Journal articles on the topic 'Ear – Massage'

The high number of patients who come for ear therapy with massage skills, the P3T Center intends to carry out an observational screening of ear therapy. This screening aims to find out how the diagnostic method and application of ear therapy with massage skills and the benefits of ear therapy to overcome the problem of hearing loss (hearing impairment). This screening design uses an observational method in which the researcher makes observations and interviews with respondents. Data collection techniques were carried out by looking at the results of the examination of respondents' hearing tests and the results of interviews with respondents. Patient therapy results in 18 people (60%) no progress or the same as the original condition. this shows that therapy can be said to be ineffective in curing ear disorders. The results of the audiometry examination of the right and left ear stated that none of the patients was normal. Even though there are patients who claim to be able to hear loud sounds in the questionnaire, it is not supported by audiometry results. So it can be concluded that ear therapy with massage skills has no impact on patients suffering from hearing loss.

Background: Neonatal care practices are different in different communities. Before any intervention planned to reduce mortality and mortality in community, understanding of local belief and practices is necessary. Some of the harmful practices need to be abandoned and good or harmless practices need to be appreciated. This study was conducted to understand the cultural beliefs and practices in newborn care among residents of Uttarakhand.Methods: This was descriptive, cross-sectional study carried out among 300 postnatal mothers admitted to the hospital. The data was collected using self-administered questionnaires. Statistical analyses of the data was done using SSPS version 22.0.Results: 4% of the mothers believed colostrum to be unsuitable for the newborn. 71% mothers were practicing daily baby massage. 71.3% believed that hot and cold foods can harm their baby’s health. 57.3% practiced application of Kajal on baby’s face. 74.7% of mothers would keep Knife under pillow and 16.7% match box under baby’s cloth. 5.3% mother believed in practice of branding. 81% of mothers accept to practice of pouring oil in baby’s ear. 22.3% mothers believed in isolating mother baby together for 30-40 days.Conclusions: Certain practices are still prevalent like Branding, discarding colostrum, Kajal application, pouring oil in baby’s ear and very restricted dietary regime of mothers. These practices need to be stopped by educating mothers and relatives in postnatal wards.

Abstract Introduction With a severe facial burn, injury often involves the ear(s) resulting in damage or loss which may require reconstruction. In consideration of the functional and psychological effect that loss of a defined ear lobe may entail, reconstruction is an important consideration for the burn survivor. Two cases described in detail with illustration will highlight an auricular contracture release; one with V-Y Advancement and the other with a transposition flap. Preservation of the auricular reconstruction is accomplished by implementing necessary splinting. The auricular splint fabricated was made from a combination of silicone and low-temperature thermoplastic material. A step-by-step process will illustrate the needed materials and techniques to fabricate a worthy splint in order to preserve what was surgically achieved. The splint maintains the space between the ear and head to properly position and prevent contracture through the healing and scar maturation process. It secured with a one-inch head band that is sublime enough to foster compliance with wear. The auricular splint material also serves as scar management with the many proven benefits of silicone. Methods Two case studies are reviewed with auricular contractures that required release and reconstruction. The auricular splints were fabricated to stabilize and preserve the reconstructed ear lobe. The wear schedule was intermittent during the day and overnight in combination with scar massage. The patients reported good compliance with wear and stability of splint position with overnight wear. Skin integrity was not compromised with overnight or intermittent wear. The splint fabrication process is reviewed and illustrated with a simplistic innovative end result that is user friendly. Results Surgical reconstruction was required following development of auricular contractures and partial loss. With post-operative bandage removal and wound closure, positioning was a necessary consideration to preserve post-surgical reconstruction. Conclusions In conclusion, the peri-auricular splint is fabricated with low temperature splinting material lined in silicone proved worthy for effective positioning and reported comfort with wear. Effective splinting is necessary for the preservation of surgical reconstruction and to prevent contracture from sabotaging surgical efforts. Applicability of Research to Practice Consideration of fabrication of silicone auricular splints to preserve the accomplishments of auricular surgical reconstruction.

Neonatal piglets are often used in biomedical research applications that require artificial rearing. Social housing can be problematic because the piglets develop belly nosing, navel and ear sucking that can result in injury. Our objective was to determine the effectiveness of using feeding devices that provide various opportunities for sucking and nosing behaviour on reducing piglet-directed behaviour of group-housed laboratory piglets. Fifteen piglets were used in each of four trials. The piglets nursed their dam for approximately 72 h to obtain passive immunity before transfer to a laboratory facility where they were allotted, five per group, to one of three stainless steel isolator units. Each unit featured a different style of feeding system for the delivery of milk replacer: a plastic trough (T), a nipple (N) mounted on a smooth plexiglass wall, or a nipple mounted on a pliant bag of sterile water (artificial udder [AU]). Each system had five feeding spaces so that all piglets fed simultaneously. Milk was provided at 6-h intervals, and behaviour was recorded on alternate days for 12 days post-weaning. Although trough-fed piglets began to eat much sooner than those piglets fed from nipples, time spent nosing, chewing or sucking on pen-mates and belly nosing were markedly higher in T piglets than in either N or AU, overall (mean: P <0.05) and over time (quadratic: P <0.05). Over time, N piglets developed a stereotypic snout rubbing on the wall behind the nipples, while AU piglets massaged and often fell asleep in contact with the udder from day 2 of the trial. Resting patterns were also affected. N and AU piglets settled down to rest more quickly (P <0.01) and spent significantly more time resting in the hour following feeding than T piglets (P <0.05). A feeding device that accommodates both sucking and massage can significantly reduce piglet-directed behaviour and may facilitate social housing of artificially reared piglets.

The objective of our study was to investigate if auriculotherapy (AT) can modulate pain threshold. In our experiments, AT consisted of placingVaccariaseeds over the “fingers point” of one ear. Two groups of healthy volunteers were enrolled for the study. Each subject was asked to perform an autoalgometric test developed by our group on three occasions: before, 1 hour after, AT and 24 hours after AT. Participants of the first group received a 2-minute long session of AT, while participants of the second group received a 2-minute long session of sham treatment, consisting of a puncture/massage above the skin of the neck. The autoalgometric test consisted of applying an increasing pressure with the finger-tips and finger-backs of four fingers by the subjects themselves (i.e., eight sites were evaluated) against a round-shaped needle for two times: until a minimum pain sensation (first time, minimal test) or a maximally tolerable pain sensation (second time, maximal test). Our results showed a significant higher pain threshold in the maximal test at 24 hours after AT compared to sham treatment. This result indicates for the first time that AT can increase pain tolerability, rather than affecting the minimal pain threshold.

Background The Facial Grading Scale (FGS) is a quantitative instrument used to evaluate facial function after facial nerve injury. However, quantitative improvements in function after facial rehabilitation in people with chronic facial paralysis have not been shown. Objective The objectives of this study were to use the FGS in a large series of consecutive subjects with facial paralysis to quantitatively evaluate improvements in facial function after facial nerve rehabilitation and to describe the management of chronic facial paralysis. Design The study was a retrospective review. Methods A total of 303 individuals with facial paralysis were evaluated by 1 physical therapist at a tertiary care facial nerve center during a 5-year period. Facial rehabilitation included education, neuromuscular training, massage, meditation-relaxation, and an individualized home program. After 2 months of home exercises, the participants were re-evaluated, and the home program was tailored as necessary. All participants were evaluated with the FGS before the initiation of facial rehabilitation, and 160 participants were re-evaluated after receiving treatment. All participants underwent the initial evaluation at least 4 months after the onset of facial paralysis; for 49 participants, the evaluation took place more than 3 years after onset. Results Statistically significant increases in FGS scores were seen after treatment (P<.001, t test). The average initial score was 56 (SD=21, range=13–98), and the average score after treatment was 70 (SD=18, range=25–100). Limitations A limitation of this study was that evaluations were performed by only 1 therapist. Conclusions For 160 patients with facial paralysis, statistically significant improvements after facial rehabilitation were shown; the improvements appeared to be long lasting with continued treatment. The improvements in the FGS scores indicated that patients can successfully manage symptoms with rehabilitation and underscored the importance of specialized therapy in the management of facial paralysis.

