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Post-Traumatic Stress Disorder: An invisible epidemic of unhinged norms

By Daniel M. Ryan
web posted September 26, 2016

As you already know, there's an outright epidemic of post-traumatic stress disorder. It's no longer "the invisible epidemic;" it's visible to the point where special courts exist for veterans diagnosed with PTSD. Its status as an outright epidemic – in these times – does raise some suspicions about the culture. Why now? Even though the economy's growth has been subpar ever since 2009 – arguably, since 2000 – things haven't been all that bad. As the proposals for a universal guaranteed income indicate, we're not that far from the meliorist point that Schopenhauer predicted would cause an epidemic of boredom. Instead, we have an epidemic of PTSD.

It's a worrying and counterintuitive phenomenon. PTSD was first known as a real psychic injury due to World War 1. Even though it was called "shell shock," it was PTSD in the same way that "hyper-active disorder" is ADHD. Although knowledge of the malady did have to be expanded and fine-tuned, the WW1 docs were the first to latch onto the real thing.

The PTSD epidemic back then made sense, because the "War To End All Wars" was a world-scale catastrophe. Eight figures' worth of people were killed in it, and the kill count was upped considerably by the postwar influenza epidemic. So it was easy for the public mind to peg shell shock as an epidemic similar to influenza. It gave Sigmund Freud his in; his psycho-analysis was the only treatment protocol that offered promise to treat it. Had it not been for the shell-shock aftermath of The Great War, most of us would have never even heard of Freud and his concoctions.

Interestingly, the epidemic seemed to have largely afflicted the Allied side. It's interesting because, as we readers of pre-Hitler history know, the "stab in the back" myth that he exploited was only made possible by widespread lying to the German empire's subjects. Almost to the point of the unconditional surrender, the German public were continually assured that Germany was on the verge of winning the war. The lying had gotten almost to the point of official psychosis, with no Baghdad Bob to unintentionally provide the kind of humour that restores sanity.

Also of interest is the fact that World War 2 was by some measures even bloodier than World War 1, but WW2 did not lead to an epidemic of PTSD. True, there were some hidden cases that were dealt with by self-medication: drinking from after dinner to bedtime. Granted, a WW2 vet could cover up PTSD thanks to the 9-to-5 workstyle and a post-Prohibition culture that made it manly to drink. But psychic injuries that can be treated with self-medication are usually mild. More severe ones make it impossible to work to a schedule.

One of the main symptoms of PTSD is obsessive revisiting or replaying the moment at which the stress made you snap, alternating with unconscious avoidance of the stressor situation. Think of it this way: imagine a computer programmer who started a controversial startup with a born-entrepreneur partner who committed suicide. The partner being self-confident and dynamic, a man that seemed destined to become rich, the suicide was even more shocking. The programmer-survivor goes into a funk that looks like severe depression, in which he runs the pre-tragic phase over and over again. By doing so, he hopes to self-medicate his symptoms away. (One of the quack cures for PTSD comes from conflating it with a classical avoidance neurosis like agoraphobia, and recommending exposing oneself to the frightening situation to make the symptoms go away. Sadly, one of Robert A. Heinlein's early stories – "Blowups Happen" - shows that quack cure working for a minor character named Steinke.)

When he apparently shakes off his deep depression, he turns back to working on the same coding for the startup in the vain hope that he can carry it through alone. After apparently regaining his old energy, he suffers a nervous collapse which shifts him back to avoidance. Years later, on the hope that time heals all wounds, he buys self-learning books and Udemy courses obsessively – but does next to nothing with them. His attempts to buckle down and use what he's paying for don't last long. Instead, he keeps buying and buying like an Alzheimer's sufferer who buys quart after quart of milk. He's trapped in a compulsion-avoidance loop that seems infinite.

I'm using a "civvie" example because the military has thankfully recognized PTSD as a real injury. You'd have to go back a long time to find a military example that shows the compulsion-avoidance loop clearly. A WW1-era example would be a soldier who collapses moaning in the hospice until (perhaps after being administered the old-fashioned quack cures of bullying or morale-building) he's convinced that it's over with and he's fit for battle once again. After which, he goes back to the field, has a nervous collapse, and goes back to writing in the hospice bed or a tent...

