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THECLINICALUSESOF
PSYCHOHISTORY
SANDRAL.BLOOM
TheJournalofPsychohistory,20(3):259266,1993

Icametopsychohistoryoutofdesperation.Throughmyclinicalworkasa
psychiatristdirectinganinpatientunit,Ihadcometorecognizethatwewere
"missingtheboat"onmanyofourpatients.Longignored,theactualtraumatic
eventsoflife,particularlyeventsofchildhoodtrauma,clearlyplayedamuch
moresignificantroleintheevolutionofmentaldisorderthanIhadbeenledto
believeinallmytraining.
Bythelate1980's,someofusworkingingeneralpsychiatricsettingshadbegun
toroutinelyaskabouttraumawhilegatheringdatafrompatientspresenting
withdepression,selfmutilation,addictions,eatingdisorders,panicanxiety,
dissociativedisorders,andcharacterdisorders.Toourastonishment,webegan
discoveringthatover80%ofthemhadhistoriesofprolonged,severe,and
repeatedexperiencesoftraumaintheirbackground,usuallybeginningin
childhoodandcompoundedinlaterlife.
Thepatientsdidnotchangetheyhadapparentlyalwaysbeenpreparedto
revealtheirhistories.Butwebeganaskingdifferentquestions.Insteadofasking
thequestionthatisimplicitinmostpsychiatricinterviews,namely"whatis
wrongwithyou?"webeganasking"whathappenedtoyou?"Theshiftaway
fromblamingthevictimsandtowardawillingnesstobeawitnesstothe
victimsresultedinentirelydifferentanswers.Theanswersbegantochangeour
outlookonourworkand,indoingso,begantochangeourlives.
Eventsofrecenthistoryhaveplayedasignificantpartinthisevolutionof
thinkingaboutposttraumaticstress.ItwasthehistoricalrealityoftheVietnam
Warandallitsaftermaththatledtothedevelopmentofanentirefieldof
traumaresearch.ButpriortothatitwasthehistoryoftheHolocaust,World
WarII,andHiroshimaandNagasakialongwiththehistoryofevenmorerecent
survivorsofkidnappingandtortureandvariousmanmadeandnaturaldisasters
throughouttheworldthatprovidedresearcherswithenoughdatatoinsistthat

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thereisauniversalhumanresponsetotraumathathasbiopsychosocialand
crossgenerationallongtermeffects.
Psychotherapyhasalwaysbeenahistoricalmethod.However,manytherapists
havebeenasselectiveintheirhistoricalstudiesasanyothergroupofhistorians,
choosingonlycertainindividualhistoricaldetailsasthemajorfocusofattention.
Butbeginninginthe'70s,therapistsworkingwithveteransofwar,feminists
workingwithbatteredwivesandrapevictims,andchildworkerswitnessingthe
abuseofchildrenbegantolookatthehistoriesoftheirparticularpatients.As
theydidso,theybecameincreasinglyawarethatsomethingwasmissingfrom
thetraditionaltherapeuticformulatheprofoundeffectoftheexternaltrauma
itselfonnormaldevelopment.
Itiseasytounderstandwhytherehasbeensomuchhistoricalresistancetojust
howtraumatichumanlifegenerallyis,particularlyforchildren.Onceyouare
willingtorecognizehowastonishingdamagingtraumaisforhumanbeingsand
howwidespreadistheamountoftrauma,itcanbecomeanobsession.Ifound
myselfdrivingdowntheroadatnight,lookingatthehousesinmy
neighborhood,wonderingwhatwasreallygoingonbehindthoseapparently
welcomingwindows.
Traumapiercestheshieldofinvulnerabilitythatwesurroundourselveswithas
adefenseagainstanoftenharshreality.Witnessingthetraumatizationofothers
producessecondarytraumatizationintheonlookersitiswhytortureofaloved
oneissomuchmoreeffectivethantorturingthesubject.Whenfacedwiththe
magnitudeofthisnewinformation,theclinicianimmediatelybecomesde
skilled,shornoftheusualdefensesthatwehaveallbuiltupovertheyearsof
ourtrainingtoprotectusfromtoomuchaffect.Theattendantfeelingsbecome
overwhelmingandchasemorethanoneclinicianawayfromthistheoreticaland
practicalapproach.
ThemorequestionsIaskedmypatients,themoreanswersIgotthatIdidn't
wanttohear.Ifoundmyselfbecomingincreasinglyfilledwithdespair,feeling
helplessandhopeless,notsomuchaboutmyindividualcases,butmoreabout
thestateofmycivilization.ThenIcameuponpsychohistory.
BythetimeIcametopsychohistoryIwasseveralyearsintothestudyofpost
traumaticstressandinthatcontexthadrapidlycometotermswiththelimitof
ourpresentstateofknowledge.Ithadbecomequiteobviousthatneither
biologicalnorpsychologicalinterventionsweresufficienttohealthedeep
woundingoftrauma.IntraditionalpsychiatriccareasIunderstoodit,the