Introduction: Despite the successes that have recently been made in the field of control and prevention of communicable diseases, the incidence of chronic illnesses has increased. And cancer as a chronic disease after accidents and unintentional deaths is the third leading cause of death in children. Given that cancer patients have multiple chemotherapy during their healing period and chemotherapy itself causes a lot of harm to the patient and that nausea and vomiting are a common complication in chemotherapy patients, Therefore, this systematic review was conducted to determine the most important methods for reducing the nausea and vomiting induced by chemotherapy in cancer patients.
 Materials and Methods: This study is a systematic review Using the articles published in the last 20 years, it was based on the most important methods for reducing the nausea and vomiting of chemotherapy in cancer patients. The search was carried out in search engines, SID, Magiran, and Google Scholar, Embase, ResearchGate, Sciencedirect, and PubMed in Persian and English. In the first stage, 47 articles were found. Of these, 10 related articles that have been published in the last 20 years have been reviewed.
 Results: In this study, we investigated the most important methods for reducing the nausea and vomiting of chemotherapy in cancer patients. In one of these studies, the rate of nausea and vomiting in patients undergoing chemotherapy was studied at the stage. In the first stage, without intervention, in the second phase, music was broadcast to patients using headphones. In the case of nausea, measurements with numerical criteria at 16 and 24 hours and descriptive criteria showed significant difference only at 24 hours after chemotherapy. However, there was no significant difference in vomiting between two stages of chemotherapy.
 Conclusion: According to the studied studies, ice massage in the Negan spot can be effective in reducing the frequency and severity of nausea and vomiting in cancer patients undergoing chemotherapy. It can also be said that muscle use reduces nausea in children with chemotherapy malignancy. It is suggested that nurses use ear acupressure technique as a complement to relieve nausea and vomiting caused by chemotherapy.

During excavations of the Iron Age ringfort of Sandby borg (ad 400–550), the remains of twenty-six unburied bodies were encountered inside and outside the buildings. The skeletons and the archaeological record indicate that after the individuals had died the ringfort was deserted. An osteological investigation and trauma analysis were conducted according to standard anthropological protocols. The osteological analysis identified only men, but individuals of all ages were represented. Eight individuals (31 per cent) showed evidence of perimortem trauma that was sharp, blunt, and penetrating, consistent with interpersonal violence. The location of the bodies and the trauma pattern appear to indicate a massacre rather than a battle. The ‘efficient trauma’ distribution (i.e. minimal but effective violence), the fact that the bodies were not manipulated, combined with the archaeological context, suggest that the perpetrators were numerous and that the assault was carried out effectively. The contemporary sociopolitical situation was seemingly turbulent and the suggested motive behind the massacre was to gain power and control.

This study was to investigate effects of auriculoacupoint (AAP) treatment on carbon tetrachloride ( CCl 4)-induced acute hepatic injury in ten dogs (four females and six males). Dogs have been divided into two groups: the control group (four dogs), not stimulated after induction of hepatic injury and the experimental group (six dogs), stimulated with AAP and massaged at the affected liver region of internal ear after induction of hepatic injury. Serum enzyme activities and histopathological findings were examined after the application of AAP. Compared to the control group, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities in the experimental group were significantly decreased at the 4th day ( p <0.05) and at the 5th day ( p <0.05), respectively. Histopathological findings of the experimental group showed decrease of necrotic region and size of lipid droplets compared to the control group. In conclusion, AAP treatment had a therapeutic effect on the recovery of liver injury induced by CCl 4 in dogs.

Background: Labor and birth are physiological processes of women. Although it is natural for women, but in general, the process is accompanied by severe pain and sometimes even lead to life-threatening. Childbirth pain is a problem that receives proper attention from nurses. Many alternative and complementary methods besides the use of drugs, can be applied to reduce pain. The methods applied include a holistic approach to ear massage, deep breathing relaxation, and guided imagery.
 Research method: This research is a quasi experiment. The research design used in this study is the "pre test and post test group design experiment" research by collecting data twice, namely before and after treatment.
 Results: From the analysis results obtained p value<0.05 indicating the three variables give the effect of the difference in pain between before and after the intervention. The difference in mean between the three interventions, ear massage and guide imagery have the same effect of reducing pain scale. However, if observed from the large value, imagery guide is the most effective in reducing labour pain. This is because the guide imagery can minimise labor pain by up to 12 times, while ear massage reduces labor pain by up to 10 times and breathing relaxation in reducing labor pain by up to 8 times.
 Conclusion: There is an effect of ear massage, deep breathing relaxation and guide imagery in reducing labor pain.
 Keywords: ear massage, deep breathing relaxation, and guide imagery, labor pain

Objective: to identify the Sundanese cultural value for family in mother’s postpartum care and new born baby Methods: Qualitative method was used in this study along with descriptive techniques to analyzed the data. Data mining is done using profound interview with four respondents who originally from the Sundanese tribe and live in Cipagalo village. Respondents are mothers who have two to six months old child.. Furthermore, the interview was also conducted with paraji as person who are still active giving services in the area. All data was collected by recording the conversations and based on the respondents’ consent. Next, the data were interpreted, reduced, and coded for final result. Analytical descriptive analysis was next conducted to this research findings using journals assessment. All findings were divided into three categories; useful findings, harmful findings, and insignificant findings. Useful findings are results that have scientific evidence and can be recommended to do. Harmful ones are things that are scientifically proofed to have harmful effect, whereas insignificant findings are results with unknown scientific proofs whether its harmful or not.Results: Results in this study showed various Sundanese cultural habits in Cipagalo village:(1) There are some forbidden food and beverages during the postpartum phase, including spicy, sour, and cold ones.(2) Suggestion to consume apple during the postpartum phase.(3) Herbs or traditional potion for postpartum. Herbs can be consumed in various ways like (a) boiling and drinking it, (b) grating and squeezing it, (c) boiling and using it to wash the private area (smeared).(4) Rest and sleep pattern. There is tradition which done by the mothers; they should not take a nap in the afternoon, afraid that the white blood cells would go up the eyes, or they could take a nap in a seated position with both toes tied together in hope it would help to tighten mom’s private area.(5) Clothes and mother’s care. There is a habit of using corset (stagen) or what they called bebengkung, soaking feet in warm water, and massaging mom’s body.(6) Massaging mom’s body. Not only massaging body parts, there is also massaging the uterus (disangsurkeun).(7) Baby care culture and traditional ceremonies. This includes placenta burial using spices or what the sundanese called as bali, baby girls circumcision and ear piercing.Conclusion: The habit of consuming apple, body massage, feet massage in warm water, the use of binahong leaves and ginger, handeuleum, and baby massage showed benefits not only for moms, but also babies during postpartum phase.

