The understanding of Trauma in lower and middle countries is said to be a major burden disease, in South Africa as it falls into the middle-income countries. This essay will start by defining trauma as Post Traumatic Stress Disorder (PTSD). Secondly, the essay will describe the criterion used to diagnose this disorder. Thirdly, the essay will provide are understanding of trauma from a western to an African understanding of trauma. Fourthly, it will provide the South African sociocultural understanding of trauma. Lastly, this essay will discuss the sociocultural adaptability and controversies.
In psychological literature trauma refers to experiences that are usually unanticipated that happen to many aspects of psychological functioning and placing excessive demands on the persons coping strategies (Kaminer & Eagle, 2010). Given this definition the Diagnostic statistical manual supports this definition to say traumatic experience are not only caused by a person’s subjective response to external stressors which cause the person to view a particular experience traumatic or not incident (Bedard-Gilligan & Zoellner, 2008). This, in turn, causes the individual to develop psychological distress disorder called Post-traumatic stress disorder (PTSD). PTSD is a disorder which is diagnosed as a response to external events these include exposure to rape, torture, and natural disaster (Osterman & de Jong, 2007).
In the DSM-5, this disorder is classified on its own category as the Trauma and stress disorder which now separates it from the category it used to be grouped in the DSM 4. This new category comes with many changes to how the disorder used to be known, these changes include the emphasis on criterion B symptoms as being the core symptoms (Brewin, Lanius, Novac, Schnyder and Galea, 2009). Criterion B describes this disorder as having associations which other prevalent disorders which overlap with how the disorder is understood. The move from criterion A was based on the departure from the emerged meaning of what PTSD is understood asvv and the suffering of the victims who are exposed to this life threatening events (Brewin et al, 2009).
The common PTSD symptoms include the persistent re-experiencing of the traumatic event, persistent avoidance of stimuli associated with the event, numbing of general responsiveness, and signs of increased arousal. In spite of the fact that all these symptoms may be observed in all traumatized people, including Africans, relying on the symptoms alone should not be the only way to assess or diagnose trauma (Motsi, 2018).
The understanding of trauma from the western perspective comes from a researcher, American psychologist Becker, who is an expert on this subject matter. Becker defines trauma as a traumatic experience which occurs in the individual’s mind causing problems in the individuals cognitive processing (Becker, 2000). Many researchers understand this disorder as a not scientifically rigor as other disorders but it accounts for every danger response and was created as a sociopolitical construct (Shepard, 2005). It does not have core symptoms as the DSM5 claims to say it has mostly verbal responses and it is not based on any clinical framework. This disorder diagnosis comes with issues where what is socially recognized as normal stress is pathologies which question what is really stress and depression do they have an exact time frame for their detersive state (Friedman et al, 2007).
Clinicians believe this distress causes some brain abnormalities which comes to the body reaction with fatigue, headaches and insomnia etc. These are cognitive vulnerabilities that trauma victims face including many cognitive abnormalities which lead to symptoms development (Elwood, Kathryn, Hahn, Bunmi, Olatunji, Williams, 2009). Some of the abnormalities take place in the amygdala and prefrontal cortex, which play an important role to regulate negative emotions and the negative affect it arises, when it seems to be impaired (van der Kolk, 2004).
Universally many therapists would agree all psychological stressors are cognitively mediated and therefore should account for the individual and their spiritual being. The African understanding of trauma comes from a South African researcher Motsi who discusses trauma as a type of anxiety disorder which is a result of experiencing a traumatic experience which can include assault, rape, and injury. According to Motsi, this present psychological distress to the individual who got exposed to the traumatic experience and broadly seen as a diagnosis to be pathologies (Motsi,2018). The researcher continues to say from an African perspective trauma should be interpreted as a culture which has a set of beliefs and secondary factors which go against the tangible understanding of biology.
