to tell their stories in order to survive”
(1995:63). This largely held assumption provides the template for framing the
production of traumatic memories for Bosnian Muslims in the Chicago pro-
gram. Weine, as a self-identified descendant of persecuted Eastern European
Jews, joins Laub in reiterating the normative and ethical imperatives to give
voice to survivors and to bear witness that have arisen in conjunction with the
emergence of the Jewish Holocaust as the prototype of historical trauma in
the West. I would maintain that testimony and commemorative practices of
the Jewish Holocaust variety have emerged as some of the dominant models
for shaping the contours of practices of posthistorical trauma memory work in
much of Western trauma theory.
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At this juncture, I will trace several beliefs and assumptions that together set
into motion a causal logic that can result in a form of ideological closure that
Dominick LaCapra calls the “grid of victimization” (2001). In this mythical
structure, psychological, moral, and political ambiguity and complexity are
eliminated by purifying and idealizing victims and demonizing and othering
perpetrators.
Denial of Fantasy and the Innocence of Victims

Scholars have suggested that there is a tendency in Western culture to deny or
devalue fantasy or the imagination in many cultural practices including, as
Laurence Kirmayer points out, formulations about “psychological develop-
ment” (1996). Thus, fantasy may be marked as the childlike, primitive,
irrational, and psychopathological and be polarized against adulthood, civiliza-
tion, rationality, and sanity, except in circumscribed social domains in which
fantasy and the imagination are celebrated and often commoditized—televi-
sion, films, literature, art, and so forth. Lambek and Antze have identified
instances of what they call “literalist” interpretations of memory, which associ-
ate memory with veridicality, facticity, and realism as examples of the broader
cultural tendency in the West, and especially in the United States, to make
“assault[s] on fantasy” (1996:xxviii).
This cultural disposition toward controlling and domesticating the potentially

destabilizing power of fantasy and the imagination has found its way into clini-
cal discourses about trauma victims. I interviewed a New York–based trauma
expert, Martha Bragin, who argues for the reintegration of fantasy and the
unconscious in clinical treatment of survivors of political violence (2001).
Using Kleinian psychoanalysis as a springboard for her thesis, Bragin claims
that unconscious fantasies of victims including aggressive, rageful, sadistic, and
destructive ones are not fully acknowledged in what has become the hegemonic
clinical discourse on trauma in the United States, where psychology also tends
to be antipsychoanalytic. According to Bragin, transgressive “phantasy,” a fun-
damental aspect of human nature that grounds the potential for aggression, has
become taboo to acknowledge when talking about “innocent” victims. Janice
Haaken (1994) too has observed that transgressive parts of the selves of victims
are typically associated with the injuries of their traumatic pasts. These are per-
ceived as effects of the violence perpetrated against subjects rather than as
desires or wishes that reflect a prior and, perhaps, common human capacity for
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286 ETHOS
the infantile, aggressive, or vengeful. The denial of these aspects of human sub-
jectivity contributes to rendering an unambiguous picture of innocence or
purity that appears to be a necessary condition for legitimizing victimhood in
Western culture. I would argue there is a connection thus between the denial
or disavowal of victim fantasy (as irrational urges, wishes, and desires, especially
of the vengeful and aggressive variety) and the need to idealize trauma sur-
vivors as pure and innocent as preconditions for clinicians to have solidarity
with them and for the possibility of redemption.
In clinical work, the role of fantasy is further complicated (and implicated) in

this equation, as sometimes survivors of historical trauma do not have subjec-
tive certainty about what was real or imagined in their experiences. The very
feeling that what happened to them may have been a dream, or something they
made up, can be extremely unsettling. What are considered the culturally and
historically legitimate or normative distinctions made between what is “inter-
nally generated and what is externally imposed, what is understood to be more
literal and what more symbolic” become blurred for survivors, and to have
those distinctions reconstructed or reinforced can actually be important for
healing. Therefore, given our sociocultural constructions of reality, fantasy, and
imagination, my concern here is not to argue about what is real or not but,
instead, about when and what happens when the fantasy end of the spectrum is
devalued and subsumed by the literal.5
Accurate Memory and the Need to Believe

