Baksbat (broken courage): a trauma-based cultural syndrome in Cambodia

Whether posttraumatic stress disorder (PTSD) sufficiently explains and encompasses the symptoms experienced by people from non-Western cultures is debatable. The etymological, social, and historical contexts of idioms of distress experienced by Khmer, known as baksbat, were studied through interviews with 53 Cambodian experts. Phey-khlach (double fear), bor-veas-cheas-chgnay (wishing that the trauma would go away), dam-doeum-kor (planting a kapok tree-remaining mute), chos-nhorm (submissive, easily giving in), kob yobal (ideas are buried), and loss of togetherness, were all identified as specific symptoms of baksbat. Similarities and differences between symptoms of baksbat, PTSD, anxiety, and depression indicate that baksbat is a Cambodian idiom of distress with sufficient characteristics to be recognized as a formal cultural trauma syndrome distinct from PTSD. Increased awareness of its criteria and phenomenology may help clinicians provide appropriate support for traumatized Cambodians.