The understanding of trauma in South African can be linked to the countries historical past events which took place. This includes the apartheid era, Soweto uprising and recently #FeesMustFall protests to name a few historical events. The understanding of violence in this country is different as it is seen as something normal whereas for psychology that is traumatic and seeks intervention. For author Mulago describes trauma in South Africa as a shared experience where an individual experience by them alone but a community with shared values. Where some of these experiences have caused negative results in the individual’s early childhood development where it has affect the individual’s emotions, cognition and memory (Hardcastle, 2016; Brewin et al, 2009). Madikizela continuous the argument to say trauma is something inherited as a result of genocide, colonial oppression and different types of mass atrocities. These experiences of trauma present themselves as wounds which appear as fear, anger and aggressiveness as after effects of witnessing trauma that will never heal but continue to be wisdom passed down to different generations (Pera, 2019).
The understanding of trauma in South Africa is something which is intergenerational which comes from a historical connotation where the past generation lived traumatic experiences. This directs to a sad, resentful and shameful feeling causing trauma. Some old generation members believe trauma started in the apartheid era where oppression was done to minority groups. With this the main goal is to clearly present an all-round understanding of trauma from different perspectives which present different worldviews to the understanding of trauma (Motsi, 2018). This essay will now be moving on to discuss the sociocultural factors understanding of trauma in South Africa.
The term social can be linked to society as a way of functioning, this refers to how people living together share similar norms, beliefs, values and customs. Culture is defined as an institution which is represented by roles, settings, objects, language, rituals, art and symbols. These two concept marge a foundation of two worlds which were social constructed to be knowledge carriers (Matsumoto, 2009; Marsella, 2010). The understanding trauma from a sociocultural perspective stems from the contexts that people make sense of their way of living. This happens with the person encoding traumatic event in their minds which then their minds take note of the event and influences their experience, response to it (Zayfert, 2008). This includes discussing it from these elements such as the culture of violence, culture of blame, poverty, patriarchy, alcohol use and an African worldview (Wright, 2013).
The culture of violence
The culture of violence in South Africa has been seen as a normalized way of living, this is seen through the traumatic events we come across in society. These events include human trafficking, rape, gender-based violence, robbery and other similar traumatic events (Nagata &Takeshita, 1998). All the mentioned traumatic events speak to the endorsement of violence in society were any form of violent act is rewarded and never seen as a punishable offence. This culture comes from past generations where such acts where seen as a way to attain power and enforce power dynamics and subordination (Matsumoto, 2009). For many people who are considered the subordinates they experience trauma from an aspect where it is collective as it has historical underpinnings.
This experience with historical underpinnings according to Alexandra is referred to as cultural trauma. Cultural trauma is the experience that indicates a collective memory where society were was abused and became slaves who have influences African people’s identity sculpturing (Alexandra et al, 2001; Rosenblatt, 1988). This experience becomes visible in many media forms such as song’s lyrics in Hippop and Trap music, Poetry, stage plays, video games and television. These media forms have been used to explain the feelings of cultural trauma to what apartheid did in South Africa to are majority of black African people who were seen as subordinates to the British colonial leaders. For a black person these violence actions come from the racism traumatic experience which affected them, and they ended up believe violence is a solution to everything. In society violence is something accepted and foster a continuation of violence as a way to get what they want. This can be power in social status and recognition (Alexandra, 2015).
The culture of blame and patriarchy
The blame culture in society comes from a place where culture is granted power that should be traumatic events take place power inequality should apply. This in a way for sociocultural understanding comes from a place where the person has experienced traumatic events comes from an victim and perpetrator positioning. This positioning places the victim in the wrong place as the one who provoke the perpetrator and the perpetrators are seen as someone innocent who can never commit such a crime (Sharpe, 2015). The blame culture is more visible in instance where women are involved; consider the Femicide cases like the Karabo Mokoena, Jabulile Maseko. They were blamed never given a chance to tell their side of the story since society never believed them and considered them as people who called the occurrence to themselves. This blame culture for these two cases in literature can be understood as self-blame where society will put the wrong on the victims, not the perpetrator. If the social understanding of trauma was from the two victim’s perspective, it will be considered characterological blame. Characterological blame refers to victims being able to talk about their trauma experience, victim qualities which might have made them prey to the perpetrator (Wright, 2013).