Multiple disabilities is term for child with several disabilities sensory associated with motor disabilities. Growing number of children are presented with development issues caused by cerebral palsy , autism, learning disabilities, ADHD, Genetic disorder , global delayed development . Problem of this children are multifold and affects the daily life of whole family No such conventional treatment can cure these problems these problems. They are treating specific symptoms of Autism and global delay improve the child functioning and helping them in daily activity . It is ethically correct to take advantage of ozone therapy when the best orthodox treatment has failed . Anecdotal study was done in 47 children ranging from 8months to 12 yrs of age with multiple disabilities . Along with conventional treatment and various therapy like occupational therapy , physio therapy , sensory integration, speech therapy, ozone therapy i.e rectal insufflation (10mcg to 80mcg per kg) ear insufflation (10mcg / 120ml for 5 to 10 mins ) were given. In selected cases S/C injection, vacuum massage, matra basti with Ayurvedic medicated ghrut like “Bhrami Ghruth, Ashwagandha Ghruth, Mahakalyank Ghruth”. The rectal insufflation of ozone is a systemic routed which dissolves quickly in the luminal contents of the bowel, where mucoprotiens and other secretory products with antioxidants activity readily react with ozone to produce reactive oxygen species (ROS) and lipid peroxidation products. These compound penetrate the muscular mucosa and enter the circulation of venous and lymphatic capillaries. This non-invasive technique can be used without risk in pediatric and elderly patients. Ear insufflation through capillaries of ear: it is believed that it is absorbed, it secretes hormone endorphin which gives cool & calm effect which improves the quality of sleep. Vacuum increases the blood flow and ozone can react better and S/C injection improves local blood circulation . Herbal drugs like centella acitica(Brahmi) shows significant improvement in neuron function in areas of the brain associated with learning and memory useful in ADHD. “Withenia Somnifera (Ashwagandh)” shows high affinity for GABA receptors that is helpful in memory loss, anxiety and ADHD “Ghrut” is a detoxifying agent makes the organ soft increases intelligence refine the intellect (dhi), improve the memory(Smruti), increases digestive AGNI ,cools the body and gives synergistic effect with ozone application (Yogwahi) OBSERVATION : 1. Improvement in Alertness, immunity, Digestion 2. Weight Gain 3. Improvement in muscle tone that enables child to perform daily physical activity It is very early to arrive at any conclusion, But results are encouraging and Very Safe

Introduction: Sentinel lymph node biopsy is indicated as gold standard in the surgical treatment of initial breast cancer, presenting as a more conservative approach and preventing total lymphadenectomy. Dyes or technetium radiopharmaceuticals can be used to identify the sentinel lymph node. The most used dyes for the identification of the sentinel lymph node are patent blue and isosulfan blue, and, in lower frequency, methylene blue. However, hypersensitivity reactions to blue dye have been described, estimating its prevalence in 0.6%‒2.7%. The clinical status that characterizes the allergic reaction to the dye can range from mild skin changes to the severe condition, with circulatory collapse. Objectives: To present a severe case of allergic reaction to patent blue in a patient submitted to surgical treatment for breast cancer. Method: This is a case report study based on the analysis of medical records and literature review. Case report: T.L.O.M, female, 49-year old woman, white, married, born in Patos de Minas, MG. Patient diagnosed with Breast cancer, T1N0A0, with indication for sentinel lymph node analysis with blue patent and segmental resection of the tumor. ASA 1 pre-anesthetic evaluation, without history of allergy. The patient was submitted to general inhalation anesthesia and subcutaneous injection in the left breast of 2ml of patent blue, followed by massage. During the anesthetic plan, after 40 minutes of surgery, the patient was hypotensive (40x20 mmHg), with low saturation (ETCO2 28), tachycardia (120 bpm), associated with bluish urticariform papules, and major edema in the ear lobes, being immediately assisted with adrenaline bolus, metaraminol, and decadron. The patient became stable, and it was possible to conclude the procedure. Then, she was referred to the intensive care unit, under sedation and intubated due to the risk of laryngospasm. She evolved hemodynamically stable, and was extubated without intercurrences. Conclusions: A severe anaphylactic reaction to patent blue can risk the life of a patient in an unpredictable manner. Considering this case, it is essential that the entire staff involved in the sentinel lymph node biopsy be aware of the possibility of a hypersensitive reaction to the dye, being prepared to recognize and immediately handle the possible repercussions.

Resumo Objetivo sintetizar as evidências disponíveis na literatura sobre os tipos de superfícies de compressão utilizadas na RCP e analisar quais características das superfícies de compressão têm impacto na eficácia da compressão torácica durante a RCP. Método revisão integrativa da literatura, cujos critérios de seleção e inclusão foram: artigos completos, em inglês, português ou espanhol e que respondessem a seguinte questão de pesquisa: “Quais são as características das superfícies de compressão que têm impacto na eficácia das compressões torácicas durante a RCP?”. Realizada entre os meses de junho e julho de 2019. Resultados inclui-se 12 artigos de estudos experimentais, cuja extração de dados revelou 13 tipos diferentes de colchões. Em relação às pranchas, seis tamanhos diferentes foram relatados, com diferentes materiais. Constatou-se influências do tipo de superfície de compressão na força necessária para realizar as compressões torácicas. Conclusão as evidências apontam que colchões de maiores dimensões e com tecnologia para redução de pressão e camas mais largas apresentam impactos negativos na qualidade das compressões torácicas. Implicação para prática o conhecimento sobre a influência do tipo e características das superfícies de apoio na qualidade das compressões torácicas podem subsidiar profissionais na escolha e incorporação de tecnologias no ambiente hospitalar.

