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Last Refuge: The Escape from Violence in Kafka on the Shore

By Bailey Anderson '18

ENGL-375: 20th Century Literature

In her essay, Bailey brings together Japanese history during World War II, the psychological condition known as dissociation, and the characters’ response to traumatic violence in their lives. It is a rich and compelling reading of a fascinating novel. I also enjoy Bailey’s referencing of the Japanese literary tradition of “living spirits” to probe the elusive meaning of Haruki Murakami’s Kafka on the Shore.

-Michael Harris


Postmodernist novels famously defy convention and resist unifying theories or ideologies. They lack conclusionary details and the most bizarre occurrences are often left “up in the air.” Even in the novels themselves, readers are sometimes advised against trying to make too much out of the stories they tell. Haruki Murakami, in his novel Kafka on the Shore, writes a character who decides “Better not to try to make sense…of what basically doesn’t make any” (344). Despite the author’s own embedded warning, readers are compelled to rise to the challenge, creating a meaning from the book by noticing patterns in the narrative. After all, nothing is truly random. Murakami must have a process and purpose behind what he writes. Knowledge in other areas of interests, like psychology, explains these patterns. One such pattern, and its accompanying explanation, is the use of dissociation by characters like Nakata, Kafka Tamura, and Miss Saeki, in order to escape from the violence of their realities, and the use of a separate otherworldly physical space as a refuge.

Nakata, one of the protagonists in Kafka on the Shore, grows up with the violence of World War II, as is clear in the papers surrounding Nakata’s period of unconsciousness. In the interview with Nakata’s school teacher, she speculates about the purpose of a military plane’s flight overhead in the moments before the children’s collapse. She thinks it was “on its way to bomb some large city somewhere, or maybe on its way back from a raid” (Murakami 14). The ease with which she discusses bombs and raids indicates the normalcy of violence during this time in Japanese history. She does not at all seem alarmed at the proximity to the war, and in fact muses it “seemed like something in a faraway land that had nothing to do with us” (Murakami 16). Given these reflections upon the impact of the war, it might be tempting to understand the war as an inconsequential detail, or merely something Murakami had to address due to the setting of the event.

However, in a letter the same teacher later writes to a psychiatrist investigating Nakata’s case, she reveals her own violence toward Nakata in this moment by admitting that she slapped him, even though “I’d never, ever struck one of the children before” (Murakami 100). She connects both scales of violence when she reasons, “Just over the horizon the violence of the war went on, with countless people dying. I no longer had any idea what was right and what was wrong” (Murakami 101). For the teacher, the barbarity of the war muddles her own sense of ethics, blurring the lines between good and evil, which, she seems to suggest here, contributed to her violence toward Nakata. In Ian Buruma’s article “Becoming Japanese” in which he interviews Haruki Murakami, Murakami himself addresses his awareness of violence in Japanese history. Buruma narrates: “He could no longer escape from something he had always feared: the capacity for irrational violence in Japanese society” (Buruma 61). Nakata’s teacher also realizes the capacity for “irrational violence,” as is revealed in the text of Kafka on the Shore, but at the same time participates in an act of violence herself when she slaps him as a child. The setting of violence in Nakata’s childhood is therefore purposeful and reflects Murakami’s own interest in Japan’s role in World War II and the capacity for violence it indicates (New York Times). This violence, especially as it is exposed to Nakata through his educator, in part explains the phenomenon of his unconsciousness.

It is alongside the violence of World War II and the slap delivered to Nakata that he enters a dissociative state as a child. After the unnamed schoolteacher slaps him, the entire class falls unconscious. For Nakata, the comatose state lasts for weeks, and is investigated by the American military because it may have a connection to the war. In the transcript of an interview with the psychiatrist Doctor Shigenori Tsukayama, he observes “It seemed like the real Nakata had gone off somewhere, leaving behind for a time the fleshly container, which in his absence kept all his bodily functions going at the minimum level needed to preserve itself” (Murakami 67). The psychiatrist introduces the idea of potential separation of the self, although he does not yet have a word to describe it. Sigmund Freud and Josef Breuer, as they studied dissociation in 1955, described dissociation as a “splitting of the consciousness” in moments that “are to be described as ‘traumatic’” (Spiegel 126). Although the psychiatrist does not explicitly use the word “dissociation” to describe Nakata’s state at this time, because Freud and Breuer had not yet studied it in those terms, the dissociative state would have existed before the word for it did, so Dr. Tsukayama seems especially attuned to it. Matthew Strecher, in his book The Forbidden Worlds of Haruki Murakami, hypothesizes that Nakata “entered the ‘other world’ as a child” perhaps in order “to escape the rampant violence that surrounded him in his own world” (Strecher 51). The retreat of part of Nakata’s self into another world to escape violence is Freud and Breuer’s definition of dissociation. At the time of his unconsciousness, the name for his state did not exist, but that does not mean the phenomenon itself did not exist, and Murakami certainly was aware of dissociation as he wrote the scene.

