Unit 4  Section 3Exercise 10Post-traumatic stress syndrome Phi-Phi Island
Clinical correlate #9 Post-traumatic stress disorder
The following passages are taken from a book, PhiPhi Island, by Joseph Haslinger, an Austrian novelist. He was vacationing in Thailand with his family when the tsunami hit. He, his wife and two teenage children survived. The absence of upper case letters relates to the fact that he cut the tendons in several fingers during the upheaval, limiting his use of the computer’s keyboard. A year after the trauma, Haslinger and his wife returned to Thailand to revisit the scene and try to understand what happened in the tsunami’s aftermath. About half of all people had drowned.
Read the excerpts and answer the questions about post-traumatic stress syndrome.
From PhiPhi Island, by Joseph Haslinger
up to that point I had had the feeling of being able to do something, of not being at the mercy of the situation. now I realized how powerless i was. i had let go of edith’s hand, the water pushed me back against the concrete parapet and lapped over me. i was suddenly under water and also became aware of the fact that the water wasn’t just water, but was full of objects that knocked against me. i had to unhook my knees and let go of the concrete parapet.
when i came up, i didn’t see edith anymore, but i saw other people in the wood ballast and sheet metal. the water jammed up against the wall of the hotel, the rubble kept coming at us and kept flooding through between the hotel and the administrative building. i remember half of a bungalow roof floating towards me and people climbing on it. i reached for it and tried to climb it also but then there were already too many people on it, the roof tilted towards me and pushed me down. i was swept away by a whirlpool of mud and garbage. i was under water, it swirled me around as though I had landed in a mixer. i was constantly being struck by some sort of debris, then washed upwards until a sudden undertow pulled me down again. I couldn’t see anything, water went into my mouth and suddenly i no longer knew what was up and down.
at that moment the fear overcame me, that I wasn’t going to make it. and then the clear thought: now this is the end. To be sure, this realization came as a shock, but there was no sense of despair. it was more like a sense of regret, having to do with the fact that i wasn’t going to die a different death, but would here. it was the feeling of an absolutely undignified end. when i say regret, i mean a sort of melancholy regard of farewell, because i had had a false picture of life. because I had thought that it had some kind of purpose. now i saw myself becoming part of the filth surrounding me. and I knew that in fact I had never been anything else. and then the resolve to fight to the end. as long as you can move, i told myself, you must try to get out of here. p. 78
sophie dreams, the water has come to vienna. she runs home from the park with her friend marianne, the water chasing them. they run up the stairs, but the water also rises, floor by floor. everytime they turn around, it’s close behind them. when they reach our apartment on the fourth floor, the water is still climbing and they run further up all the way to the attic. the attic is all of a sudden our other apartment in Leipzig. they step out onto the terrace and discuss feverishly where they might find a boat that would take them away from there. they don’t find any solution. the water spills over onto the terrace, and she wakes up. in all her dreams she’s in flight.
i am the only one who for the time being doesn’t have any nightmares. but during the day i sometimes react strangely. I am walking along ringstreet in vienna to get a new membership card from the automobile club. i hear some shouting behind me. i look around automatically to see into which entrance i can run, and up which stairway I can take flight. The moment I start running toward the Bristol, i realize how absurd my behavior is. there’s no tsumanmi here. i try to figure out where the noise is coming from. At the schwarzbergerplatz there’s a bauerndemonstration going on. pp. 176.
People often speak to us about our experiences and we tell them as well as we can. i’m more talkative than the others. elias knows many details, but he can’t connect the memories. sophie also has major gaps in her memory.eEdith once again relives with great intensity the situation. p. 177
when, a good half year after the tsunami i am asked to contribute to an anthology, i can’t think of anything that doesn’t have to do with the tsunami. and so I finally begin writing about it. my approach is to start at the end. i write about how the contents of our safe was returned to us from thailand and then, even though I’d considered myself to be the one family member who’d managed to distance myself most from what happened, everything suddenly seemed strangely real. only now do my nightmares start. they continue night after night. Sometimes they are quite vivid, sometimes indistinct, but i still wake up in a sweat. i stop working on the manuscript for a while…asking sophie and elias to tell me about what they remember from the tsunami causes them to have nightmares all over again. again they have to do with water, but the dreams have become less noxious, and everything always ends up all right.p. 180
Study questions
1. How does post-traumatic stress manifest itself?
2. What effect does writing about the tsunami have on the author? Would you consider the effect to be healthy or unhealthy? Read the following passage from Maelainder, whose essay on memory we have already encountered earlier in this unit, and comment on the possibility of blocking memories through medication. Do you believe that the author or any of the other family members would have been good candidates for memory-blocking medication? Why or why not?
Maeilander on memory. Read to answer study question above:
“In its October 2002 meeting, the President’s Council on Bioethics heard from two experts in memory research (James McGaugh and Daniel Schachter) about current research on the formation of memory, attempts to enhance memory, and the possibility of blocking the formation of long-term “explicit” memory of certain events. (Explicit memory may be contrasted with implicit memory, which is the retention of certain skills, such as “how” to ride a bicycle. Explicit memory is the memory of “what,” of events. Thus, Dr. McGaugh noted that it might be possible for a person suffering from Alzheimer’s to remember the mechanics of playing golf while being unable to remember how many strokes he had taken on any hole.) For now, at least, it appears that we are more able to block memory than to enhance it, and we can imagine that such erasure of memory might be very appealing in certain traumatic circumstances.Anti-anxiety drugs or beta-blockers can be used to prevent the formation of long-term memories. This is possible because, in the formation and consolidation of those memories, our emotions play a significant role. For example, the rush of adrenaline during intense emotional experience may help to form especially powerful memories. Because that is true, we can understand why a beta-blocker, which counteracts the effects of adrenaline, might, if administered immediately after a highly emotional experience, diminish the strength of our memory of the event.We can imagine persons in a range of circumstances who might experience severe trauma and be likely to suffer post-traumatic stress disorder (PTSD)—those who’ve witnessed a horrible accident, soldiers in battle, a woman who has been raped, rescue workers at a disaster, a child who has seen his mother killed (or, perhaps, who has simply seen his mother die). If such people were administered beta-blockers soon after the event and for several weeks thereafter, they would (as Dr. McGaugh put it in conversation with the Council) experience “a significant decrease in the expression of PTSD” months later. Why should they suffer such painful memories if the means to relieve them are at hand?”
We encountered Judith Herman on trauma and recovery in previous units. Here is a useful link which elucidates the relationship of her work to PTSD.
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