Psychological anthropologists have observed that memory is approached
through “remembering;” in that memories are performed “in the service of
something” and that memory performance may be evaluated (Miller
1994:175). However, Lambek describes how in Western society normative dis-
courses on memory may isolate and define memory as a thing rather than an
act, framing it in terms of “accurate or inaccurate.” This is true to the extent
that it is difficult to conceive of memory in other terms like “subtle, tactful or
reasonable, well or poorly crafted, elegantly or clumsily performed . . . justified
or unjustified” (1996:238). With the politicization of the therapeutic process,
that is, when memory becomes testimony, survivor memory, insofar as it is
embedded in the accurate–inaccurate cultural binary and is subjected to
processes that evacuate transgressive fantasy from its production, is often taken
at face value as “accurate.”6 Indeed, for witnessing professionals to doubt the
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“accuracy” or what may be called the truth of the traumatic memory of sur-
vivors may be tantamount to joining the conspiracy of silence. This stems
partly from the need of clinicians to compensate for the fact that
one of the fundamental fears experienced by survivors of torture and

organized violence, both at the time of the trauma, but even long there-
after, is that their stories will not be fully comprehended or worse still,
that their testimony will not be believed. [Silove et al. 1991:488]
This fear has itself been likened to a form of terror or torture because, in fact,
sometimes survivor stories are not believed or are negated or silenced. This
may be more likely to happen when master narratives of truth are produced in
the interests of a state or other political actors who are perpetrators of violence
and repression or who otherwise have an agenda that would be threatened by
these testimonies outside of therapeutic contexts.7
Yet most therapists would agree that both the registration of a traumatic event
and the memory work that happens after are interpretive, culturally con-
structed, and socially mediated processes. Memory conceived in this way is
anything but the objective, unassimilated, literal record of some kind of event
and cannot necessarily be evaluated as accurate or inaccurate. Two opposing
“chronotopic conventions of memory” (Lambek and Antze 1996:xix) thus
operate in the formation of testimony: what Lambek and Antze have identified
as the “therapeutic” and “juridical.” Most obviously, the two chronotopic con-
ventions merge when memory as testimony is circulated by clinicians in the
public sphere, for example, in oral history projects or during observances of
UN Torture Day. These are considered therapeutic as well as political events
(for survivors and witnesses), but “juridical” memory displaces or obscures
“therapeutic” notions of memory in these contexts. However, more subtly this
displacement can occur when clinicians break the conspiracy of silence by bear-
ing witness to the truth of historical trauma in the context of therapy. In its
extreme, this stance involves embracing the memory narrative as “literal.”
Purity of Trauma
Ruth Leys, a historian of trauma, takes two prominent trauma theorists, Cathy
Caruth and Bessel van der Kolk, to task for certain claims that they have made
about trauma, witnessing, narrative, and literal memory (2000). Here I am select-
ing parts of her argument that I believe are most salient to my own (see Schwartz
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288 ETHOS
2002 for critique of Ley’s work). According to Leys, Caruth maintains, in line
with other trauma theorists (esp. Jewish Holocaust specialists) that trauma
ruptures the possibility of representation; trauma is fundamentally incompre-
hensible, unreadable, and inaccessible. However, the symptoms of psychic
trauma, such as flashbacks or nightmares, are thought to be “literally and time-
lessly encapsulated in a special memory system” as is the trauma itself (Leys
2000:254). These “engravings” or “icons” of external events are not representa-
tions, however, but exist unassimilated or symbolically unintegrated; hence, they
are outside history and outside psychic senses of self (Leys 2000:250).
In telling the trauma story, the traumatic memory of the traumatized subject
can only be languaged, but languaging the trauma entails a loss of the truth of
the trauma. And, for the listener of testimony, the trauma itself can only be
fully witnessed paradoxically “when the referential function of words begins to
break down” (Leys 2000:268). Thus, there is a “gap between traumatic mem-
ory and narrative memory [that] is so radical that it can never be bridged” (Leys
2000:254). When the traumatic memory is narrated, it is not the record of the
event that is witnessed but, instead, the trauma itself is transmitted through
nonverbal accompaniments of the telling. The trauma remains pure in the
sense that it accompanies but is not completely absorbed by the narrative. Leys
remarks on these theories, “The transmission of the unrepresentable—a trans-
mission imagined by Caruth as simultaneously an ineluctable process of infection
and involving an ethical obligation on the part of the listener—therefore impli-
cates those of us who were not there by making us, as Laub has put it,
participants and coowners of the traumatic event” (Ley 2000:267–269).
Most relevant to the present discussion is an epistemology (and metaphysics) of