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profoundsocialandmoralwoundingofchildabusewasnoteven
comprehended,muchlessaddressed.
IcametothestudyofpsychohistorythroughLloyddeMause'sworkonthe
historyofchildhood,aswellasAliceMiller'spsychobiographicalwork.This
materialhadapowerfulinfluenceonme.Likesomanyothers,Ihadsomehow
acquiredtheideathatthingsusedtobebetterandthatcivilizationhasbeen
goingdownhillforanindeterminateamountoftime.Accordingtothis
mythology,somewhereinthemistyshroudsofthepasttherewasagoldenage
ofchildhood,whenparentsknewhowtobeparentsandchildrenwereallowed
tobechildren.Thisattitudeistypicalofmanyofmypatientswhocomeinwith
severepathology,allthewhileclaimingthatalthoughthereisclearlysomething
wrongwiththem,theyhadwonderfulandfaultlessfamilies.
Psychohistoricaldatainformedmethatmyidealizednotionofthepastwas
ridiculousanduntrue."Thehistoryofchildhoodisanightmarefromwhichwe
havejustbeguntoawaken,"saidLloyddeMause,backingupthisclaimwith
massesofhistoricaldata.
Ireadthismaterialandwasstruckbyasortof"innervision."SuddenlyIsaw
that,asacivilization,wearenotinevitablyandirrevocablyslidingheadlonginto
theslime.Asfarasourtreatmentofchildrenisconcerned,wearestillevolving,
stilllearningaboutthe"responsibilityofcare,"asfeministresearcherCarol
Gilliganhascalledit.Thechallengetousasaspeciesiswhetherwewilllearnto
beresponsibletowardschildrenandallotherlivingthingsbeforeweself
destruct.Butatleastthereishopethatourcontinuingevolutionwilloutstrip
ourcompulsiontoreenacttrauma.
Theseinsightsprovidedanantidotetothehelplessnessandhopelessdespair
intowhichIhadbeensinking.AsmyunderstandingincreasedIbecameaware
ofthearbitraryisolationintowhichmuchofthepracticeofpsychotherapyhad
fallen.Therapyinitselfhadbecomedisconnectedfromanywidersocial
meaning,narcissisticallypreoccupiedwithhelpingtheindividualto"adjust."
Psychohistoryprovidedthetheoreticalconstructforsocialreconnection.The
sufferingofmyindividualpatientsbecameembeddedinahistoricaland
politicalcontextoutofwhichcouldbederivedameaningandpurposebothfor
theirpainandforthetransformationofthispainintosocialactionandsocial
reconstruction.
Traumaisolatesthevictim.Trauma,particularlythesecretsufferingofthechild
placesthevictimoutinthewilderness,setoutsideofthehumancommunity,
weigheddownbytheburdenofshameandalienation.Traumaexperiencedat

