BOOK FORUM
Schuyler W. Henderson, MD, MPH
Assistant Editor
Alienations
P
sychiatrists were once called alienists. Its an inter-
esting word, in some ways more accurate than the
Greek portmanteau word psychiatrist, which combines
doctor (iatros) with a diffuse evocation of spirit, soul, and
mind (psyche), a reminder of the uncertainty about, and the
magnitude of, what were treating.
Alienist speaks to the absolute stigma of difference
afforded the mentally ill: strangers, the estranged, visitors
from another world who do not belong, less familiar than
animals. There is a careful positioning that occurs in the
word psychiatrist, rooting the practitioner in a profession
of doctors and uprooting the afliation with a patient pop-
ulation. The refusal to identify our patient populations as
aliens or strangers is positive, but the refusal to identify
so closely with our patient populations might hint at the
phenomenal fear of contagion in stigma.
In this months Book Forum, we encounter people who
are reputedly alienatedthe traumatized, the autistic, the
hated parentfrom writers defying pat notions of alien-
ation and reconsidering the boundaries of recognition. The
books speak to the commensurability of experience, of
language, and of healing with supposedly alien others. The
Roman playwright Terence famously said, Homo sum,
humani nihil a me alienum puto (or, Im a humannothing
human is alien to me). It might be a mission statement
for alienists.
Collective Trauma, Collective
Healing. By Jack Saul. New York:
Routledge; 2014.
M
ental health providers are often drawn toward
treating afictions that they have encountered
personally.1 In Collective Trauma, Collective
Healing, Saul offers an autobiographic narrative of collective
trauma, intertwining his personal and professional per-
spectives with his overlapping identities as healer, witness,
and survivor of collective trauma.
Sauls interest in refugees and torture survivors emerged
from his personal and professional focus on intergenera-
tional trauma with a family history connected to mass
trauma, which he depicts poignantly when he chronicles a
JOURNAL OF THE AMERICAN ACADEMY OF C HILD & ADOLESCENT PSYCHIATRY
VOLUME 54 NUMBER 2 FEBRUARY 2015
pilgrimage with his spouses parents to Poland, where they
survived the atrocities of the Holocaust.
Saul notes that whether parents spoke or were silent
about their Holocaust past, children often felt that their
parents past had somehow penetrated them as if by
osmosis (p. 24). As a daughter of Vietnamese refugees
who escaped after the fall of Saigon in 1975, I found that
Collective Trauma, Collective Healing facilitated my reection
on my ancestral connection to mass trauma. By going into
the mental health eld, I was attempting to give a voice to
my familys experience, which was never mentioned in my
household. Through budding Socratic questioning skills, I
elucidated familial trauma experiences from the Vietnam
War: witnessing other villagers get killed in the crossre of
central Vietnam; my mother imprisoned multiple times in
unsanitary communist prisons until nally escaping to a
refugee camp by crowded shing boat; and male family
members imprisoned and tortured in re-education camps.
Like Saul, my professional career as a mental health clinician
at an agency providing treatment to trauma survivors with a
concentration on serving survivors of torture has reected
my personal roots.
In Hermans seminal 3-stage model of recovery, she
delineates the primary tasks of each stage: safety and
stabilization in the initial stage, remembrance and
mourning in the second stage, and reconnection in the
third stage.2 In Collective Trauma, Collective Healing, Saul
advocates for a de-emphasis of narrow interventions
targeting individuals; the affected community cannot
solely be the steadfast environmental context in which
reintegration and reconnection occur for the individual
survivor. Instead, responses to collective trauma should
focus on fostering community resilience as a platform by
which other stages of recovery can happen collectively
through a multisystemic approach.
Saul promotes Landaus LINC (Linking Human Systems)
Community Resilience Model as the framework deployed to
promote community resilience and recovery in the wake of a
collective trauma, which hinges on using ambassadors
within the affected community. Saul illustrates these prin-
ciples for identifying, developing, troubleshooting, and
sustaining community responses to collective trauma
through rsthand anecdotes spanning local, national, and
transnational boundaries that underline the humanity of
collective recovery from genocide, political unrest, war,
torture, and terrorism.
Saul elucidates the development of collective healing and
recovery in diverse localities through family- and
community-targeted interventions and highlights his pro-
fessional and interpersonal relationships mobilized in the
process: postwar Kosovo as part of a collaborative team of
mental health consultants; Lower Manhattan after the
September 11 attacks, as an insider offering a professional
www.jaacap.org 149