1909–22: Turkey exterminated over 1.5 million of its ethnically Armenian, and hundreds of thousands of its ethnically Greek and Assyrian, citizens. Most died in 1915. This period of decimation in now widely called the Armenian Genocide (Balakian 179-80).1910: Siamanto first published his poem, The Dance: “The corpses were piled as trees, / and from the springs, from the streams and the road, / the blood was a stubborn murmur.” When springs run red, when the dead are stacked tree-high, when “everything that could happen has already happened,” then time is nothing: “there is no future [and] the language of civilised humanity is not our language” (Nichanian 142).2007: In my novel The Edge of the World a ceramic bowl, luminous blue, recurs as motif. Imagine you are tiny: the bowl is broken but you don’t remember breaking it. You’re awash with tears. You sit on the floor, gather shards but, no matter how you try, you can’t fix it. Imagine, now, that the bowl is the sky, huge and upturned above your head. You have always known, through every wash of your blood, that life is shockingly precarious. Silence—between heartbeats, between the words your parents speak—tells you: something inside you is terribly wrong; home is not home but there is no other home; you “can never be fully grounded in a community which does not share or empathise with the experience of persecution” (Wajnryb 130). This is the stubborn murmur of your body.Because time is nothing, this essay is fragmented, non-linear. Its main characters: my mother, grandmother (Hovsanna), grandfather (Benyamin), some of my mother’s older siblings (Krikor, Maree, Hovsep, Arusiak), and Mustafa Kemal Ataturk (Ottoman military officer, Young Turk leader, first president of Turkey). 1915–2013: Turkey invests much energy in genocide denial, minimisation and deflection of responsibility. 24 April 2012: Barack Obama refers to the Medz Yeghern (Great Calamity). The use of this term is decried as appeasement, privileging political alliance with Turkey over human rights. 2003: Between Genocide and Catastrophe, letters between Armenian-American theorist David Kazanjian and Armenian-French theorist Marc Nichanian, contest the naming of the “event” (126). Nichanian says those who call it the Genocide are:repeating every day, everywhere, in all places, the original denial of the Catastrophe. But this is part of the catastrophic structure of the survivor. By using the word “Genocide”, we survivors are only repeating […] the denial of the loss. We probably cannot help it. We are doing what the executioner wanted us to do […] we claim all over the world that we have been “genocided;” we relentlessly need to prove our own death. We are still in the claws of the executioner. We still belong to the logic of the executioner. (127)1992: In Revolution and Genocide, historian Robert Melson identifies the Armenian Genocide as “total” because it was public policy intended to exterminate a large fraction of Armenian society, “including the families of its members, and the destruction of its social and cultural identity in most or all aspects” (26).1986: Boyajian and Grigorian assert that the Genocide “is still operative” because, without full acknowledgement, “the ghosts won’t go away” (qtd. in Hovannisian 183). They rise up from earth, silence, water, dreams: Armenian literature, Armenian homes haunted by them. 2013: My heart pounds: Medz Yeghern, Aksor (Exile), Anashmaneli (Indefinable), Darakrutiun (Deportation), Chart (Massacre), Brnagaght (Forced migration), Aghed (Catastrophe), Genocide. I am awash. Time is nothing.1909–15: Mustafa Kemal Ataturk was both a serving Ottoman officer and a leader of the revolutionary Young Turks. He led Ottoman troops in the repulsion of the Allied invasion before dawn on 25 April at Gallipoli and other sites. Many troops died in a series of battles that eventually saw the Ottomans triumph. Out of this was born one of Australia’s founding myths: Australian and New Zealand Army Corps (ANZACs), courageous in the face of certain defeat. They are commemorated yearly on 25 April, ANZAC Day. To question this myth is to risk being labelled traitor.1919–23: Ataturk began a nationalist revolution against the occupying Allies, the nascent neighbouring Republic of Armenia, and others. The Allies withdrew two years later. Ataturk was installed as unofficial leader, becoming President in 1923. 1920–1922: The last waves of the Genocide. 2007: Robert Manne published A Turkish Tale: Gallipoli and the Armenian Genocide, calling for a recontextualisation of the cultural view of the Gallipoli landings in light of the concurrence of the Armenian Genocide, which had taken place just over the rise, had been witnessed by many military personnel and widely reported by international media at the time. Armenian networks across Australia were abuzz. There were media discussions. I listened, stared out of my office window at the horizon, imagined Armenian communities in Sydney and Melbourne. Did they feel like me—like they were holding their breath?Then it all went quiet. Manne wrote: “It is a wonderful thing when, at the end of warfare, hatred dies. But I struggle to understand why Gallipoli and the Armenian Genocide continue to exist for Australians in parallel moral universes.” 1992: I bought an old house to make a home for me and my two small children. The rooms were large, the ceilings high, and behind it was a jacaranda with a sturdy tree house built high up in its fork. One of my mother’s Armenian friends kindly offered to help with repairs. He and my mother would spend Saturdays with us, working, looking after the kids. Mum would stay the night; her friend would go home. But one night he took a sleeping bag up the ladder to the tree house, saying it reminded him of growing up in Lebanon. The following morning he was subdued; I suspect there were not as many mosquitoes in Lebanon as we had in our garden. But at dinner the previous night he had been in high spirits. The conversation had turned, as always, to politics. He and my mother had argued about Turkey and Russia, Britain’s role in the development of the Middle East conflict, the USA’s roughshod foreign policy and its effect on the world—and, of course, the Armenian Genocide, and the killingof Turkish governmental representatives by Armenians, in Australia and across the world, during the 1980s. He had intimated he knew the attackers and had materially supported them. But surely it was the beer talking. Later, when I asked my mother, she looked at me with round eyes and shrugged, uncharacteristically silent. 