the traumatic that Leys calls into question, namely the views that trauma is
intrinsically inassimilable and unrepresentable and traumatic memory is liter-
ally and indelibly the “real,” pure, and unmediated. I would agree with LaCapra
that when trauma is so characterized, it can become “sacralized” (LaCapra
2001). My contribution to these arguments is the observation that when
trauma takes on a sublime character or becomes sacralized, the victims who
have been traumatized and, thus, embody this sacralization may also become
sanctified.
In my fieldwork, the sanctification of victims was most readily apparent in the

ways in which survivors were represented to outsiders by clinicians—to the
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media or to other professionals through words and pictures that conveyed a

sense of their virtue through innocence and victimhood (e.g., images of
women and children refugees with large beseeching eyes) or through their
heroism and courage, whether the victims would attribute their survival to
these virtues or not (Novick 2000). However, this sanctification seems less pro-
nounced for contemporary refugees and survivors of collective violence from
Africa, for example, than for Jewish Holocaust survivors in the United States
and Israel. For the latter group of survivors and their descendants, their iden-
tity-making work and remembrance practices, along with important social and
political conditions, have shored up reverence and respect associated with the
virtuousness of their surviving historical trauma that can at times resemble
sanctification (Kidron 2003; Novick 2000).
Ana Douglass and Thomas Vogler maintain that in post-Holocaust, poststruc-

turalist discourses “the traumatic event [is] now the paradigm for the historical
event” (2003:5). They offer an interesting interpretation of how this conceptu-
alization deconstructs certain binaries, such as the real and the mediated:
the traumatic event, as that which violates expectations and traumatizes

the perceiving subject, is that which cannot be anticipated and repro-
duced. It thus allows a return to the real without the discredited notions of
transparent referentiality often found in traditional modes of historical dis-
course. This combination of the simultaneous undeniable reality of the
traumatic event with its unapproachability offers the possibility for the
reconciliation between the undecidable text and the ontological status of
the traumatic event as an absolute signified. [2003:5]
However, in designating the traumatic event as an absolute signified, I look

toward LaCapra (2001) again, who argues that it then may fill up the vacancy
created in secular contexts with the death of God; in other words, the traumatic
becomes sacralized.
Denial of Fantasy + Accurate Memory + Purity of

Trauma = The Grid of Victimization
When processes that disavow culturally abhorrent or unsettling fantasies and
desires of the victims, privilege “accurate” memory, and sacralize trauma begin
to coalesce and become mutually reinforcing, a powerful momentum is cre-
ated that may result in the “grid of victimization” (LaCapra 2001). In this grid,
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victims, perpetrators, witnesses, and bystanders are unambiguous and categor-

ically distinct, and victims and witnesses tend to be idealized as all good while
perpetrators are all bad. What I am describing is akin to a defense mechanism
psychoanalysts call splitting, where representations of self and other are organ-
ized by a split between goodness and badness, without rapprochement between
the two (Robben and Suárez-Orozco 2000; Haaken 1998). In expanding this
construct as I have done, I am not implying that one cannot have certainty
about who are victims or perpetrators. Clearly that would be absurd. I am
speaking about the formation of an ideology in which psychological and
moral complexity and ambiguity are reduced and simplified, leading to forms
of closure, polarization, and exclusion.
For the PTSD treatment program that Allan Young studied, mentioned in the
beginning of this article, it was assumed that the patients committed atrocities
and that telling their trauma stories included speaking about the violence they
perpetrated (1995). The Vietnam vets in the program were considered both
victims and perpetrators. By contrast, the ideology that grids victimization has
been institutionalized in centers for survivors of torture and refugee trauma
across the United States, where, in a consortium agreement, these centers have
prohibited the treatment of “perpetrators.”8
At the Haven, if the staff in the program felt that someone met the criteria of a
“perpetrator,” that person was referred elsewhere (although according to Emil
this happened on only one or two occasions). When I asked him, “What about
a soldier who committed atrocities but was also a victim himself, suffering tor-
ture, having family members killed or whatnot?” He said that the Haven would
not accept that person. On one occasion, the Haven was presented with a case
that was not so clear-cut. The program decided in the end to treat this person,
whose victimhood was established on the basis of the fact that he had been a
“child” (child coded as innocent and pure) soldier.
Serbians who presented themselves as potential clients posed a rather sticky