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thehandsofotherhumansalienatesthevictimsfromtheirexperienceoffull
humannessandseriouslyimpairstheircapacitytotrustorloveotherpeople.It
mayinfactbetruethatthemostessentialandfarreachingdamagethattrauma
doesistodestroythesenseofsocialbondednessandsubstitutetraumatic
bondingtorelationshipsofthepastthatarecompulsivelyrelivedinthepresent.
Iusethestudyofpsychohistorytohelpreconnectvictimstothishuman
community.Recoveryfromtraumaisaboutempowerment.Ifyouareavictim
andyoubelievethatyourvictimizationwasaninevitableconsequenceof
somethingdeeplyandfundamentallywrongwithyou,thenthereisverylittle
hopeofchangeorfreedomfromtherepeatedcycleofvictimization.
If,however,yourvictimizationisaresultofalegacyofabusethathasbeen
unthinkinglypassedonfromgenerationtogeneration,generatedbythepain
anddifficultyofhistoricalandevolutionaryhumandevelopment,thenthereis
hopethatyoumaybeabletodosomethingaboutconsciouslyrefusingto
continuethatcycleofvictimization.
Additionally,ifyoucanbegintoseeyoursufferingexperienceinthecontextofa
largerhumanprocess,thenthereisnocausetosustainthatcontinuedburden
ofpersonalshame.Therootsofeverytotalitarianandfascisticpolitical
movementcanbefoundinthetotalitarianabuseofpowerintrinsictoour
historicalfamilystructure.Whenthismaterialbecomesevident,thereisan
increasingrecognitionthatitisnotjustyourfamilyoryourparentswho
engagedinignominiousandappallingbehaviorthereisnofamilythathasbeen
unscarredbytheabuseofchildren.Itissimplyapartofourcommonhuman
heritage.
Itmakesnomoresensetodrownourselvesasindividualsorasaculturein
shameandguiltoverthisrealitythanitdoestoblameourselvesbecausewe
oncethoughttheearthwasflat.Theevolutionofthoughtandthedevelopment
ofconsciousnessisstillprogressing,andthereissomereasontobelievethat
thereisstillopportunityforcreativeratherthandestructivechange.
Thefundamentalassumptionofthetraumabasedapproachisthat"abnormal
reactionstoabnormalsituationsisnormalbehavior."Thisprocessofthe
normalizationofapparentpathologyisfundamentaltotherecoverymovement,
asittakesthepowerandresponsibilityforchangeoutofthehandsofthe
expertsandputsitbackintothehandsofthepopulace.Whenpersonal
pathologyisplacedinthecontextofmajorhistoricalchangeanddevelopment,
itceasestobepersonallypathological,freeingtheindividualfromthecrushing

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weightofhopelessculpability,enablinghimorhertoassumeincreased
responsibilityfornecessarypersonalandsocialchange.
Debunkingthemythofsomegoldenageofchildhoodservesthepurposeof
movingusbackintotheflowoftime,creatingnewpossibilitiesforthefuture
insteadofpursuingthehopelesstaskofrestoringthepast.Victimsoftrauma
are,bydefinition,trappedintime,arrestedatthestageofthetrauma,endlessly
repeatingtheirpast.Theabilitytoseeandunderstandthishistoricalrepetition
compulsionprovidespeoplewiththeopportunitytomakeaninformedchoice
aboutwhethertheywanttocontinuetodothingsthewaytheyhavealways
beendone,withthesameultimateoutcome,orwhethertoentertainthe
possibilityofreal,ratherthansimulated,change.
Theavailablepsychohistoricalmaterialallowsmetohelptheindividual
recognizehisorherownpatternsofrepetitionandplacethosepatternsfirmly
inacontextofanentirecivilizationrepeatingtrauma.Thisintellectualexercise
initselfisareconnectingact,awayofjoiningindividualsufferingtogroupand
historicalsufferingandindoingsodecreasingindividualalienation,guilt,and
shame.
Inthisway,psychohistorybecomesanintellectualweaponinthefundamentally
subversiveandrebelliousworkthatiseffectivepsychotherapy.Thegoalsof
individualpsychotherapyaretosubverttheprocessoftherepetition
compulsionandallowforthepossibilityofcreativeendeavor.Thismustbe,by
itsnature,arebellionagainsttheformsandauthorityofthepast.Thisis,
perhaps,thereasonwhyeffectivepsychotherapyandradicalpsychohistory
tendtomeetsuchresistance,denial,andoutrightopposition:theyboth
implicitlydemandachangeinthestatusquothatmustinevitablyleadto
individualandsocialchange.
Intheindividual,theunconsciousneedtoreenacttraumawieldsapowerover
individualchoiceandwillthatistrulyawesometobehold.Thisdrivetorepeat
traumaappearstobefueledbytheunacceptableanddissociatedaffect
pressingforexpressionandintegration.Theunconsciousspeaksdirectly
throughaffect,symbols,images,andactions,notthroughlanguageexpression.
Thereappearstobesomethingvitalaboutthetransferofaffectiveandsymbolic
experienceintonarrativeexpressiontoenableintegrationofdissociatedaffect
tooccur.Itisalsothroughlanguagethatourprivateandinteriorimagesand
feelingscanbesharedenoughtocreateabridgewithotherhumanbeings.Itis
inthecontextofrelationshipswithotherhumanbeingsthattheindividualis
offeredthechoiceofrepeatingthepastorcreatingafuture.