Apart from the splitting of the self in Nakata’s character in Kafka on the Shore, he also displays other symptoms of a “fugue state,” or a state in which a person dissociates from her or his surroundings and her or himself, according to the interview with Dr. Tsukayama (Goldberg). Upon awakening from his comatose state, Nakata forgets everything about his previous life: names of family and friends, reading and writing skills, and even which planet he inhabits; in essence, he loses much of his identity. The psychiatrist in the interview conjectures, “rather than a memory loss, it was more a memory lack” (Murakami 63). Nakata’s memory “lack” hints at an answer to his condition, for which the phrasing would not emerge until later in the development of psychological theory. In “Hypnosis, Dissociation, and Trauma,” David Spiegel explains, “a person in a fugue [state] functions as an individual who lacks memory or his usual personal identity” (127, emphasis added). The psychiatrist’s observation of Nakata’s memory lack is an obvious display of the symptoms described by Spiegel of a dissociative or “fugue” state, but Spiegel’s addition regarding the loss of identity can also be applied to Nakata’s recovery from unconsciousness. When Nakata awakes, he refers to himself in the third person, a trend which continues for the rest of his life. He did lose aspects of his identity, which he reiterates into adulthood.

The aspects of Nakata’s personality which were lost during this childhood traumatic event are apparently never recovered, at least according to Nakata himself. He repeatedly alludes to feeling “empty” as the book progresses. As Nakata recovers some of his memory, at least enough to remember what his life was like before his fugue state, he confides to truck driver Hoshino:

Nakata’s empty inside…Nakata’s like a library without a single book. It wasn’t always like that. I used to have books inside me. For a long time I couldn’t remember, but now I can. I used to be normal, just like everybody else. But something happened and I ended up like a container with nothing inside. (Murakami 306)

The emptiness felt by Nakata in the entirety of his adult life, especially in comparison with his sparse memory of childhood, indicates that the part of him which left while he was in the hospital has never returned. There are even visible signs of Nakata’s emptiness. Mr. Otsuka, a name given to a neighborhood cat with whom Nakata can speak, tells him, “The shadow you cast on the ground is only half as dark as that of ordinary people” (Murakami 51). There is, quite literally, something missing from Nakata’s life, which contributes to his being “empty.” According to psychiatrists Bessel van der Kolk, Onno van der Hart, and Charles R. Marmar, dissociation can occur in moments of trauma and “as a long-term consequence of traumatic exposure” (306). It is not far-fetched to assert, therefore, that Nakata’s dissociation has been ongoing since his teacher slapped him. In reality, it does not necessitate the desaturation of Nakata’s shadow, but since the book itself does not claim to be entirely based upon natural law, the two can, and should, be connected. Later in the novel, dissociation and violence intersect for Nakata once again.

When Nakata meets a figure who calls himself Johnnie Walker, violence and the mind/body separation in his life intersect, meaning that he yet again shows symptoms of dissociation. Johnnie Walker reveals his plan to bait Nakata into killing him: he will cut out the hearts of live cats and eat them (in order to extract the souls), cut off the heads, and discard the bodies. Johnnie Walker uses war-like language in describing the plan, and Nakata’s role in it. He tells Nakata, “This is war. You’re a soldier, and you have to make a decision. Either I kill the cats or you kill me” (Murakami 143). The call-back to war is significant because it connects Johnnie Walker’s actions to World War II during Nakata’s childhood and clarifies the role of violence in the scene.