problem for the program because of the strong anti-Serbian sentiment felt by
some of the counselors, but these individuals were accepted if they could estab-
lish that they were not directly involved in committing violence. One Bosnian
counselor preferred not to take Serbian clients, and her position on this matter
was for the most part accommodated by the program. Emil, protective of the
Haven and his position there, was reluctant to say much more about this policy,
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but he did convey to me that he felt it denied the complexity of some wartime
realities in which victims and perpetrators could be one and the same.
I would suggest, with Bragin and Haaken, that the “grid of victimization” has
another unintended consequence: it denies rather than honors the full moral
and psychological agency of victims, therefore preventing the attainment of
one of the recuperative goals of empathic listening and bearing witness. Veena
Das has argued against these impoverished views of subjectivity and agency,
claiming that subjectivity is formed through the “complex agency made up of
divided and fractured subject positions,” “transgressor, victim and witness,” in
which the “poisonous knowledge” of violence and suffering” is essential to the
self-creation of the victim-witness (Das 1997:222).
Conclusion
Clinicians in this field find themselves entangled in difficult moral, political,
and practical dilemmas and face the depths of human suffering and questions of
meaning as part of their daily work. Not only are clinicians involved in making
sure their clients have enough money for food and safe shelter, but “this work
forces one to confront existential questions, like the question of evil” as a con-
sulting psychologist at the Haven once said. I do not want to minimize the
challenges these clinicians face or the thoughtfulness that many have brought
to their work, nor is it my intention to homogenize and dismiss their efforts.
The trauma story-as-testimony represents a therapeutic intervention that

counters the de-politicizing and de-contextualizing effects of psychomedical-
ization. It provides a framework for survivors to make sense of and find meaning
in their suffering and to connect their personal experiences with collective and
historical processes in a demand for social justice. It also gives clinicians a way
to move from feelings of impotence, hopelessness, rage, or sadness to a posi-
tion in which they are witnesses to history and their activities have political
significance beyond the “narrowing prisms” of psychomedicalization. In this
discussion, we have seen that the politicization of the therapeutic process can
happen simply with the clinician’s empathic listening to the story of traumatic
memories while understanding that historical trauma is the context for the
individual client’s suffering. It can also happen when clinicians go beyond their
usual clinical roles to engage in public and collective commemorative activities
such as oral history projects.
Ethos3503_01 7/17/07 12:13 PM Page 292
292 ETHOS
However, when therapists uncritically embrace the proposition that their

clients’ stories are the literal representations of transparent external events,9
deny the role of fantasy in what are generally agreed to be interpretive and
socially mediated processes of memory work, and sacralize trauma, the “grid of
victimization” may emerge, in which innocence and guilt, good and evil, and
victims and perpetrators are unambiguously demarcated.
In Weine and Laub’s work on narrative, testimony, and witnessing, it appears