Self-blame in society is seen something which need to be social addressed as it affects the violence understanding and the context in which victims become prey to subordination. Consider rape culture faces many social misconceptions of rape as something the victim brought on to themselves. Placing the blame on the victims clothing, behavior and pride to give others a chance to date them (Matsumoso, 2009). Whereas, the rapist is seen as someone who has sexual addition, disturbed, performing are gang ritual and has sexual dysfunction making them need power or control from their victims. In this instance the perpetrator utilized violence, anger, lust to intimidate their victim (Kaminer & Eagle, 2010). This intimidation comes from a time when a male patriarchy places a key role to dehumanize, legitimize power dynamics relation to their actions and blaming social norms as creators of male’s dominance. This in the end leads to the substance dependence to numb traumatic experience.
Alcohol use and poverty
The understanding of trauma in many circumstances has been based on contexts where the individual finds themselves. In a community where gang activities are worshipped, society finds itself to really with how gang actions become messy, violent and at times taking away many lives of those who were victims of illegal activities. As a result, traumatic event occurs where one finds themselves medicating them with substance abuse to ease the witnessed trauma (Sharpe, 2015). This addiction to substance abuse takes away money which was put aside for food and household essentials. This presents a case where society has broken down a relationship between social capital which becomes the persons moral conscious causing moral transgression which causes emotional shame. This emotional shame talks to the sociocultural, psychological and spiritual aspects of understanding trauma (Bateman,2016). Society now finds itself having high poverty because of substance abuse, violent act where some acts which happen to be physical have left victims disabled and not able to work anymore. For many women poverty sends them to become sexual violence victims and future prostitutes hoping that it will help take away poverty at home but adding to themselves psychological distress. Whereas with many male’s alcohol use has led to then getting into car accidents because of intoxication and alcohol drinking limit exceeding (Wright, 2013).
The African worldview
The understanding of trauma in the sociocultural context comes from the interaction of the body and mind that should any part of the body become ill the entire body becomes sick. This understanding comes from a shared knowledge system where society finds pleasure from putting the person on a place where the individual is seen as someone connected with their community. The understanding of the individual’s traumatic experiences is understood from the collective African frame and in the western the understanding of individual comes from an individualistic frame (Konner, 2007). In the western view people believe trauma is something affecting the mind, body and soul no other thing is considered to explain the disorder (Motsi & Masango, 2012).
When African people come across a traumatic experience it is perceived as a sign the ancestors are not happy with you therefore you should go and appease them. A study by Crawford and Lipsedge (2004) looked at how mental illness in IsiZulu home language speakers conceptual understanding of physical and mental illness could be categorized in their understanding of trauma. The results of the study found that the prevalence, aetiology understanding of trauma was explained using ancestors and sorcery. This in an African system has kept majority of black understanding of illness going for generations, whereas in the western context trauma is only explained by its ethnocentric explanation which are given scientific rigor and validity (Van der Kolk et al, 2007).
For the Africans trauma issues have become topic which have caused many social instabilities in the economic, political and social views. This goes to show violence is not only something affecting the individual but also their surroundings. The African perspective of trauma is crucial to the understanding of care needed to be shown to other African who have suffered from similar traumatic distress. Which might present themselves as inability to sleep, intensified alertness, anxiety and concentration difficulties (Hybels-Steer 1995).