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Thistransformationofimagetowords,ofunconscioustoconscious,ofbodyto
mind,ofanimaltomanistheessentialworkofpsychotherapy.Itiswhyithas
beencalledthe"talkingcure,"Butthistransformationdoesnotcomeeasily,It
requiresthattheindividualstopactingouthisorherunexpressedemotions,
holdstill,andfeel.Thefeelingsproducesuchdiscomfortthatifcompulsive
behaviorisinhibited,theintellectandwilltheexecutivefunctionsofthemind
areforcedtocometotheaidofthesufferingorganism.Inotherwords,the
individualisforcedtolearnhowtothink.Civilizationhasproducedthe
increasinginhibitionofaffectiveexpression,butunfortunately,sometimes
civilizationforgetsthepurposeoftheinhibitionmeaningfulproblemsolvingand
thought.
Forthelastseveralyears,wehavebeenendeavoringtocreateaninpatient
milieuthatwouldprovidetheopportunityforvictimsofchildhoodabuseto
havea"correctiveemotionalexperience."Ourgoalsaretoprovideanintensive
psychoeducationalcurriculumthatpromotestheconsciousdevelopmentofthe
intellectualcapacities.
Ourpsychoeducationalcurriculumusespsychohistoricaldataasthefoundation
forcreatinganewframeworkofknowledgetoreplacethepatient'slimited
understandingoftheworkingsofhumannature,anunderstandingthatbegins
withfundamentalselfblameandproceedsinadownwardspiralofself
recrimination,guilt,shame,andalienation.
But,asweknow,intellectualunderstandingisnotenoughtoproduce
behavioralchange.Atsomepointintreatmenttheintellectiscalleduponto
assistthewillinmakingthecrucialdecisiontoinhibitwhatevercompulsive
behaviorispreventingthesurfacingofunresolvedandunintegratedaffect.The
therapeuticmilieuthenprovidesthestructure,limitsetting,andsupport
necessarytoassistthepersoninthedeliberateinhibitionofthesebehaviors.
Whenthisiseffective,therepressedaffect,memories,andimagesrisetothe
surface.
Thedangeristhatthisreconstructiveworkwillsimplyberetraumatizingifthere
isnotasignificantreworkingofthepreviousexperience.Theenvironmentis
designedtoprovideforjustsuchadifferentreworking.Weassumethatthe
fundamentaltraumaisnotthephysicaloremotionaldirectdamageofthe
trauma.Thefundamentaltraumaisthatofexperiencingpainandhelplessness
withoutobtainingcomfortandsolacefromotherhumanbeings.
Giventhisassumption,thenoncethetraumaticaffectandmemoriesresurface,
itisthefunctionofthetherapeuticmilieutoprovidethatsafety,support,

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comfort,andtrainingthatwasmissingintheoriginalexperience.Wecannot
changethepastbutwecanchangethewaythepastisconstantlyrelived.
Whenwearesuccessful,thechangeinourpatientsis,attimes,miraculous.The
victimsregaintheirlostsenseofpersonalmastery,feelempowered,areableto
empathizewiththesufferingsofothers,anddevelopaprofoundsocial
commitmenttoconsciousandpositivechange.
ThusfarIhavebeendescribingwaysinwhichpsychohistoryenrichesmyclinical
work.Complementarityisatestofallmutualrelationships,thereforeitis
worthwhiletoexplorehowclinicalworkleadstopsychohistory.Itismy
contentionthatourincreasingknowledgeaboutthemanifestationsandeffects
ofpsychologicaltraumaonthehumanpsychehasbroadapplicationtothe
understandingofthegrouppsycheaswell.
Asaclinician,Iamdevotedtodiscoveringwaysinwhichrecoveryfromtrauma
canbefacilitated.Fromthepointofviewofpsychohistory,Iaminterestedin
exploringthepracticalapplicationsofpsychohistoricalinsights.Iseethe
traumabasedtherapeuticmilieuthatwecalla"Sanctuary"asahuman
laboratoryforwhatIhopewilleventuallybelargersocialchange.Ifindividuals
whohavesufferedseveredegradation,neglect,andabusecandiscoverwaysto
healtheirwoundsandtransformtheirpainintocreativeendeavor,thenit
shouldbepossibleforlargersocialgroupstodosoaswell.
Isuspectthatthenextstepintheevolutionofpsychohistoryisthefurther
developmentofconcretewaystoimplementandutilizepsychohistorical
knowledge.Theinsightsderivedfromindividualpsychotherapyformthe
experimentalsituationinwhichtotryoutdifferentstrategies.Butindividual
psychotherapyisnotasolutiontotheuniversalandprofoundsocialchanges
thatarenecessaryifwearetosurviveandprosperasaspecies.Thequestions
areWhen?AndHow?Answerstothesequestionsnecessitatethe
collaborationandnetworkingofrepresentativesfromallfieldsofhuman
endeavor.Thevariousfieldsthatfocusonthestudyofhumannaturehavebeen
practicallyseparatedforfartoolong.Thereismuchthatwearelearningin
individualtreatmentthathasdirectrelevancetothelargersocialbody.Butthe
fieldofpsychiatrypresentlylackstheknowledgeorexperiencetoapplysuch
insightstowidespreadsocialchange.
Thereareindicationsthatthesociety,oratleastalargepartofit,isreadytobe
exposedtonewandmorehopefulsolutions.IwouldcontendthattheSenate
debates,limitedastheywere,overentryintotheGulfWar,theThomasHill
hearings,andevenmorerecentlythepreoccupationwiththeL.A.riotsall