that distortions or myths do not call into question the possibility of historical
“truth,” but that true historical reality can be rightfully revealed when one duti-
fully corrects these distortions and myths. In another publication, Weine
(1999) acknowledges that historical reconstruction is fraught because of the
interpretive nature of memory yet he maintains an Enlightenment faith in
the possibility of truth and historical progress. This tension, created between
the inherently perspectival and mediated memory of the traumatized individ-
ual and the notion that there is the possibility of historical “truth,” is managed
or suspended by “a powerfully entrenched, if undertheorized, commitment to
the redemptive authority of history” (Leys 1996:123). Leys goes on to say,
For Herman and for the modern “recovery movement” generally, even if
the victim of trauma could be cured without obtaining historical insight
into the origins of her distress, such a cure would not be morally accept-
able. Rather she must be helped to speak the horrifying truth of her
past—to “speak of the unspeakable”—because telling that truth to herself
and others has not merely a personal therapeutic but a collective value as
well. It is because personal testimony concerning the past is inherently
political and collective that the narration of the remembered trauma is so
important. [1996:123]
It appears that the notion that victims need to narrate, symbolize, or otherwise
tell the story of their traumatic experiences for the redemptive purposes of
personal recovery or collective reconstruction may be a particular cultural and
historical notion and not a universal or timeless one. That these forms of
memory-work may resonate with the Muslim Bosnian survivors in the Chicago
program could be the result of certain cultural, historical, and political factors
rather than a universal need to tell trauma stories. Strawson (2004) has taken a
critical view on “narrativity” and argued that there are two views, one psychologi-
cal and the other normative and ethical, that are widespread in the academy
today. He makes an argument (albeit with idiosyncratic syntax), that the ideas that
Ethos3503_01 7/17/07 12:13 PM Page 293
“all normal non-pathological human beings are naturally Narrative” and that
“Narrativity is crucial to a good life” are views that “hinder self-understanding,
close down important avenues of thought, impoverish our grasp of ethical pos-
sibilities, needlessly and wrongly distress those who do not fit their model, and
are potentially destructive in therapeutic contexts” (2004:429). I would agree
that the narrative imperative I have identified should be critically reflected on
as Strawson has done, especially when the trauma narrative is elicited in social
and political contexts of therapeutic memory work, commemoration, and social
reconstruction that seek reparation, restitution, and reprisal.
Further, as I have demonstrated in this discussion, interventions such as the

testimony method also function as vehicles for inculcating particular cultural,
political, and moral views that pose as universally meaningful and desired ones
through discourses of human rights or master narratives of progress.
In the clinical practices I have described not only are clinicians called to elicit
the trauma story so they may fulfill their ethical duty to bear witness, but, in
addition, the survivors of historical trauma face the normative and ethical call
to tell their stories as witnesses. This pressure to tell puts clients in a position
where their silence, self-censorship (Dickson-Gómez 2004), need to forget, or
practice of suffering outside of institutional frames may be considered psy-
chopathological or unethical (Alcoff and Gray 1993; Foxen 2000).
Although I am critical of the psychoanalytic paradigm that maintains that there

needs to be some kind of “working through” of trauma by remembering it
(normatively as narrativization) and that if there is not such a working through,
the disavowed traumatic past will reappear as the “return of the repressed”
(Robben 2005), psychoanalytic theory is valuable for its acknowledgment of
fantasy and the irrational. It is true that the attention paid to countertransfer-
ence provides an opportunity for clinicians to examine their own unconscious
fantasies and behaviors, but it has been my experience that this type of analysis
does not eliminate “boundary maintenance” (Kidron 2003) practices that func-
tion to constitute the identity of authentic witnessing professionals. These
boundary maintenance practices also appear in anthropology, where a “you are
either with us or against us” politics may emerge based on a moral position that
anthropologists take in terms of their political engagement as professionals.
As anthropologists, many of us have been committed to enabling the oppressed

to have a voice to tell their stories and protest injustice. Yet, we, as witnessing
Ethos3503_01 7/17/07 12:13 PM Page 294
294 ETHOS
professionals, are not immune to the same ideological rigidity as trauma clini-
cians. I would argue that we need to be self-reflective about our own tendencies
to construct ideologies that idealize victims or our own roles as political
activists,10 because as Haaken argues, these ideologies reduce rather than
increase “cultural space . . . for meaningful debate, for exploring the ambigui-
ties and uncertainties” that constitute social and historical realities (1994).
Psychological anthropology, with its attention to the intersections between the
psychological and the social, narrative and personhood, may offer important
perspectives that can help to circumvent the creation of these forms of closure.
KELLY MCKINNEY is Postdoctoral Fellow in the Departments of Social and Transcul-