In modern times, PTSD-suffering vets are thankfully given honourable medical discharges and are removed from the specific stressors by going back to civilian life. They're also supported by disability services. But once away from the military, they still suffer from these symptoms which I got from this veterans' help page:

  • Feeling upset by things that remind you of what happened.
  • Having nightmares, vivid memories, or flashbacks of the event that make you feel like it's happening all over again.
  • Feeling emotionally cut off from others.
  • Feeling numb or losing interest in things you used to care about.
  • Feeling constantly on guard
  • Feeling irritated or having angry outbursts [or becoming robotic because you want to stifle these outbursts, while keeping them bottled up in your head – DMR.]
  • Having difficulty sleeping.
  • Having trouble concentrating.
  • Being jumpy or easily startled [for example, by normal interruptions that are part of normal social life – DMR.]
Sadly, the breakdown of the culture offers some PTSD sufferers the chance to take a leaf from some schizophrenia sufferers. Just as the latter sometimes fall in love with their symptoms by imagining that they evince special powers like telepathy, some PTDS sufferers fall in love with their hyper-vigilance by deciding that it gives them superior street-OPSEC.

There are two-takeaways from the above. First of all, real injury-level PTSD is too severe even for the old 9-to-5 routine. This gloomy fact shows that WW2's carnage did not lead to a PTSD epidemic. It would have been too noticeable if it had. There would have been article after article on "The New Shell Shock." There weren't.

The second takeaway is that there's something really wrong with our times, because the current PTSD epidemic has not coincided with the multimillion-soldier carnage of a World War 1. As I wrote above, a WW1-scale war made the shell-shock epidemic make sense: it was like influenza. That time is profoundly unlike our times, war-wise. The total number of fatal casualties in the Vietnam War was "only" about 58,000. This number is way above the fatalities of every war since the Grenada operation. If any top general commanded a war in which 58,000 of his soldiers died, he would be deeply shamed. From the fatality side, war is much "better" nowadays than then. Even a long war like the Iraq War, which has lasted about as long as the Vietnam War, has resulted in less than a tenth of the fatalities of the Vietnam War – and less than a twentieth of the World War 1 fatalities suffered by the U.S., even though America fought in WW1 for only nineteen months.

Clearly, there's something terribly wrong with the way the U.S. fights modern wars – something horribly wrong that is papered over by the low fatality counts.

The Importance Of Norms…

I remember listening to a recorded discussion, which I unfortunately didn't save and couldn't Google, with a lawyer who identified the kind of public defender who's at risk for PTSD – and what kind of public defender is not at risk.

The one at risk is someone who sought the job because she believes that the jails are chock-full of poor black folks who've been railroaded into prison by a vicious court system. She's the type that used to be labeled as brimming over with Perry Mason fantasies. But after starting the job, she finds out that her typical client is a hardened criminal who uses "the white man keepin' the black man down" as a get-out-of-jail-free card. It should work its magic regardless of what the perp really did. Some of her clients are outright sociopaths. She experiences a reality that's jarringly at odds with what her ideal tells her.

Most public defenders of this type do not develop PTSD. Instead, they go down the track plodded on by all-too-many social workers, teachers, and – yes – police officers. Their ideal slowly whittles away inside until it's hollow. Underneath the shell, they become embittered. As they become older, they either cling to the shell as an impractical ideal or shake it off entirely and become yet another liberal who was mugged.

But some do develop PTSD from that jarring contradiction between their ideals and the facts they experience every day. People like this are unusually idealistic, to the point where experiencing the defendants' bad characters affect them like a kind of abuse. (The main cause of civvie PTSD is abuse. Since the "rape culture" stuff is so politicized these days, I'm folding sexual abuse into abuse.)

There are some kinds of psychological abuse that act, for lack of a better term, like a reverse orgasm. When the abuse is occurring, it hurts - but the pain disappears after the drubbing is over. It's the type of pain, aided by our relief-reflex, that's easy to dismiss afterwards as no real harm done. Unlike a burn or a cut, it doesn't leave any lasting hurt. Easy to shrug off.

The trouble comes with repeated sessions of the abuse, especially if the sufferer pats himself on the back for being tough enough to tough it through each time. This routine can continue for a long stretch, with no harm apparently done, until your energy collapses to ultra-low for no reason you can figure out.

A public defender whose false ideals are abused by the real character of her clients, who falls into this routine by telling herself that a true professional ought to tough it through, is at risk of collapsing into a real case of post-traumatic stress disorder.

Contariwise, the public defender whose ideal is "even the scum of the earth deserve a fair trial" does not get PTSD. Because this ideal is not mauled by the real character of the typical defendants, she can serve it without any psychological risk of this sort.

In a very real way, the public defender of the first type is like the Norwegian man who was outright raped by a Somali migrant: when that migrant was deported, he felt guilty! His Stockholm syndrome shows starkly the power of ideals, of the norms that we live by and count on. Why would a man who was raped – raped! – feel guilty when justice was done on his behalf? Only because he swallowed a set of Euroleftie ideals similar to the ones swallowed by the public defender at risk for PTSD.