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indicateadesireonthepartoftheAmericanpublictomoveoutofapathyand
alienation.Alargeproportionofthepopulationstayedgluedtotheirtelevisions
throughouttheseevents.Forafewdays,thepopulacehadacommonfocal
point,anopportunityforsocialandprivatediscourse.
Moreimportantly,perhaps,theseeventsevokeunderlyingandrepressed
"national"affect.Allthedetritusthatwewouldratherdenysexism,racism,
narcissisticrage,hatred,fear,andloathingrisestothesurfacewhenour
nationaldefenseisthreatened,justliketheyrisetothesurfaceintheindividual
whoisthreatened.Theopportunityisthereforepresentedforaconscious
recognitionandresolutionoftheunderlyingdarkforcesthatsecretlymotivate
somuchofhumanbehavior.Ifweignoreorrepressthosedarkforces,they
becomepowerfulunconsciousmotivatorsforhumanactionbothindividual
andgroupactionactionthatisfrequentlyviolentandselfdestructive.When
individualsareabletotakeresponsibilityfortheirdarksideandintegrateit
insteadofdenyingit,theydiscoverthattheunconsciousisthewellspringof
endlesscreativityandselfprotective,notselfdefeatingenergy,andhumor.
Thereisnoreasonthatthegroup,anygroup,cannotdothesame.Itwould
serveuswelltolaughabitmoreathowsilly,horrid,selfdefeating,andstupid
weareasanation,asapeople,withouthavingtoalwaysfindsomeoneelseto
blame,somepoliticalfiguretodenigrate.Afterall,wemustrememberthatour
politiciansareourdelegates.
Thereisatremendousopportunityavailabletodirectthenationalpsyche
towardmoreconstructive,open,andproblemsolvingskills.Theknowledge
baseisalreadypresent.Thereisamassiveamountofpsychoeducationthatis
beingspreadthroughouttheculturethroughthemassmedia.Unfortunately,
however,atthispointintime,theinsightsgainedfromindividualpsychotherapy
haveyettofitintoamethodologythatcanbeappliedtolargergroupsinaway
thatdoesmoregoodthanharm.Thismaybeoneofthenexttasksfor
psychohistorians.
WhichbringsmetothequestionofWhen?Ourpatientsentertreatment
becausetheirsufferinghasbecomeunendurable.Theydonotdoitbecause
theyknowitisright,orbecausesomeonetellsthemtheyshould.Theydoit
becauselifehasbecomeunsupportableasitis.Humanevolutionhasgearedus
for"survival,"notforsatisfaction,pleasure,selfactualization,orhigher
consciousness.Werepeattodaywhateverstrategyguaranteedoursurvival
yesterday,nomatterhowmiserableitmakesus.Howmuchmorewillwehave
tosufferbeforeweconvinceourselvesthatlifehasbecomeunendurableand
mustbechanged?Howmuchclosertothebrinkofannihilationmustweedge

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beforewerecognize,asfinallydomypatients,thatcontinuedsurvivalcanonly
beaccomplishedbyholdingstill,integratinguncomfortableaffect,learninghow
toreasonandcare,andgrowingup?