Rituals and Ceremonies, Therapeutic Use of

Rituals and ceremonies can be useful adjuncts in the treatment of posttraumatic stress disorder and other sequelae of traumatic events. Rituals and ceremonies have been used throughout human history to contain transitions or disturbances within the social order, when roles and status of members are changed, such as at birth and death, entrance to adulthood, marriage, promotion, and retirement. The purpose of the ritual is both to represent the transformation in relationships that are occurring and to provide public acknowledgment and acceptance by the authority of this transformation.

Therapeutic rituals differ from ordinary rituals in that they aim to provide more room for participants to express and explore their feelings and views, and thus therapeutic rituals serve less of the containing function of ordinary rituals. Consistent with this purpose, therapeutic rituals include a direct representation of the threat to the social order, that is, the disturbing element that the community is attempting to accommodate.

In the treatment of psychological trauma, these threats are the traumatic events themselves—combat, rape, death of loved ones, child abuse—events that involve deeply held emotions of loss, fear, shame, and helplessness.

Because many if not most victims of trauma feel cut off from their community and loved ones by having experienced something so unique and terrifying, therapeutic rituals and ceremonies for trauma victims have been especially useful in helping them reconnect with their social support networks as well as articulate publicly what happened to them.

The design of these ceremonies includes the gathering of a large number of family, friends, and other members of the public. Someone meaningfully in authority presides. The parties enter the ceremonial space, and the threatening situation is then described or represented visually. The intended transformation is then mentioned. A symbolic act representing this transformation is then performed by the participants, who are given an opportunity to share their feelings or views, followed by their family members and audience. Usually some kind of physical action [Page 574]or object is then conferred onto the participants to recognize their transformation, accompanied by a statement of approval by the authority. The parties then exit from the ceremonial space.

In the treatment of women traumatized by sexual assault or domestic violence, ceremonies have been devised to represent the transformation of their helplessness in the event to a renewed sense of empowerment in the present; to process the withdrawal from their spouses into a return of intimate relations; and to process their prior silence about the event into an ability to stand up and give their testimony.

For example, in one ceremony, a woman described the meaning of a large stick on which she had woven many different colored threads that represented her rape experience. Then she invited her husband to stand behind her, both of them placing their hands on the stick, and then together snapping it in two, representing that together they could overcome her trauma.

In the treatment of veterans returning home from war, ceremonies have been designed to help process the loss of their comrades, transforming their grief into mourning; to process the transformation of their identity as soldiers back into regular members of their communities; to process the changes in their relationships within their families (transforming resentment and withdrawal into forgiveness and embrace); and to process their homecoming to society as a whole (transforming being rejected into being welcomed). Symbolic actions that have been used with veterans include sweat lodges, tree plantings, fires, dances, throwing ashes into the sea, and walking into town on a road lined by family and friends welcoming the veteran home. Ceremonies have also been designed to celebrate the completion of a treatment program, and are similar in structure to a graduation ceremony, only that each veteran and their family are given time to speak about their journey or the veterans' progress.

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