Reconsidering our turn towards trauma: a psychosocial study of mental illness, social suffering and service user subjectivity

Lauter, Shoshana Esther (2024) Reconsidering our turn towards trauma: a psychosocial study of mental illness, social suffering and service user subjectivity. PhD thesis, London School of Economics and Political Science.

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Abstract

This thesis examines the expansive use of the trauma concept in community mental health settings. The turn towards trauma in Western therapeutic culture over the past four decades has moved the concept far beyond the warzone and into all realms of social and political life. Trauma has become the “major signifier of our age”: it is our normal means of linking hardship to something ruptured in the recent past or in a distant memory (Fassin and Rechtman 2009). The trauma-informed model is a formidable voice in the current mental health crisis. Understanding how service users with serious mental illness narrate their daily social suffering under its remit has never been more pressing. The study draws on 17 months of ethnographic fieldwork – made up of participant observation and narrative interviews with service users – at two trauma-informed services: an NHS women’s residential crisis house and a charity-based psychotherapy programme for adult psychosis. To investigate how the trauma concept is taken up in service users’ narrative practices, the thesis applies a psychosocial methodology that utilises concepts of social suffering, hidden injury, and complex and defended subjectivity. The findings are organised around three narrative dimensions: the dominant, latent and embodied. The first dimension lays out a narrative practice in which the trauma concept is used to invoke explicit and recognisable reflections on iatrogenic harm and systemic failures; shared narratives of empowerment flatten service users’ more complex subjectivities. In the second dimension, service users disclose more intimate, uncertain and inchoate afflictions; the trauma concept is used to shroud hidden injuries and promote narratives of resiliency and coherency. The third dimension explores pre-discursive narratives that are reflected through the body and enacted unconsciously; social suffering is compounded through its self-management in daily habits and behaviours. These findings indicate that trauma has become a faulty translational tool. The reparative fantasies and disavowals of vulnerability built into the trauma concept risk further psychosocial dislocation of the service user from their self, from others, and from the systems meant to provide them care and recognition.

Item Type:	Thesis (PhD)
Additional Information:	© 2024 Shoshana Esther Lauter
Uncontrolled Keywords:	trauma, social suffering, ethnography, psychosocial methodologies
Library of Congress subject classification:	B Philosophy. Psychology. Religion > BF Psychology H Social Sciences > HM Sociology R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Sets:	Departments > Health Policy
Supervisor:	Evans-Lacko, Sara and Freeman, Emily
URI:	http://etheses.lse.ac.uk/id/eprint/4825

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