tural Psychiatry and Social Studies of Medicine at McGill University.
Notes
Acknowledgments. This research was supported by the Wenner-Gren Foundation, the City
University of New York’s David Spitz Award, and a CIHR-Training Grant postdoctoral fellow-
ship in Culture and Mental Health Services at McGill University. I would like to thank Shirley
Lindenbaum, Vincent Crapanzano, Allan Young, and Laurence Kirmayer for guiding my thinking,
Carol Kidron for her inspiration and invaluable intellectual contributions, and Paul Antze, Janet
Dixon Keller, and an anonymous reviewer for their insightful and challenging reviews of earlier
drafts of this article. Above all, I am deeply grateful to the clinicians and survivors who participated
in my research for their extraordinary generosity and openness.
1. I have given the Haven staff and Danish therapists (e.g., Dr. Eriksen) pseudonyms. However, I
have not used pseudonyms with clinicians whose ideas and views have been published or are other-
wise in the public domain, for example, Danieli, Agger, Jensen, Bragin, and Weine.
2. Douglass and Vogler note how there is now a “flourishing industry” in archiving personal testi-
monies of trauma. They argue that this “industry . . . seems to assume that the accumulation of witness
accounts will somehow “add up” to a collective view” (2003:33). These authors also cite Enrico Santi’s
(1992) criticism of “the academic enthusiasm for Latin American testimonio” as an example of what he
calls “Latinamericanism,” whereby northern academics dedicate themselves to the suffering of their
Latin American subjects to morally justify their own work (Douglass and Vogler 2003:3).
3. As I got to know Natalija, a Haven counselor, we talked about her past and what happened to her
during the Bosnian war. It was very difficult for her to speak about this at times, and once she
handed me a paper and said, “This is my story. If you want to know what happened to me, it’s in
there.” She had handed me the letter of application she wrote to Ed for the counselor position at
the Haven. Part of her “trauma story” was contained in this letter, which I suppose she included to
Ethos3503_01 7/17/07 12:13 PM Page 295
show why she would be qualified for the position: she was a refugee herself, and her experiences led
to her wanting to help others who had suffered similar experiences. The job application letter func-
tioned as an unconventional form a “testimony” for her.
4. Young (1995) discusses the relationship between individual memory and history in the thera-
peutic practices at the VA hospital: “Day in and day out, therapists labor to transmute the patient’s
collective memory, a thing that is located in historical events (to which the patients have privileged
access), into individual memories, a thing situated in mental events (to which the therapists have
privileged access)” (1995:221). What is different about the testimony method is that it takes this
process one step further: the therapist then takes this individual memory and rejoins it with collective
memory and history.
5. I would like to thank an anonymous reviewer of this article for reminding me about this impor-
tant point.
6. Eve Sweetser (1987) discusses folk models underpinning cultural constructs of the lie. She
explains that literal and real truth are prototypically connected in Western culture, and that “liter-
ally” true claims are valued over patently false claims, even if the literal truth does not conform to
the moral framework of honest knowledge and information exchange, that is, the literal truth is not
really the real truth. She also describes cross-cultural differences in lying and illustrates how in var-
ious contexts and cultures lies can be more or less morally wrong. For this discussion, it is important
to note that when the terms and stakes change in different contexts, the accurate–inaccurate evalu-
ation of memory may be more or less dominant.
7. See Young (2007) for a discussion of positions that champions of survivors take on discovering
that survivor stories are fabricated or partial truths. Returning to Sweetser (1987), the survivor or
pseudo-survivor seems to have more authority or power than the witness, insofar as the witness is
dependent on the survivor to honestly transmit his or her knowledge or information.
8. Young (2002) has analyzed remarkable phenomena in which men in the United States either
have fabricated memories of their wartime experiences as soldiers when, in fact, they never served
in the armed services or fabricated memories of atrocities they committed when, in fact, those
atrocities never occurred. These examples show how problematic notions of truth, lying, authen-
ticity, and identity may be despite the efforts to tame them.
9. Laurence Kirmayer (personal communication, 2006) offers that if we think of “memory” as a

looping series of elements including sensate, bodily memory (implicit memory), declarative mem-
ory, and narrative representation, giving greater valence to one element in the loop will affect the
others. Thus, if we rhetorically privilege narrative, memory may then appear as “just a story.” To
compensate for this, memory needs to become more solid and substantial. This is rhetorically
accomplished by making memory literal.
10. I heard a story of a colleague whose manuscript on the civil war in a country in Latin America
was rejected. This was on the ideological ground that it represented the “victims” with nuance and
Ethos3503_01 7/17/07 12:13 PM Page 296
296 ETHOS
complexity that called into question the ideal of their essential goodness. The editor felt it was his
moral duty to uphold this ideal over a more complex representation of the situation.
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Ethos3503_01 7/17/07 12:13 PM Page 265