Johnnie Walker commits violence against the cats, certainly, but Nakata himself must participate in the violence in order to save his cat friends. As Nakata gets angrier at Johnnie Walker’s actions, he begs, “Please, stop it. If you don’t, Nakata’s going to go crazy. I don’t feel like myself anymore” (Murakami 148). Nakata here hints at his use of dissociation in order to cope with violence or anger by warning he does not “feel like [himself] anymore.” Nakata is experiencing a negotiation between an “emotional” personality, which surfaces as a result of traumatic events in patients with post-traumatic stress disorder, and an “apparently normal” personality (Van der Hart and Marmar 317). As a result of the trauma Nakata has experienced as a child, for which the “emotional” personality serves as a container, he can more easily separate himself from his experience, and does so during the cat-killing scene with Johnnie Walker. Matthew Strecher agrees, but classifies Nakata’s two personalities differently. Of Nakata in this scene, Strecher asserts, “His darker inner self rises to the surface, forcing his surface persona into a subordinate position, and let loose its destructive urges” (103). The “darker” self is, in the terms used by psychiatrists, the “emotional self.” Dissociation as studied by psychiatrists, and the state in which Nakata finds himself upon witnessing violence or experiencing anger, are described in the same terms. Nakata has employed dissociation since childhood in order to cope with the violence of his world, and his experiences serve as a benchmark for understanding the events surrounding Kafka Tamura, Kafka on the Shore’s second protagonist.

Artwork

Raigen Furness, “Occupied,” graphite

Just as Nakata’s body becomes separated from his spirit as a child, as a result of a dissociative or fugue state, Kafka Tamura, the fifteen-year-old runaway seems aware of the potential for separation of the spirit and the body. The chapters in which Kafka serves the narrator are rife with impersonal references to the body. At times, Kafka’s body and his spirit align with each other. Early in the book, Kafka feels “safe inside this container called me. With a little click, the outlines of this being–me–fit right inside and are locked neatly away. Just the way I like it. I’m where I belong” (Murakami 55). Kafka understands his body to be detachable from the essence of him–his personality, his identity–and in this moment, he is content with their position together. He feels whole. Only pages later, though, after Kafka wakes up in an unfamiliar place covered in blood, he suffers the opposite sensation: like his body and his spirit have become separated. In this moment, he must “pick up the scattered pieces of me lying all around” (Murakami 69). His essence has become fragmented due to an occurrence during his unconscious state, which he cannot remember. The sense of separation from one’s body is referred to by psychologists as “depersonalization” and is a symptom of dissociation (McNally 172). Kafka’s predisposition for understanding his body and his spirit as separate makes it easier for him to dissociate in psychologically traumatic moments.

Kafka, as becomes clear throughout Murakami’s novel, uses dissociation to separate himself from violent acts when his body commits them. After waking up in an unfamiliar location, covered in blood, he tells Oshima, a librarian and ally for Kafka, he does not mean to be violent, “but it’s like there’s somebody else living inside me. And when I come to, I find out I’ve hurt somebody” (Murakami 266). Kafka’s inability to remember the violence his body has committed aligns with the symptoms Nakata displays after an act of violence is committed against him. Both the experience and enactment of violence qualify as “traumatic.” Kafka lacks the memory of committing the act, and blames any actions on “somebody else living inside me.” Additionally, Kafka Tamura rapes Sakura, who he and readers believe could be his sister, in a dream. During the act, he insists, “Actually I haven’t made up my mind about anything. Making up your mind means you have a choice, and I don’t” (Murakami 370). Kafka is unable to control his actions in the dream, but is composed enough to respond to Sakura and remember the events later. His insistence that he has no choice except to rape Sakura is a deferral of blame from himself onto whoever does have the choice (who is unspecified). Dissociation, according to David Spiegel, is a “model of defense” against the mediation of “incompatible mental contents,” which would include Kafka’s perception of himself as incapable of violence (126). In order to avoid the task of reevaluating his assessment of his identity in the moment, he distances himself from unsavory acts entirely. Compartmentalization of the self in Kafka’s character requires that “two or more parts of the personality and the associated actions” remain “relatively divided” (Nijenhuis and Van der Hart 422). Kafka certainly achieves this in the moment violent actions are taken against others. Readers question Kafka as his “true identity grows less and less clear” (Strecher 96). Kafka associates himself with a character who helps him understand the separation between the spirit and the body, which he has always perceived.