For approaches like the sociocultural traumatic symptoms are based on experiences from traumatic events which have presented negative results to the person who witnessed them. Africans will therefore prefer to use culture as a shield which will protect them and their integrity. Forgetting that this will start the development of PTSD, where now culture is seen as a double plug a shield, security and protector there to reassemble the person’s identity in society. Culture now becomes the person’s willpower for their progress in life (Brown & Prudo, 2007). Trauma needs to be understood from a view which applies to their context not the universal validity of PTSD from western cultures. These western perspectives take away the African social experience of being African, and the experience of participating in traditional healing approaches (Kirmayer et al., 2007). The African viewpoint calls for social reconstruction of the understanding of the African person and their indi¬vidual healing. Psychology might suggest a combination of approaches to help the individual but there never effective, continue to misdiagnosis or overgeneralize traumatic experi¬ences (Konner, 2007). The western understanding of psychological distress is viewed from a point where it needs medication taking away the patients human rights to explain human victimization and oppression (Eagle, 2004).
An African viewpoint of trauma comes from a phase where African marginalization is addressed and challenged. A time when western ideas of trauma and other psychological disorders perceived universality is challenged. Society needs a chance to be given optional traumatic aesthetics and provide a clear understanding of trauma understanding from first and third world countries trauma exploration (Konner, 2007).
Consequences of trauma
Considering, the amounts of literature available to speak to this subject, many black south Africans find themselves unable to talk of themselves as people who have experienced trauma. It is only those who have studied further who have that kind of knowledge and those without that kind of knowledge become passive subject enduring to that kind of pain Shorter (1998:43). Research alludes the understanding of grief and trauma is understood as a social construct never a scientific medical diagnosis and believe their collective experiences, social structures influence the accessibility of psychosocial resources. Many South Africans find themselves in the receiving end being people who cannot afford counselling services that are said to normalize traumatic thoughts. Where they have accumulated a lot of pain from many historical experiences that have presented many unresolved communally shared traumas. Some issues which have been ignored and point to physical wellbeing and socioeconomic implications (Bonnano,2008).
Traumatic experiences should be critically understood from a plural not a singular framework outside the ethnocentrism of the Western trauma paradigm. This discusses the potential for explanatory frameworks that are more holistic, interdisciplinary and multidimensional (Suarez, 2000). Literature on trauma reports that culture has related impact on trauma that includes beginning of symptoms, symptoms dissociation, stress pattern onset, and patterns of re-experiencing trauma (Marsella, 2010). The idioms of stress on individuals has shown cultural variation to how people experience emotional states. For different sociocultural groups stress idioms differ because of the culture norms, values and traditions. This talks to the idea that PTSD has universality across culture which matches were cultural influences decontextualize (Van Rooyen & Nqweni, 2012). In many cultures PTSD prevalence has shown to be more common to criterion C and as a result lower countries that have come across symptoms such as avoidance/numbing are more influential because of their culture. Many victims find themselves not recovering quickly as they experience more severe symptom conditions include depression, substance abuse, and anxiety disorders (Kaminer & Eagle, 2010; Kirmayer et al., 2010).
In South Africa, the understanding of trauma has been attempted to be visited using the Truth Reconciliation Commission as a form of healing method. This method was meant to help trauma suffers understand the traumatic events effects on individual’s consciousness which impacted on the persons personal and political healing. Multiple trauma has impacted on a majority of black people who experienced pain and continue to come across the apartheid colonial wheel of trauma (Ngcwane, 2018). This wheel model has created a number of serious human rights abuse which were affected by political violence from the apartheid era. Physical violence has impacted on the individual suffering as they become affected by humiliation, powerlessness, vulnerability and poverty. The political violence and torture in Africa is the major contributing cause of trauma that needs to be eradicated. This intervention has not been any successful but it has faced many biases. The ANC might have created interventions but many of them still need to be redressed to end marginalization in society (Alexandra, 2015).
However, it is clear to say this essay discussed what is trauma and the different understanding of trauma from the western to the African context. The essay then moved on to describe trauma symptoms and understanding of the causes of trauma included factors such as crime and violence, male dominance, blame and the use of drugs and alcohol. The essay moved on to discuss the sociocultural factors understanding of trauma. It lastly provided a brief discussion on the Truth Reconciliation Commission as it was used as a method of healing in South Africa but it was not successful but more bias.