Abstract
This chapter discusses the complex relations between the SBO and SA during trauma. It contends that in the presence of a discrepancy between SBO and SA, the individual is unable to function properly and body-disownership may develop.
This chapter is based on a combination of several papers (Ataria, 2015a, 2015b, 2015c; Ataria & Neria, 2013).
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Notes
- 1.
Unless otherwise noted, all the testimonies in this and the next two sections are quoted from my previous study (Ataria, 2015a), for which thirty-six victims of terror attacks (including suicide bombings on buses and in other crowded areas, stabbings, and rocket attacks from Gaza and Lebanon) were interviewed. The interviewees were aged 22–78 (mean age 50.56, SD = 12.26), 13 men (7 severely injured) and 23 women (3 severely injured), all recognized by the Israeli National Insurance Institute as suffering from PTSD (with more than 20% disability), all members of the charitable organization One Family (a non-profit organization), and all scoring more than 44 (44 < 85) on the PCL questionnaire, a 17-item self-report scale for PTSD based on the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV. It should be noted that the collection of data for this research was part of a more extensive quantitative research study conducted by Dr. Michael Weinberg, Prof. Avi Besser and Prof. Yuval Neria and supported by Psychology Beyond Borders (PBB). For more methodological issues see Appendix 1.
- 2.
According to the Merriam-Webster dictionary, helplessness is a situation in which you are “not able to defend yourself.” Similarly, the Cambridge English Dictionary characterizes helplessness in terms of being “unable to do anything to help your[one]self or anyone else.” Other dictionaries define helplessness as a feeling of being “powerless or incompetent” or “deprived of strength or power; powerless; incapacitated.” In addition, helplessness defines a situation that the individual finds “impossible to control.” None of these definitions designates physical injury as a precondition for developing a sense of helplessness.
- 3.
Note that this can result from a change in the numerator, the denominator, or both.
- 4.
Unless otherwise noted, all the testimonies from this point onward in this section are quoted from my previous study with prisoners of war (Ataria & Neria, 2013) for the purpose of which, fifteen Israeli ex-prisoners taken captive during the 1973 Yom Kippur War were interviewed. Each interview lasted between one and four hours, and all were recorded and subsequently transcribed. The interviewees were male combatants in the war, whose military roles varied from combat pilots to infantry soldiers. They were held in captivity in Syria, Egypt, and Lebanon and experienced periods of isolation ranging from 36 days to three-and-a-half years. At the time of the interview, the subjects were between 59 and 71 years old. Apart from one subject, the native language of all the interviewees was Hebrew.
- 5.
Clearly, it is possible for both sense of agency and sense of body-ownership to decline rapidly, yet under such circumstances one cannot function. Scientific literature (Baldwin, 2013; Bracha, 2004; Kozlowska, Walker, McLean, & Carrive, 2015) defines this phenomenon as collapse or flaccid immobility. Under severe stress, and when the threat is perceived as impossible to handle, this tonic immobility (characterized by stillness, fixed eyes and stomach tension with a pounding heart rate of 100 bpm, and fast shallow breathing) turns into flaccid immobility or fainting, including an extraordinary drop in heart rate and blood pressure. This state is characterized by flaccid immobility (floppiness) and glazed or averted eyes, accompanied by bradycardia (HR ≤ 60 bpm) and slow, shallow breathing. Numbness and analgesia (endogenous opioids) may also occur. According to Schauer and Elbert (2010), this stage can be defined as a system shut-down. Flaccid immobility cannot be switched on/off easily. It is not a yes/no reaction and has a slow onset and a slow termination. On the one hand, muscle stiffening changes to flaccidity and voluntary movements stop, as does speech, over the course of only several minutes. On the other hand, it may require several minutes or even hours for one to become oriented back into reality from this state. Clearly, in this situation, both SBO and SA drop to zero: one cannot control a body that is not one’s own.
- 6.
Note that such a situation can result from a change in the numerator, the denominator, or both, though in each case the phenomenology is different.
- 7.
For a full explanation of why Jean Améry was selected as a case study, see Appendix 1
- 8.
This entire section is written in the masculine because it refers to Jean Améry’s testimony.
- 9.
Whereas the former quotation tended towards a subjective description of an experience from within (albeit in a limited manner), in contrast this one offers insights more than a subjective portrayal of experience. It is vital to create this distinction because among trauma victims we must emphasize the movement between 1PP and 3PP. Clearly, that which is defined here as “a subjective experience” is also influenced by the theoretical approach, while the theoretical approach is influenced by Améry’s experiences. Moreover, at times, Améry moves between the subjective and the theoretical. Despite this, it seems appropriate to attempt to distinguish between the two kinds of descriptions.
- 10.
For a more detailed explanation of the use of sources to describe this experience, see the Appendices. It appears almost impossible to find descriptions of such experiences that are lacking in pathos. Shalamov’s book is an exception that provides an exact and in-depth description.
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Ataria, Y. (2018). The Complex Relations Between SA and SBO During Trauma and the Development of Body-Disownership. In: Body Disownership in Complex Posttraumatic Stress Disorder. Palgrave Macmillan, New York. https://doi.org/10.1057/978-1-349-95366-0_5
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