Kafka Tamura enters a sexual relationship with Miss Saeki, a middle-aged librarian whose dissociated fifteen-year-old self visits him every night, and who readers and Kafka himself believe might indeed be his mother. Miss Saeki, much like Nakata, casts only half of a shadow, indicating that she too, experiences the same emptiness as Nakata does, but in her case it manifests itself differently. Instead of losing her ability to read and write, she loses her vitality. Miss Saeki’s dissociation has occurred because of the death of her long-time boyfriend, who was killed by a group of vigilante student protestors by mistake. Readers’ knowledge of Nakata’s childhood means that they can connect the two, and understand the reasons for Miss Saeki’s dissociated self more than the characters themselves can. Kafka, in discussing the appearance of Miss Saeki’s younger apparition, asks Oshima, “Do you think it’s possible for someone to become a ghost while they’re still alive?” (Murakami 224). Oshima is not so sure, while Kafka remains convinced that “while they’re still alive, people can become ghosts” (Murakami 224). Because of the knowledge lent to readers through Nakata’s character, his assessment at first seems correct. As the novel progresses, though, it becomes less convincing. Instead, another interpretation emerges through other characters.

Oshima and other characters in the novel are more persuasive in their hypothesis that characters like Miss Saeki and Nakata are actually participating in the tradition of spirits, established culturally in Japan as separate from the body, and a logical connection to the process of dissociation. Dr. Shigenori Tsukayama, the psychiatrist who described Nakata’s symptoms in alignment with the definition of dissociation, alludes to spirits in his interview. He reminds his interviewer, Lieutenant Robert O’Connor, that Japanese folktales are full of “spirit projections,” in which “the soul temporarily leaves the body and goes off a great distance to take care of some vital task and then returns to reunite with the body” (Murakami 67). At such an early point in the novel, the acknowledgement of spirits in Japanese culture might be easy to overlook. As the novel proceeds, the same explanation is given for Miss Saeki’s younger apparition, again connecting the situations of Nakata and Miss Saeki for the audience. Oshima, after Kafka asks if it is possible to become a ghost while alive, in reference to Miss Saeki’s apparition, instead connects it to Japanese literature:

That’s what’s called a ‘living spirit.’ I don’t know about in foreign countries, but that kind of thing appears a lot in Japanese literature. The Tale of Genji, for instance, is filled with living spirits. In the Heian period–or at least in its psychological realm–on occasion people could become living spirits and travel through space to carry out whatever desires they had. (Murakami 225)

Oshima’s explanation bears resemblance to that of the psychiatrist at the beginning of the novel. The psychiatrist makes a comparison between his sense that the real Nakata had gone away, a sign of dissociation, and the cultural establishment of spirits in Japan. Oshima, on the other hand, is not using spirits in Japanese literature to compare with Kafka’s experiences; he is instead transferring literary concepts to real life. In this book, it is not illogical to do so. Some scholars might argue that Haruki Murakami has never been a “Japanese” writer, and is in fact more fascinated with US-American and European cultures. However, he did include these references to Japanese literature willingly and purposefully, and according to Buruma, this book was written as Murakami embraced his own heritage (Buruma). In his novel Kafka on the Shore, Japanese literature aids in the understanding the events of the book, especially in combination with the psychological concept of dissociation.

In Kafka on the Shore, the world is continually portrayed as having no escape from violence, which informs the audience about the separate world discovered in the forest. The Boy Named Crow, Kafka Tamura’s alter ego and companion, enlightens him: “There’s no war that will end all wars…War breeds war. Lapping up the blood shed by violence, feeding on wounded flesh. War is a perfect, self-contained being” (Murakami 387). The Boy Named Crow understands Kafka’s world to be inherently dangerous because of the pervasiveness of war and violence. It would follow, then, that it is impossible to escape from violence. Even as the novel begins, Mimi, a cat who has befriended Nakata, philosophizes, “This world is a terribly violent place. And nobody can escape the violence” (Murakami 83). Many of the events in the novel are connected in one way or another to violence, and this fact only proves the point that both Mimi and The Boy Named Crow are making in these passages. Violence, and war, are simply a part of their world.

