Image and trauma.

In 1980, when the diagnosis of Posttraumatic Stress Disorder (PTSD) was introduced into the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-III), survivor guilt--a symptom long associated with trauma of the Holocaust and other extreme experiences--was included in the list of symptom criteria. But in the revised edition of the manual of 1987 (DSM-IIIR), survivor guilt was demoted to the status of merely an "associated feature" of the condition. Now that survivor guilt has disappeared from the official lexicon of trauma, shame has come to take its place as the emotion that most defines the traumatic state. This paper examines the rationale for the shift from survivor guilt to shame in the context of the American Psychiatric Association's revisions. It argues that the shift can be understood as yet another manifestation of the oscillation between mimetic and antimimetic theories of trauma that, I have argued in my book Trauma: A Genealogy (2000), has structured the understanding of trauma from the start.