2002: Greek-American diva Diamanda Galas performed Dexifiones: Will and Testament at the Perth Concert Hall, her operatic work for “the forgotten victims of the Armenian and Anatolian Greek Genocide” (Galas).Her voice is so powerful it alters me.1925: My grandmother, Hovsanna, and my grandfather, Benyamin, had twice been separated in the Genocide (1915 and 1922) and twice reunited. But in early 1925, she had buried him, once a prosperous businessman, in a swamp. Armenians were not permitted burial in cemeteries. Once they had lived together in a big house with their dozen children; now there were only three with her. Maree, half-mad and 18 years old, and quiet Hovsep, aged seven,walked. Then five-year-old aunt, Arusiak—small, hungry, tired—had been carried by Hovsanna for months. They were walking from Cilicia to Jerusalem and its Armenian Quarter. Someone had said they had seen Krikor, her eldest son, there. Hovsanna was pregnant for the last time. Together the four reached Aleppo in Syria, found a Christian orphanage for girls, and Hovsanna, her pregnancy near its end, could carry Arusiak no further. She left her, promising to return. Hovsanna’s pains began in Beirut’s busy streets. She found privacy in the only place she could, under a house, crawled in. Whenever my mother spoke of her birth she described it like this: I was born under a stranger’s house like a dog.1975: My friend and I travelled to Albany by bus. After six hours we were looking down York Street, between Mount Clarence and Mount Melville, and beyond to Princess Royal Harbour, sapphire blue, and against which the town’s prosperous life—its shopfronts, hotels, cars, tourists, historic buildings—played out. It took away my breath: the deep harbour, whaling history, fishing boats. Rain and sun and scudding cloud; cliffs and swells; rocky points and the white curves of bays. It was from Albany that young Western Australian men, volunteers for World War I, embarked on ships for the Middle East, Gallipoli, sailing out of Princess Royal Harbour.1985: The Australian Government announced that Turkey had agreed to have the site of the 1915 Gallipoli landings renamed Anzac Cove. Commentators and politicians acknowledged it as historic praised Turkey for her generosity, expressed satisfaction that, 70 years on, former foes were able to embrace the shared human experience of war. We were justifiably proud of ourselves.2005: Turkey made her own requests. The entrance to Albany’s Princess Royal Harbour was renamed Ataturk Channel. A large bronze statue of Ataturk was erected on the headland overlooking the Harbour entrance. 24 April 1915: In the town of Hasan Beyli, in Cilicia, southwest Turkey, my great grandfather, a successful and respected businessman in his 50s, was asleep in his bed beside his wife. He had been born in that house, as had his father, grandfather, and all his children. His brother, my great uncle, had bought the house next door as a young man, brought his bride home to it, lived there ever since; between the two households there had been one child after another. All the cousins grew up together. My great grandfather and great uncle had gone to work that morning, despite their wives’ concerns, but had returned home early. The women had been relieved to see them. They made coffee, talked. Everyone had heard the rumours. Enemy ships were massing off the coast. 1978: The second time in Albany was my honeymoon. We had driven into the Goldfields then headed south. Such distance, such beautiful strangeness: red earth, red rocks; scant forests of low trees, thin arms outstretched; the dry, pale, flat land of Norseman. Shimmering heat. Then the big, wild coast.On our second morning—a cool, overcast day—we took our handline to a jetty. The ocean was mercury; a line of cormorants settled and bobbed. Suddenly fish bit; we reeled them in. I leaned over the jetty’s side, looked down into the deep. The water was clear and undisturbed save the twirling of a pike that looked like it had reversed gravity and was shooting straight up to me. Its scales flashed silver as itbroke the surface.1982: How could I concentrate on splicing a film with this story in my head? Besides the desk, the only other furniture in the editing suite was a whiteboard. I took a marker and divided the board into three columns for the three generations: my grandparents, Hovsanna and Benyamin; my mother; someone like me. There was a lot in the first column, some in the second, nothing in the third. I stared at the blankness of my then-young life.A teacher came in to check my editing. I tried to explain what I had been doing. “I think,” he said, stony-faced, “that should be your third film, not your first.”When he had gone I stared at the reels of film, the white board blankness, the wall. It took 25 years to find the form, the words to say it: a novel not a film, prose not pictures.2007: Ten minutes before the launch of The Edge of the World, the venue was empty. I made myself busy, told myself: what do you expect? Your research has shown, over and over, this is a story about which few know or very much care, an inconvenient, unfashionable story; it is perfectly in keeping that no-one will come. When I stepped onto the rostrum to speak, there were so many people that they crowded the doorway, spilled onto the pavement. “I want to thank my mother,” I said, “who, pretending to do her homework, listened instead to the story her mother told other Armenian survivor-women, kept that story for 50 years, and then passed it on to me.” 2013: There is a section of The Edge of the World I needed to find because it had really happened and, when it happened, I knew, there in my living room, that Boyajian and Grigorian (183) were right about the Armenian Genocide being “still operative.” But I knew even more than that: I knew that the Diaspora triggered by genocide is both rescue and weapon, the new life in this host nation both sanctuary and betrayal. I picked up a copy, paced, flicked, followed my nose, found it:On 25 April, the day after Genocide memorial-day, I am watching television. The Prime Minister stands at the ANZAC memorial in western Turkey and delivers a poetic and moving speech. My eyes fill with tears, and I moan a little and cover them. In his speech he talks about the heroism of the Turkish soldiers in their defence of their homeland, about the extent of their losses – sixty thousand men. I glance at my son. He raises his eyebrows at me. I lose count of how many times Kemal Ataturk is mentioned as the Father of Modern Turkey. I think of my grandmother and grandfather, and all my baby aunts and uncles […] I curl over like a mollusc; the ache in my chest draws me in. I feel small and very tired; I feel like I need to wash.Is it true that if we repeat something often enough and loud enough it becomes the truth? The Prime Minister quotes Kemal Ataturk: the ANZACS who died and are buried on that western coast are deemed ‘sons of Turkey’. My son turns my grandfather’s, my mother’s, my eyes to me and says, It is amazing they can be so friendly after we attacked them.I draw up my knees to my chest, lay my head and arms down. My limbs feel weak and useless. My throat hurts. I look at my Australian son with his Armenian face (325-6).24 April 1915 cont: There had been trouble all my great grandfather’s life: pogrom here, massacre there. But this land was accustomed to colonisers: the Mongols, the Persians, latterly the Ottomans. They invade, conquer, rise, fall; Armenians stay. This had been Armenian homeland for thousands of years.No-one masses ships off a coast unless planning an invasion. So be it. These Europeans could not be worse than the Ottomans. That night, were my great grandfather and great uncle awoken by the pounding at each door, or by the horses and gendarmes’ boots? They were seized, each family herded at gunpoint into its garden, and made to watch. Hanging is slow. There could be no mistakes. The gendarmes used the stoutest branches, stayed until they were sure the men weredead. This happened to hundreds of prominent Armenian men all over Turkey that night.Before dawn, the Allies made landfall.Each year those lost in the Genocide are remembered on 24 April, the day before ANZAC Day.1969: I asked my mother if she had any brothers and sisters. She froze, her hands in the sink. I stared at her, then slipped from the room.1915: The Ottoman government decreed: all Armenians were to surrender their documents and report to authorities. Able-bodied men were taken away, my grandfather among them. Women and children, the elderly and disabled, were told to prepare to walk to a safe camp where they would stay for the duration of the war. They would be accompanied by armed soldiers for their protection. They were permitted to take with them what they could carry (Bryce 1916).It began immediately, pretty young women and children first. There are so many ways to kill. Months later, a few dazed, starved survivors stumbled into the Syrian desert, were driven into lakes, or herded into churches and set alight.Most husbands and fathers were never seen again. 