Monday, April 24, 2006

PTSD and Normality

In last week's discussion of Post-Traumatic Stress Disorder, MT made an interesting statement,

What especially makes distant times and cultures seem unfathomable to me is that what I count as "trauma" begins there as a child, and even the concept of what childhood is for and about may differ (even for a time and place so near as the coal-mining regions of the U.S. before child labor was abolished...or growing up nowadays in crack-ridden urban gang warfare zones). I suppose it's hard for something to get noticed as a syndrome when it applies to whole classes of people.
This touched on some thoughts that I myself have been having about PTSD.

We do take very much for granted the ease and lack of danger of contemporary life. Our personal sense of history tends to go back three generations. One's grandparents' time is likely the farthest back one gets a sense of and anything that has been constant over three generations intuitively appears to have always been the case. But life outside of the last three generations in the Western world is quite different. Statistics about infant mortality just 100 years ago are stunning. MT is right that our sense of trauma is one that comes from a staggering degree of comfort and security.

Add to this the fact that in the state of nature, we are from somewhere in the middle of the food chain. We were not the top predator, we were prey. Our psychological capacities came about quite recently in an evolutionary time frame. While I have concerns about certain claims by folks playing in evolutionary psychology, there is no doubt that mind has an ineliminable biological component that is the result of selection pressures. Our psyche, deep down, is that of the hunted. Hobbes was right that life in the state of nature was "solitary, nasty, brutish, and short" (I once had a blind date with a woman like that). Since our biology is in part derives from our place in the state of nature, is, as MT suggests, PTSD natural?

I do not mean natural in a normative sense in which natural is good and ought not be tampered with or prevented. Rather, I mean it in the sense that farming is not natural, we take land and we get from it more than would naturally be produced by it. We remove what would naturally be growing there, plant what we want, keep out weeds that would otherwise grow there naturally, augment the nutrients in the soil beyond what would normally be there, add water beyond rainfall,... I have to work very hard to keep my garden from reverting back to its natural state. I may work with nature to some degree in trying to grow organic vegetables, but there is no doubt that I am working against nature as well. In the same way as we cultivate land, we seem to cultivate minds in the way we structure society and perhaps PTSD is a type of weed that occupies a particular niche in the cerebral ecosystem of the psyche of a hunted species.

PTSD seesm to be the result of rewiring certain parts of the brain by experience. Such an encoding mechanism would make sense in learning to avoid dangers. But this is exactly what worries me. It was not as if some infectious agent had invaded my grandfather's body and we just needed the proper drug regimen to ward it off. It was his own body he was fighting. Websites like this one from the Los Angeles County Department of Mental Health seem to aim for what my grandfather experienced as a best case scenario. He was able to go on to live a normal life despite the PTSD that haunted him until his last moments. If this is the case, and PTSD is something that must be lived with and not cured, then we must come to grips with the real human costs of our social choices -- not only war, especially wars of choice, but also social and economic injustice as MT points out. Unfair labor laws and unsafe neighborhoods can have lasting effects. If Hobbes was right that morality is what takes us out of the state of nature, then we seem to be ethically bound to be vigilant in creating a civilized world where as few people as possible live lives afflicted by trauma.