The forest, a major setting in the final chapters of the book narrated by Kafka, is the otherworldly escape from violence in the novel’s reality. Kafka’s own reason for retreating into the forest is the police’s pursuit of him in the murder of his father. While they cannot prove he committed the crime, and wish to question him on the matter in hopes of finding the real killer, he cannot prove that he did not do it. To escape from their grasp he is smuggled to a cabin in the forest. Matthew Strecher in The Forbidden Worlds of Haruki Murakami recognizes that each character who ventures into the other world (Nakata, Kafka, and Miss Saeki) does so in a “moment of chaos and fear” (97). These characters enter the forest under the influence of violence, trauma, or personal crisis. The impact of violence on the existence of the other world is highlighted by Kafka himself. As he wanders farther into forest, he begins to contemplate war, wondering “Why do people wage war? Why do hundreds of thousands, even millions of people group together and try to annihilate each other? Do people start wars out of anger? Or fear? Or are anger and fear just two aspects of the same spirit?” (Murakami 386). The story Oshima told him about the World War II soldiers who got lost in the forest while practicing military drills leads logically to his considerations of war in general. However, it is no coincidence that these reflections occur as he delves deeper into the forest. Through Kafka’s purpose of escaping from a personal crisis and the connection he draws between the forest and violence, he understands the forest as a refuge from violence. Kafka’s understanding of the woodland is affirmed when he meets the World War II soldiers who went missing during their military training. The two men, one “brawny one” and another “tall one,” meet Kafka on the outskirts of the other world, where they permit him entrance and acquaint him with its rules. He recognizes them as the soldiers from Oshima’s story, and when he asks them why they escaped, the “brawny soldier” reasons “neither one of us wants to kill anybody. And being killed’s even worse” (Murakami 401). His brief response is later expanded upon by the “tall soldier,” who adds:

I don’t care who the enemy is–Chinese soldiers, Russians, Americans. I never wanted to rip open their guts. But that’s the kind of world we lived in, and that’s why we ran away. Don’t get me wrong, the two of us weren’t cowards. We were actually pretty good soldiers. We just couldn’t put up with that rush to violence. (Murakami 415)

Rather than fear, as the brawny soldier’s confession might suggest, the tall soldier reveals they were actually motivated by an opposition to violence. Although they were, by their own account, not cowards, they wanted to escape what they saw as pointless violence. Laura Miller, New York Times book reviewer, interprets the soldiers as choosing “suspended animation over suffering the depredations of time and loss.” Miller alludes to their choice to participate in the “other world,” where they do not age but also do not participate in life, but does not reveal their motivations for doing so in her short review. The other world as they describe it is actually devoid of any kind of violence–war, certainly, but also natural. The tall soldier, as he leads Kafka through the forest, explains to him,“no other here–poisonous snakes or mushrooms, venomous spiders or insects–is going to do you any harm” (Murakami 414). Even nature has bent to the rules of this other world to exclude the possibility of brutality of any kind. Clearly, from their statements to Kafka while they lead him into the heart of their realm, the forest is the soldiers’ escape.

Johnnie Walker, who baited Nakata into stabbing him earlier in the book, returns in order to offer yet another interpretation of the forest’s purpose. Johnnie Walker makes an appearance later in the novel when he battles with The Boy Named Crow while Kafka is exploring the other world found in the forest. Johnnie Walker asks him, “Do you know what limbo is?” and then explains, “It’s the neutral point between life and death. A kind of sad, gloomy place” (Murakami 433). This is how Johnnie Walker understands the forest. It may at first seem in opposition to the earlier perception of the forest, but in reality, it can be both a neutral point between life and death, and an escape from violence. Dissociation helps these theories work together to fully explain the forest’s purpose.

The qualities of the forest as expressed earlier by the World War II soldiers and later by Miss Saeki’s fifteen-year-old apparition, is a type of “limbo” in which the spirits of those in dissociative states can escape from violence. Kafka reunites with Miss Saeki’s younger spirit during his stay in the other world at the center of the forest. The audience already knows that “mindless violence severed” the love between herself and her boyfriend at the same age her spirit projects (Murakami 229). The apparition which appears to be Miss Saeki at the time of her heartbreak can most accurately be described as the spirit she lost through dissociation as a result of such “mindless violence.” Her body has separated from her spirit, and while her body continues living in the “real” world, her spirit waits in the forest to meet it again, protected from such cruelty. The disconnection between the fifteen-year-old spirit who tends to Kafka during his stay in the forest and the corresponding middle-aged body is proven when the young Miss Saeki herself informs Kafka, “Folks here often go a whole day without eating, no problem. They actually forget to eat, sometimes for days at a time” (Murakami 436). The only one living in the forest who has a need for food is Kafka, because he is the only being in the forest whose body is still attached to his spirit. The rest of the inhabitants of the other world are spirits without bodies, who therefore experience no bodily need, like food or water. During Kafka’s stay, Miss Saeki’s spirit does reunite with her body and move past this limbo-like state.