2003: I arrived early at my son’s school, parked in the shade, opened The Silence: How Tragedy Shapes Talk, and began to read. Soon I was annotating furiously. Ruth Wajnryb writes of “growing up among innocent peers in an innocent landscape” and also that the notion of “freedom of speech” in Australia “seems often, to derive from that innocent landscape where reside people who have no personal scars or who have little relevant historical knowledge” (141).1984: I travelled to Vancouver, Canada, and knocked on Arusiak’s door. Afraid she would not agree to meet me, I hadn’t told her I was coming. She was welcoming and gracious. This was my first experience of extended family and I felt loved in a new and important way, a way I had read about, had observed in my friends, had longed for. One afternoon she said, “You know our mother left me in an orphanage…When I saw her again, it was too late. I didn’t know who they were, what a family was. I felt nothing.” “Yes, I know,” I replied, my heart full and hurting. The next morning, over breakfast, she quietly asked me to leave. 1926: When my mother was a baby, her 18 year-old sister, Maree, tried to drown her in the sea. My mother clearly recalled Maree’s face had been disfigured by a sword. Hovsanna, would ask my mother to forgive Maree’s constant abuse and bad behaviour, saying, “She is only half a person.”1930: Someone gave Hovsanna the money to travel to Aleppo and reclaim Arusiak, by then 10 years old. My mother was intrigued by the appearance of this sister but Arusiak was watchful and withdrawn. When she finally did speak to my then five-year-old mother, she hissed: “Why did she leave me behind and keep you?”Soon after Arusiak appeared, Maree, “only half a person,” disappeared. My mother was happy about that.1935: At 15, Arusiak found a live-in job and left. My mother was 10 years old; her brother Hovsep, who cared for her before and after school every day while their mother worked, and always had, was seventeen. She adored him. He had just finished high school and was going to study medicine. One day he fell ill. He died within a week.1980: My mother told me she never saw her mother laugh or, once Hovsep died, in anything other than black. Two or three times before Hovsep died, she saw her smile a little, and twice she heard her singing when she thought she was alone: “A very sad song,” my mother would say, “that made me cry.”1942: At seventeen, my mother had been working as a live-in nanny for three years. Every week on her only half-day off she had caught the bus home. But now Hovsanna was in hospital, so my mother had been visiting her there. One day her employer told her she must go to the hospital immediately. She ran. Hovsanna was lying alone and very still. Something wasn’t right. My mother searched the hospital corridors but found no-one. She picked up a phone. When someone answered she told them to send help. Then she ran all the way home, grabbed Arusiak’s photograph and ran all the way back. She laid it on her mother’s chest, said, “It’s all right, Mama, Arusiak’s here.”1976: My mother said she didn’t like my boyfriend; I was not to go out with him. She said she never disobeyed her own mother because she really loved her mother. I went out with my boyfriend. When I came home, my belongings were on the front porch. The door was bolted. I was seventeen.2003: I read Wajnryb who identifies violent eruptions of anger and frozen silences as some of the behaviours consistent in families with a genocidal history (126). 1970: My father had been dead over a year. My brothers and I were, all under 12, made too much noise. My mother picked up the phone: she can’t stand us, she screamed; she will call an orphanage to take us away. We begged.I fled to my room. I couldn’t sit down. I couldn’t keep still. I paced, pressed my face into a corner; shook and cried, knowing (because she had always told us so) that she didn’t make idle threats, knowing that this was what I had sometimes glimpsed on her face when she looked at us.2012: The Internet reveals images of Ataturk’s bronze statue overlooking Princess Royal Harbour. Of course, it’s outsized, imposing. The inscription on its plinth reads: "Peace at Home/ Peace in the World." He wears a suit, looks like a scholar, is moving towards us, a scroll in his hand. The look in his eyes is all intensity. Something distant has arrested him – a receding or re-emerging vision. Perhaps a murmur that builds, subsides, builds again. (Medz Yeghern, Aksor, Aghed, Genocide). And what is written on that scroll?2013: My partner suggested we go to Albany, escape Perth’s brutal summer. I tried to explain why it’s impossible. There is no memorial in Albany, or anywhere else in Western Australia, to the 1.5 million victims of the Armenian Genocide. ReferencesAkcam, Taner. “The Politics of Genocide.” Online Video Clip. YouTube. YouTube, 11 Dec. 2011. 6 Mar. 2013 ‹http://www.youtube.com/watchv=OxAJaaw81eU&noredirect=1genocide›.Balakian, Peter. The Burning Tigress: The Armenian Genocide. London: William Heinemann, 2004.BBC. “Kemal Ataturk (1881–1938).” BBC History. 2013. 6 Mar. 2013 ‹http://www.bbc.co.uk/history/historic_figures/ataturk_kemal.shtml›.Boyajian, Levon, and Haigaz Grigorian. “Psychological Sequelae of the Armenian Genocide.”The Armenian Genocide in Perspective. Ed. Richard Hovannisian. New Brunswick: Transaction, 1987. 177–85.Bryce, Viscount. The Treatment of the Armenians in the Ottoman Empire. London: Hodder and Stoughton, 1916.Galas, Diamanda. Program Notes. Dexifiones: Will and Testament. Perth Concert Hall, Perth, Australia. 2001.———.“Dexifiones: Will and Testament FULL Live Lisboa 2001 Part 1.” Online Video Clip. YouTube, 5 Nov. 2011. Web. 6 Mar. 2013 ‹http://www.youtube.com/watch?v=mvVnYbxWArM›.Kazanjian, David, and Marc Nichanian. “Between Genocide and Catastrophe.” Loss. Eds. David Eng and David Kazanjian. Los Angeles: U of California P, 2003. 125–47.Manne, Robert. “A Turkish Tale: Gallipoli and the Armenian Genocide.” The Monthly Feb. 2007. 6 Mar. 2013 ‹http://www.themonthly.com.au/turkish-tale-gallipoli-and-armenian-genocide-robert-manne-459›.Matiossian, Vartan. “When Dictionaries Are Left Unopened: How ‘Medz Yeghern’ Turned into a Terminology of Denial.” The Armenian Weekly 27 Nov. 2012. 6 Mar. 2013 ‹http://www.armenianweekly.com/2012/11/27/when-dictionaries-are-left-unopened-how-medz-yeghern-turned-into-terminology-of-denial/›.Melson, Robert. Revolution and Genocide. Chicago: U of Chicago P, 1996.Nicholson, Brendan. “ASIO Detected Bomb Plot by Armenian Terrorists.” The Australian 2 Jan. 2012. 6 Mar. 2013 ‹http://www.theaustralian.com.au/in-depth/cabinet-papers/asio-detected-bomb-plot-by-armenian-terrorists/story-fnbkqb54-1226234411154›.“President Obama Issues Statement on Armenian Remembrance Day.” The Armenian Weekly 24 Apr. 2012. 5 Mar. 2013 ‹http://www.armenianweekly.com/2012/04/24/president-obama-issues-statement-on-armenian-remembrance-day/›.Polain, Marcella. The Edge of the World. Fremantle: Fremantle Press, 2007.Siamanto. “The Dance.” Trans. Peter Balakian and Nervart Yaghlian. Adonias Dalgas Memorial Page 5 Mar. 2013 ‹http://www.terezakis.com/dalgas.html›.Stockings, Craig. “Let’s Have a Truce in the Battle of the Anzac Myth.” The Australian 25 Apr. 2012. 6 Mar. 2013 ‹http://www.theaustralian.com.au/national-affairs/opinion/lets-have-a-truce-in-the-battle-of-the-anzac-myth/story-e6frgd0x-1226337486382›.Wajnryb, Ruth. The Silence: How Tragedy Shapes Talk. Crows Nest: Allen and Unwin, 2001.

