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Trauma models used at the ECCC flawed

16 Khmer rouge

It seems “trauma” was on trial last week (June 5-6, 2013) when the prosecuting and civil party teams at the Extraordinary Chambers in the Courts of Cambodia (ECCC) conducted their two half-day examinations of Cambodian psychiatrist, Sotheara Chimm MD, an expert witness whose research on “baksbat” tempers the cultural supremacy of PTSD (post-traumatic stress disorder), globally.

If only the defence team could have refrained from challenging research markers on the percentage of the Cambodian population traumatised today, they could have gathered evidence on the spread of trauma found in baksbat.

In turn, they might have opened a forum for discussion by clarifying further the atrocities Khmer Rouge leaders instigated and those that they did not. Overall, baksbat was devised via qualitative and quantitative methods, with sampling from a population that never left the country.

To date, much research on the Khmer Rouge period is cross-sectional with an over-emphasis on taking testimonies for the purpose of building evidence solely for the prosecution of key leaders.

Most noteworthy, Dr Sotheara’s research leads us away from being PTSD-bound as these norms were based on a US Vietnam veterans’ population sample (officially entered by the American Psychiatric Association in 1980 and snowballing from there).

Those survivors did not return to a land and waterscape filled with moaning, deceased ancestors, or to places contaminated by UXO landmines, poverty, starvation and disease.

Americans have had the privilege all these years post war of having a trauma system that emerged from their own cultural, religious, medical and socio political milieu, and one that represents their interests in court.

These past few days have been historical for the fields of genocide and traumatic studies. Most significantly, the formal emergence of baksbat makes more transparent the cultural assumptions that restrict our terms of justice, democracy, trauma, recovery, forced truth and reconciliation that have run right through this tribunal, and genocide proceedings elsewhere.

It is fair to note that baksbat entered the literature formally in 2000 when Cambodian psychiatrist Dr Lina Huot studied trauma in the Cambodian former refugee community in Melbourne, Australia.

Dr Sotheara developed the reliability and validity standards for the Khmer instrument inside Cambodia.

With the arrival of this long awaited measure, trauma recovery programs can account better for protective factors embedded in ritual and Buddhist practices, some of which counteract retribution as part of community health.

More and more, truth and reconciliation proceedings overlap with the growing Western trauma industry that sets up camps in post-war regions where foreign academics seek funding and ethics clearance in their home countries.

They bring PTSD criteria into the field, “prove” its existence and seek further funding for curative purposes – sometimes with resources for creating trauma institutes.  The defence lawyers in fact, quoted such studies.

PTSD is event bound, plain and simple, while genocidal trauma is seamless. Torture is never one act; it is downright premeditated and progressive.

The April 17, 1975, shock wave of mass confused exodus out of cities was followed by calculated displacement, which assisted the regime to insert its agenda more vehemently.

In all of this, it seems to me that it could be productive to put trauma itself on trial.

The Khmer Rouge agenda was ambitious to be sure, with a fanatical attempt at deconstructing a whole society to form a pure communal and agricultural state – and disengage a nation totally from Western capitalism.

But now Cambodian survivors are expected to adopt the most widespread Western capitalist measure of trauma – PTSD.

After all, this system counts traumatic “events” just as we count bodies in determining the depth of genocide.

It’s just that the criteria for baksbat invite us to reconsider the origins of our standards, and direction of scrutiny in this tribunal.

Peg LeVine, EdD, PhD, is a Clinical Psychologist/Medical Anthropologist and author of Love and Dread in Cambodia: Weddings, Births, and Ritual Harm Under the Khmer Rouge.

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