A new metaphor for speaking of trauma: the toroidal island model.

This article provides a model for speaking of trauma based on the author's ethnographic and clinical experiences mainly in Japan. It is often assumed that a person with more serious trauma has the right and ability to speak out. But those who are at the center of trauma and unable to survive cannot testify. Based on this notion, a toroidal island (TI) model, shaped like a doughnut with a landlocked inner sea, is developed. The voices come from the survivors on the inner slope and from the supporters on the outer slope on the island. The model integrates various aspects of trauma by employing metaphors of "gravity" for symptoms of trauma, "wind" for interpersonal conflicts, and "water level" for intelligibility of the speech and its social recognition. It addresses the social construction of trauma and shows the relativistic nature of when and how some traumatic experiences are recognized. Clinical and social activity to raise awareness of unrecognized trauma can be analogized to a process of creating a TI. By defying gravity and wind and lowering the water level, they keep the voices of the traumatized from being silenced and allow their suffering to be alleviated.