Dream, 2008Go to visit a friend with vulvodynia who recently had a baby only to find that she is desolate. I realise the baby–a little boy–died. We go for a walk together. She has lost weight through the ordeal & actually looks on the edge of beauty for the first time. I feel like saying something to this effect–like she had a great loss but gained beauty as a result–but don’t think it would be appreciated. I know I shouldn’t stay too long &, sure enough, when we get back to hers, she indicates she needs for me to go soon. In her grief though, her body begins to spasm uncontrollably, describing the arc of the nineteenth-century hysteric. I start to gently massage her back & it brings her great relief as her body relaxes. I notice as I massage her, that she has beautiful gold and silver studs, flowers, filigree on different parts of her back. It describes a scene of immense beauty. I comment on it.In 2008, I was following a writing path dictated by my vulvodynia, or chronic vulval pain, and was exploring the possibility of my disorder being founded in trauma. The theory did not, in my case, hold up and I had decided to move on when serendipity intervened. Books ordered for different purposes arrived simultaneously and, as I dipped into the texts, I found startling correspondence between them. The books? Neurologist Jean-Martin Charcot’s lectures on hysteria, translated into English in 1889; psychiatrist W.H.R. Rivers’s explication of a biological theory of the neuroses published in 1922; and trauma neurologist Robert C. Scaer’s interpretation, in 2007, of the psychosomatic symptoms of his patients. The research grasped my intellect and imagination and maintained its grip until the ensuing chapter was done with me: my day life, papers and books skewed across tables; my night life, dreams surfeited with suffering and beauty, as I struggled with the possibility of any relationship between the two. Just as Rivers recognised that the shell-shock of World War I was not a physical injury as such but a trigger for and form of hysteria, so too, a few decades earlier, did Charcot insistently equate the railway brain/spine that resulted from railway accidents, with the hysteria of other of his patients, recognising that the precipitating incident constituted trauma that lodged in the body/mind of the victim (Clinical 221). More recently, Scaer notes that the motor vehicle accident (MVA) from which whiplash ensues is usually of insufficient force to logically cause bodily injury and, through this understanding, links whiplash and the railway brain/spine of the nineteenth century (25).In terms of comparative studies, most exciting for a researcher is the detail with which Charcot described patient after patient with hysteria in the Salpêtrière hospital, and elements of correspondence in symptomatology between these and Scaer’s patients, the case histories of which open most chapters of his book, titled appropriately, The Body Bears the Burden.Here are symptoms selected from a case study from each clinician:She subsequently developed headaches, neck pain, panic attacks, and full-blown post-traumatic stress disorder, along with significant cognitive problems [...] As her neck pain worsened and spread to her lower back, shoulders and arms, she noted increasing morning stiffness, and generalized pain and sensitivity to touch. With the development of interrupted, non-restorative sleep and chronic fatigue, she was ultimately diagnosed by a rheumatologist with fibromyalgia (Scaer 107).And:The patient suffers from a permanent headache of a constrictive character [...] All kinds of sound are painful to his ear, and he does his best to avoid them. It is impossible for him to fix his attention to any matter, or to devote himself to anything without speedily experiencing very great fatigue [...] He has insomnia and is frequently tormented by horrible dreams [...] Further, his memory appears to be considerably weakened (Charcot, Clinical 387).In the case of both patients, there was no significant physical injury, though both were left physically, as well as psychically, disabled. In the accidents that precipitated these symptoms, both were placed in positions of terrified helplessness as potential destruction bore down on them. In the case of Scaer’s patient, she froze in the driver’s seat at traffic lights as a large dump truck slowly reversed back on to her car, crushing the bonnet and engine compartment as it moved inexorably toward her. In the case of Charcot’s patient, he was dragging his barrow along the road when a laundryman’s van, pulled at “railway speed” by a careering horse, bore down on him, striking the wheel of his barrow (Clinical 375). It took some hours for the traumatised individuals of each incident to return to their senses.Scaer describes whiplash syndrome as “a diverse constellation of symptoms consisting of pain, neurologic symptoms, cognitive impairment, and emotional complaints” (xvii), and argues that the somatic or bodily expressions of the syndrome “may represent a universal constellation of symptoms attributable to any unresolved life-threatening experience” (143). Thus, as we look back through history, whiplash equals shell-shock equals railway brain equals the “swooning” and “vapours” of the eighteenth century (Shorter Chap. 1). All are precipitated by different causes, but all share the same outcome; diverse, debilitating symptoms affecting the body and mind, which have no reasonable physical explanation and which show no obvious organic cause. Human stress and trauma have always existed.In modern and historic studies of hysteria, much is made of the way in which the symptoms of hysterics have, over the centuries, mimicked “real” organic conditions (e.g. Shorter). Rivers discusses mimesis as a quality of the “gregarious” or herd instinct, noting that the enhanced suggestibility of such a state was utilised in military training. Here, preparation for combat focused on an unthinking obedience to duty and orders, and a loss of individual agency within the group: “The most successful training is one which attains such perfection of this responsiveness that each individual soldier not merely reacts at once to the expressed command of his superior, but is able to divine the nature of a command before it is given and acts as a member of the group immediately and effectively” (211–12). In the animal kingdom, the herd instinct manifests in behaviour that impacts the survival of prey and predator: schools of sardines move as one organism, seeking safety in numbers, while predatory sailfish act in silent concert to push the school into a tighter formation from which they can take orchestrated turns to feed.Unfortunately, the group mimesis created through a passive surrender of the individual ego to the herd, while providing a greater sense of security and chance of survival, also made World War I soldiers more vulnerable to the development of post-traumatic hysteria. At the Salpêtrière, Charcot described in meticulous detail the epileptic-like convulsions of hysteria major (la grande hystérie), which appeared to be an unwitting imitation of the seizures of epileptic inmates with whom hysteria patients were housed. Such convulsions included the infamous arc en circle, or backward-arched bodily semicircle, through which the individual’s body was thrust, up into the air, in an arc of distress only earthed by flexed feet and contorted neck (Veith 231). The suffering articulated in this powerful image stayed with me as I read, and percolated through my dreams.The three texts in which I remained transfixed had issued from different eras and used different language from each other, but all three contained similar and complementary insights. I found further correspondence between Charcot and Scaer in their understanding of the neurophysiology underlying hysteria/trauma. Though he did not have the technology to observe it, Charcot insisted that the symptoms of hysteria were the result of real changes in the nervous system. He distinguished between “organic” causes of disease, and the “functional” or “dynamic” causes of such disorders as hysteria and epilepsy: as he noted of the “hystero-traumatic paraplegia” of a patient, “it depends upon a dynamic lesion affecting the motor and sensory zones of the grey cortex of the brain which in a normal state preside over the functions of that limb” (Clinical 382). He proposed a potentially reversible “dynamic alteration” in the brain of the hysteric (Clinical 223–24). Compare Scaer: “Clinical syndromes previously categorized as ‘nonphysiological,’ ‘psychosomatic,’ or ‘functional’ may be based on demonstrable dynamic neurophysiological changes in the brain” (xx–xxi).Another link between the work of Charcot and Scaer is their insistence on the mind/body as a continuum, rather than separate entities. The perspicacity of the two researcher/clinicians forms bookends to a model separating mind from body that, in the wake of the popularisation and distortion of Freudian theory, characterised the twentieth-century. Said Charcot: “the physician must be a psychologist if he wants to interpret the most refined of cerebral functions, since psychology is nothing else but physiology of a part of the brain” (cited by Goetz 32). Says Scaer: “The distinction between the ‘psychological’ and physical pathological manifestations of traumatic stress, as suggested in the term ‘psychosomatic,’ needs to be discarded” (127). He proposes that, instead, we consider a mind/brain/body continuum which more accurately reflects, “the pathophysiological, neurobiological, endocrinological, and immunological changes induced by trauma” and the bodily manifestations of disease which follow (127).Charcot’s modernity is perhaps most evident in his understanding of equivalence between mind and brain, and his belief in what we now call “neuroplasticity”. Dealing with two patients with hysterical (traumatic) paralysis, Charcot recognised the value of friction, massage, and passive movements of the paralysed limb, not to build muscle strength, but to “revive” the “motor representation” in the brain as a necessary precursor to voluntary movement (Clinical 310). He noted the way in which, through repetition, movement strengthens. The parallel between Charcot’s insight, and recent research and practice which indicates that intense exercise for stroke victims assists the retrieval of motor programmes in the nervous system, in turn facilitating increased strength and movement, is quite astounding (Doidge Chap. 5).Scaer, like Rivers before him, understands the “freeze” or immobility response to threat as a very primitive or arcane level of the survival instinct. When neither fight nor flight will ensure an animal’s survival, it often manifests the freeze response, playing “dead”. After danger has passed, the animal might vibrate and shake, discharging the stored energy, physiologically “effecting” its defence or escape, and becoming fully functional again. Scaer describes