BREAKING THE CONSPIRACY OF SILENCE 265

“Breaking the Conspiracy of

In late-20th-century Western culture, trauma emerged as a paradigmatic

the interpersonal (Pupavac 2004). A new mental health specialty devoted to

In Allan Young’s masterful study of trauma, memory, and psychiatry, he included

BREAKING THE CONSPIRACY OF SILENCE 267

culturally mediated. As a result, an ideology may crystallize that casts clients as

Methods and Settings

My primary fieldwork setting was at the “Haven,” a small psychosocial program

The Haven staffed an Anglo-American director and a Serbian–Bosnian clinical

The Narrative Imperative

BREAKING THE CONSPIRACY OF SILENCE 269

Clinicians have also questioned whether verbalizing traumatic memories

This perspective assumes a common model of trauma that defines troubling

Politicizing Therapy: The Trauma Story,

BREAKING THE CONSPIRACY OF SILENCE 271

Both in clinical settings where individual therapeutic transformation is the goal

The Haven: Case Study 1

The Haven counselors were instructed not to “retraumatize” clients by coerc-

A Haven Staff Meeting: Resistance and Countertransference

BREAKING THE CONSPIRACY OF SILENCE 273

The in-service training centered on an article, “Psychotherapists’ Participation

The following are excerpts from Emil’s presentation as he continued to

It is important to get back to the story of the survivor. It must be told to be

recovery and without integration, healing is impossible. We need to

[Resistance would include] if the therapist forgot something the client

A heated discussion followed Emil’s presentation, with the counselors arguing

BREAKING THE CONSPIRACY OF SILENCE 275

Trauma, Memory, Narrative, and the Conspiracy of Silence

“hurtful and disrespectful” or showing a lack of clinical competence but are

Søren Jensen, a Danish psychiatrist and internationally recognized figure in the

According to trauma therapists, key protections from destructive counter-

BREAKING THE CONSPIRACY OF SILENCE 277

Although inevitable, if left unmanaged, countertransferential reactions repre-

Communities of survivorship are both imagined and realized through networks

The Trauma Story and Practice

I think it is the quality of the relationship, and because of your knowledge

Dr. Eriksen went on to say,

BREAKING THE CONSPIRACY OF SILENCE 279

In the testimony method, victims of political repression provide a “detailed

BREAKING THE CONSPIRACY OF SILENCE 281

In separate interviews I conducted with Agger and Jensen in 2000, each

an ongoing therapeutic relationship, can have definite therapeutic effects.

The Testimony Method with Bosnian Refugees

BREAKING THE CONSPIRACY OF SILENCE 283

the therapeutic process by framing their work within a larger system of

In the article “Narrative Constructions of Historical Realities in Testimony

mental health professionals working with these survivors should develop a

BREAKING THE CONSPIRACY OF SILENCE 285

Denial of Fantasy and the Innocence of Victims

This cultural disposition toward controlling and domesticating the potentially

In clinical work, the role of fantasy is further complicated (and implicated) in

Accurate Memory and the Need to Believe

BREAKING THE CONSPIRACY OF SILENCE 287

one of the fundamental fears experienced by survivors of torture and

Most relevant to the present discussion is an epistemology (and metaphysics) of

In my fieldwork, the sanctification of victims was most readily apparent in the

BREAKING THE CONSPIRACY OF SILENCE 289

media or to other professionals through words and pictures that conveyed a

Ana Douglass and Thomas Vogler maintain that in post-Holocaust, poststruc-

the traumatic event, as that which violates expectations and traumatizes

However, in designating the traumatic event as an absolute signified, I look

Denial of Fantasy + Accurate Memory + Purity of