…And Why The PTSD Epidemic Is Damning To Today's Norm-Givers

I'm not going to quibble with the standard cause for civilian PTSD; I'm only going to note something odd about it. In the case of parental abuse, the epidemic is perplexingly counterintuitive. At the time when America was going from pastoral to an industrial power, accepted parental discipline was very brutal by today's standards. Bad boys were physically whipped. The teacher's willow-switch was not an adornment like the royal mace; it was used. Washing a kid's mouth out with soap was not an allegory; it was really done.

If abuse per se were the cause of civvie PTSD, there would have been an epidemic of it in the late 19th century. It would have been called a different name, like neurasthenia, but it would have been widely noticed. Coal-miner doctors back then had no knowledge of lung cancer, but they certainly knew about "black lung." On the other hand, there's no evidence of a "neurasthenia" epidemic at that time – even though normal parenting was more abusive than parenting that's legally deemed abusive today. Note the parallel between the lighter style of parenting today and the much lower fatality count of today's wars.

There are ways to be clever with this discontinuity, but the public-defender example above removes the need to unfurl the cleverness. The invisible epidemic is a sign that the norms dished out today are starkly at odds with the facts.

An example of this would be a fellow whose self-knowledge is abysmal in this way: he's convinced himself that he's a thick-skinned guy when he's really thin-skinned. When he's picked on, he tells himself that he's only facing something that he ought to shrug off. They're only catcalls, the kind that a got-it-together guy lets roll off his back. A cool cat just ignores 'em until they go away, just like the thick-skinned folks that this fellow thinks he's like. When those snipers don't go away, he falls into the same tough-it-through routine as the shrug-it-off kid above. Think of a teenage girl who's really hurt from being picked on in school but who tries to self-medicate with Taylor Swift's "Shake It Off." Or think of the male equivalent, who tells himself that complaining about it makes his weak and yelling makes him a crank.

In this case, it's a reasonable hypothesis that the kid was raised wrong – not abusively, but wrongly.

Extending it to ideals gives us the idealistic public defender who gets burned out and can't figure out why. In this case, it's not abysmal self-knowledge but ideals that are way out of whack with reality – and are clung to like a soldier holding fast to his honour.

Now, let's look at the wars that have spawned epidemics of PTSD: the Afghanistan War, the Iraq War, the Vietnam War. What do these wars have in common? They're all counter-insurgency wars, ones where the soldiers are ordered to remember that the theatre contains mixtures of goodies and baddies – and that it's mandatory to treat the goodies well. Counter-insurgency wars, complete with restrictive ROEs that mandate "everyone's a goodie unless it's shown otherwise."

The trouble with this strategy is that it makes a lot of sense on paper. After all: confining the baddies' group to known Cong, or to radical Islamists, makes the enemy group that much smaller – right? A war against Islamist extremism has the benefit of not dragging in (say) Indonesia, and also has the benefit of a Muslim ruler like the King of Jordan stating that radical Islamism is un-Islamic. On paper - particularly to a political junkie - whittling down the enemy in this way seems brilliant. Doesn't it minimize the forces of the foe and maximize the potential ally group? What could be smarter? All it takes is for the soldiers to "Shake It Off" when the goodies don't act all that good.

Well…what could apparently be smarter than assuming that the public-defender's clients are trod-upon victims of systemic racism? Doesn't that minimize client-attorney friction? Never mind that this is the kind of too-smart-by-half smarts which say that you have to treat every stranger as a potential friend else you'll throw away an opportunity. People like that, unless they're lucky or stick to their sheltered environs, get eaten alive.

It's hard to avoid the conclusion that the epidemic of sufferers are set on the PTSD path by folly. Mostso, official folly: folly that comes with the imprimatur of unchallenged authority. Folly doled out by authorities, lapped up as if it were sense or even wisdom. "Professing themselves to be wise, they became fools" – Romans 1:22.

The "invisible epidemic" is a very visible damning of today's ideal-givers. It's also very visible evidence that the costs of cultural decay are not confined to bad neighbourhoods, rougher streets and widespread unemployability. Another very human cost is an epidemic of PTSD sufferers that have been eaten alive: consumed by ideals and mission requirements that are obsolete or are just plain wrong-headed. ESR

Daniel M. Ryan, as Nxtblg, is shepherding the independently-run Open Audi Initiative Prediction Market Shadowing Project. He has stubbornly assumed all the responsibility and blame for the workings and outcome of the project.

 

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