this discharge process in animals as being “as imperceptible as a shudder, or as dramatic as a grand mal seizure” (19). The human, being an animal, also instinctually resorts to immobility when that is the reaction that will best ensure survival. As a result of this response, energy that would have been discharged in fighting or fleeing is bound up in the nervous system, along with accompanying terror, rage and helplessness. Unlike other animals that naturally discharge this energy when safe, humans often cognitively override the subtle but essential restorative behaviours that complete the full instinctual response, leaving them in a vicious cycle of fear and immobility and ultimately generating the symptoms of trauma.Scaer writes, “this apparent lack of discharge of autonomic energy after the occurrence of freezing [...] may represent a dangerous suppression of instinctual behavior, resulting in the imprinting of the traumatic experience in unconscious memory and arousal systems of the brain” (21). He proposes a persuasive model of “somatic dissociation” in which the body continues to manifest a threat to survival through impairment of the region of the body that perceived the sensory messages, and disability that reflects the incomplete motor defence (100). He writes of his patients in a chronic pain programme: “We invariably noticed that the patient’s unconscious posture reflected not only the pain, but also the experience of the traumatic event that produced the pain. The asymmetrical postural patterns, held in procedural memory, almost always reflect the body’s attempt to move away from the injury or threat that caused the injury” (84).Scaer’s concept of somatic dissociation, when applied to some of Charcot’s case studies, makes sense of their bodily symptoms. Charcot’s patient P— experiences no life threat, but a shock that involves grief and shame (Clinical 131–39). On a fox-hunting outing, he mistakes his friend’s dog for a fox, accidently shooting it dead. The friend is distraught, and P— consequently deeply distressed. He continues with the hunt, but later, when he raises his fire-arm to shoot a rabbit, collapses with a paralysis of the right side (he is right-handed), and then a loss of consciousness, with consequent confused recollection. Charcot’s lecture focuses on the “word-blindness” P— evidences, apparently associated with post-traumatic memory-deficits, but what is also arresting is the right-sided paralysis which lasts for some days, and the loss of vision on his right side. It is as if the act to shoot again is prevented by a body, shocked by its former action. The body parts affected hold meaning.In the case of the barrow man discussed earlier; although he has no lasting organic damage to his legs, nevertheless, his “feet remain literally fixed to the ground” (Clinical 378) when he is standing, perhaps reproducing the immobility with which he faced the rapidly looming van as it bore down on him. His paralysis speaks of his frozen helplessness, the trauma now locked in his body.In the case of the patient Ler—, aged around sixty, Charcot links her symptoms with a “series of frights” (Lectures 279): at eleven she was terrorised by a mad dog; at sixteen she was horrified by the sight of the corpse of a murdered woman; and, at the same age, she was threatened by robbers in a wood. During her violent hystero-epileptic attacks Ler— “hurls furious invectives against imaginary individuals, crying out, ‘villains! robbers! brigands! fire! fire! O, the dogs! I’m bitten!’” (Lectures 281). Here, the compilation of trauma is articulated through the body and the voice. Given that the extreme early childhood poverty and deprivation of Ler— were typical of hysterical patients at the Salpêtrière (Goetz 193), one might speculate that the hospital population of hysterics was composed of often severely traumatised women.The traumatised person is left with a constellation of symptoms familiar to anyone who has studied the history of hysteria. These comprise, but are not limited to, flashbacks, panic attacks, insomnia, depression, and unprovoked rage. The individual is also affected by physical symptoms that might include blindness or mutism, paralysis, spasms, skin anaesthesia, chronic fatigue, irritable bowel, migraines, or chronic pain. For trauma theorist Peter A. Levine, the key to healing lies in completing the original instinctual response; “trauma is part of a natural physiological process that simply has not been allowed to be completed” (155). The traumatised person stays stuck in or compulsively relives trauma in order to do just that. In 1885, Jean-Martin Charcot lectured at the Salpêtrière hospital in Paris, including among his case studies the patient he names Deb—. She resides more evocatively in my imagination as “the lady in the carriage”, a title drawn from Charcot’s description of her symptoms, and from the associated photographs which capture static moments of her frenzied and compulsive dance:Now look at this patient [...] In the first phase, rhythmical jerkings of the right arm, like the movements of hammering, occur [...] Then after this period there succeeds a period of tonic spasms, and of contortions of the arm and head, recalling partial epilepsy [...] Finally, measured movements of the head to the right and the left occur; rapid movements defying all interpretation, for I ask you, what do they correspond to in the region of physiological acts? At the same time the patient utters a cry, or rather a kind of plaintive wail, always the same [...] You see by this example that rhythmical chorea may be in certain cases a grave affection [affliction]. Not that it directly menaces life, but that it may persist over a very long period of time, and become a most distressing infirmity [...] The chorea has lasted for more than thirty years [...] The onset occurred at the age of thirty-six. About this time, when out driving in a carriage with her husband, she fell over a precipice with the horse and carriage. After the great fright which she had thus experienced she lost consciousness for three hours. This was followed by a convulsive seizure of hysteria major, by rigidity of the limbs of the right side, and cries like the barking of a dog (Clinical 193–95).I found this case study early in my reading of Charcot, but the lady in the carriage stayed with me as a trope of the relentless embodiment of trauma in its drive to be conclusively expressed, properly acknowledged, and potentially understood. Hence the persistent pain and distress of Scaer’s MVA patients; the patients treated by Rivers, with limbs and vocal-chords frozen in a never-ending moment of self-defence; the dramatic hysterical attacks of the impoverished patients in Charcot’s Salpêtrière; and the rhythmical chorea of the lady in the carriage, her involuntary jerky dance a physical re-enactment of her original trauma, when the carriage in which she was driving went over a precipice. Her helplessness in the event which precipitated her hysteria is a central factor in her continuing distress, her involuntary passivity removing her sense of agency and, like the soldier confined endlessly and powerlessly in the trenches waiting for inevitable terrifying action, rendering her unable to fight or flee.The fact that the lady in the carriage may be stuck in a traumatic incident experienced more than thirty years before attests to the way in which trauma insistently pushes to be resolved. Her re-enactment is literal, but Levine acknowledges the relevance of a “repetition compulsion” (181), expressed originally by Freud as the “compulsion to repeat” (19). This describes the often subtle way in which we continue to involve ourselves in situations that are replays of traumatic themes from childhood—symbolic re-enactments. Levine revitalises the idea however, by focusing on the interrupted instinctual response that calls for physiological resolution: “the drive to complete the freezing response remains active no matter how long it has been in place” (111).The knowledge a traumatised person seeks is, in trauma, literally locked in the body/mind. It rises up through dreams and throws itself aggressively at one in memories that are experienced as a terrifying present. It twists limbs in painful contractures and paralyzes the limb that was lifted in defence. The fear of turning to face this knowledge locks the individual in a recurring cycle of terror and immobility. At its end-point, s/he survives in the pathological limbo of Post-Traumatic Stress Disorder (PTSD), avoiding any arousal that might trigger all the physiological and emotional events of the original trauma. The original threat or trauma continues to exist in a perpetual present, with the individual unable to relegate it to the past as a bearable memory.It is possible to interpret such suffering in many ways. One might, for instance, focus on the pathology of an apparent system malfunction, which keeps the body/mind inefficiently glued to an unsolvable past. I choose to emphasise here, however, the creativity and persistence of the human body/mind in its drive to resolve the response to trauma, recover equilibrium and face effectively the recurrent challenges of life. As well as physical symptoms which exact attention, this drive or instinct might include the prompting of dreams and the meaningful coincidences we notice as we open our eyes to them, all of which can lead us down previously unconsidered paths. Does the body/mind only continue to malfunction due to our inability to correctly decipher its language? In relation to trauma, the body/mind bears the burden, but it might also hold the key to recovery.References Charcot, Jean-Martin. Lectures on the Diseases of the Nervous System. Trans. George Sigerson. London: The New Sydenham Society, 1877.---. Clinical Lectures on Diseases of the Nervous System: Volume 3. Trans. Thomas Savill. London: The New Sydenham Society, 1889.Doidge, Norman. The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science. Melbourne: Scribe, 2008.Freud, Sigmund. “Beyond the Pleasure Principle.” The Standard Edition of the Complete Psychological Works of Sigmund Freud. Ed. and Trans. James Strachey. London: Hogarth Press, 1955. 7–64.Goetz, Christopher G, Michel Bonduelle, and Toby Gelfand. Charcot: Constructing Neurology. New York: Oxford University Press, 1995.Levine, Peter A. Waking the Tiger: Healing Trauma: The Innate Capacity to Transform Overwhelming Experiences. Berkeley, CA: North Atlantic Books, 1997.Rivers, W. H. R. Instinct and the Unconscious: A Contribution to a Biological Theory of the Psycho-Neuroses. 2nd ed. Cambridge: Cambridge University Press, 1922.Scaer, Robert C. The Body Bears the Burden: Trauma, Dissociation, and Disease. 2nd ed. New York: Haworth Press, 2007.Shorter, Edward. From Paralysis to Fatigue: A History of Psychosomatic Illness in the Modern Era. New York: Free Press, 1992.Veith, Ilza. Hysteria: The History of a Disease. Chicago: University of Chicago Press, 1965.