A middle-aged Miss Saeki appears to Kafka later in the book. She implores him to remain whole and return to the “real” world in order to avoid the emptiness she has experienced as a result of her dissociation (Murakami 438). The moment in which she appears is the moment of her death at the Komura Memorial Library, when her younger spirit and her older body reunify. In The Forbidden Worlds of Haruki Murakami, Matthew Strecher describes Miss Saeki as sustained by her memories, which she writes in a notebook throughout her life and instructs Nakata to burn before her demise (Murakami 51). It is these memories, apparently essential to her ability to remember anything at all, that she says “went up in smoke and disappeared into the air. So I won’t be able to remember things for very long. All sorts of things–including my time with you” (Murakami 439). The memories as they are written is another separation of Miss Saeki’s self, and the elimination of that piece of herself means her death because, as Strecher establishes, these memories sustain her and make up her identity.

The ability for the pieces of Miss Saeki’s self–her spirit, her memories, and her body–to operate independently is not rare for those who suffer from dissociative tendencies. In fact, a version of dissociation theory called “neodissociation theory” suggests “subunits of the whole can function semi-autonomously rather than requiring the whole structure for any one piece to manifest its meaning” (Spiegel 134). For Miss Saeki, this is certainly the case; her body is able to accomplish tasks and perpetuate itself while her spirit is away, and her spirit experiences a certain amount of autonomy, too, evidenced by the spirit’s care of Kafka while he is accommodated in the forest. The forest, then, is a refuge for the dissociated spirits of characters in the novel who wish to separate from the inescapable violence of their world.

The other world in the depths of the forest is a refuge from the violence of the real world for the spirits of those who have experienced trauma. Three major characters in the book–Nakata, Kafka Tamura, and Miss Saeki–utilize dissociative techniques in order to cope with traumatic events and personal crisis, and in some cases even retreat into this other world as a result. The knowledge of psychological concepts like dissociation helps to make sense of patterns within a plot that at first appear to resist explanation. Even as Haruki Murakami himself warns readers against trying to tie up the novel’s ending–and indeed through this lens the novel still does not entirely conclude–they can begin to glean a meaning, and perhaps even a process, from a novel that rejects unifying ideologies and techniques.

Works Cited

Buruma, Ian. “Becoming Japanese.” The New Yorker, 23 Dec. 1996, pp. 60–71.

Goldberg, Joseph. “Mental Health and Dissociative Fugue.” WebMD, 28 May 2016, www.webmd.com/mental-health/dissociative-fugue#1. Accessed 13 April 2019

Miller, Laura. “Crossing Over.” The New York Times, 6 Feb. 2005, https://www.nytimes.com/2005/02/06/books/review/kafka-on-the-shore-realitys-culdesacs.html. Accessed 13 April 2019.

Murakami, Haruki. Kafka on the Shore. Vintage Books, 2004.

Nijenhuis, Ellert R. S., and Onno Van Der Hart. “Dissociation in Trauma: A New Definition and Comparison with Previous Formulations.” Journal of Trauma and Dissociation, vol. 12, no. 4, 2011, pp. 416–445.

Spiegel, David. “Hypnosis, Dissociation, and Trauma: Hidden and Overt Observers.” Repression and Dissociation: Implications for Personality Theory, Psychopathology, and Health, edited by Jerome L. Singer, University of Chicago Press, 1995, pp. 121–142.

Strecher, Matthew. The Forbidden Worlds of Haruki Murakami. University of Minnesota Press, 2014.

McNally, Richard J. “Theories of Repression and Dissociation.” Remembering Trauma. Belknap Press of Harvard University Press, 2005, pp. 159–185.

Van der Hart, Onno, and Charles R. Marmar. “Dissociation and Information Processing in Posttraumatic Stress Disorder.” Traumatic Stress: the Effects of Overwhelming Experience on Mind, Body, and Society, edited by Bessel A. Van der Kolk et al., Guilford Press, 1996, pp. 303–327.