COMMENTARY ARCHIVES, 20 Mar 2010
Can a nation have PTSD (post-traumatic stress disorder)? Can a diagnosis created to understand the dysregulated behavior of individuals be applied to an entire nation? I argue yes on both counts. If a diagnosis can help us understand and treat aberrant behavior, then it doesn’t matter if the aberrantly behaving thing is an individual or a nation of 350 million people. The nation’s functioning manifests the collective activity of its individual members, just as the human organism is a collective of the trillions of cells that make it up. The notion that a nation can have PTSD proposes we analyze current events from a psychological perspective, rather than a historical or political orientation. A nation can have PTSD if it meets criteria for the diagnosis. The DSM-IV, the bible of psychotherapy and psychiatry, lists six symptoms for PTSD. America has them all.
For an individual, the diagnosis of PTSD requires that the person have experienced a traumatic event involving the actual death of another or the threat of death or loss of physical integrity to the self. PTSD also requires that the person felt terror, helplessness or horror. Individuals in war often experience such traumas. Killing another human being induces horror. Seeing one’s fellow soldiers killed or dismembered by bombs induces horror. Under fire or in close personal combat, soldiers feel terror and helplessness. How has America experienced helpless terror and horror?
America was born in death and destruction. Europeans imported terror and horror to America in the form of disease, slavery and massacre. The native people were helpless against the invasion. The Spanish brought the horror of smallpox with them when they invaded the New World. The Spanish also brutally subdued the indigenous people. According to one English observer, they "did scorch and roast them to death." The native people experienced terror as they were brutalized, and their relatives experienced horror as they watched their kin burned alive with "all cruel inhumanity." The Portuguese brought slavery to the New World, importing 150,000 Africans to the Americas by 1600. Slavery brought helplessness and terror to America. The invaders perpetrated terror on their own as well as on the natives. The French had established a colony at Fort Caroline in northern Florida, and when the Spanish discovered them, they attacked the colony in 1565 and massacred everyone – men, women and children. America was established through terror, horror and helplessness.
Individuals with combat-related PTSD experience two distinct sets of symptoms: reexperiencing the traumatic event and avoidance of it. I will look first at the reexperiencing symptom, because it explains how, across the last 400 years, America has perpetuated and reperpetuated the trauma in which it was established. One way individuals reexperience a trauma is through re-enacting it. Freud called this a "repetition compulsion." America has reenacted and continues to reenact the trauma from its origins through wars of aggression. In the first 150 years of its life, America reenacted the trauma of its birth through the genocide perpetrated on the indigenous peoples. America also reenacted its trauma in lynchings of helpless black people. During the last 50 years, America has terrorized helpless peoples in Vietnam, Laos, Cambodia, Panama, Grenada and now Iraq, Afghanistan and Pakistan. America has induced terror through carpet-bombing from B-52s, through napalming and now with rocket attacks from drones. America has reenacted massacres with strikes on wedding parties, on women and on children. In Iraq alone, America has massacred more than 1 million helpless human beings. In addition to reenactment of traumatic events, reexperiencing for an individual can take the form of reliving the trauma through mental imagery. Combat PTSD often presents in soldiers in the form of recurring recollections of the traumatic event through dreams, nightmares or flashbacks. Nightmares and flashbacks of the trauma are major symptoms of PTSD in a traumatized individual.
How does America experience nightmares and flashbacks as a nation? We broadcast them to ourselves! News media and pundits constantly blast citizens with traumatic imagery and narrative. Images of 9-11 or references to it in political speeches constitute a national flashback, because every time a politician or commentator speaks the words "nine one one" the horrific television images stored in every listener’s brain are recalled along with the emotions of fear and hatred felt at the time. Broadcast traumatic imagery and narrative exemplify the reexperiencing phase of PTSD. Movies are another form in which America reexperiences trauma. America reexperienced earlier trauma as the so-called "cowboy and indian" movies that were popular in the ’50s. War movies, like "Battle Cry" and "Tora Tora Tora," constituted a national reexperiencing of the trauma of World War II. After Vietnam, a series of movies, including "Platoon" and "Apocalypse Now," reexperienced that traumatic war for the nation. Currently, "Hurt Locker" provides America the imagistic reliving of the trauma of Iraq that is a central feature of our national PTSD.
Our American nightmare has bogey men who assault us with horrific scenarios. Glenn Beck, Bill O’Reilly, Rush Limbaugh and Sean Hannity broadcast night-terrors. Ann Coulter is a shrieking succubus. Karl Rove and Dick Cheney are the monsters chasing us through bomb-cratered, nightmare streets, our leg muscles stiffening as we have more and more difficulty running. Reexperiencing trauma is a core symptom of PTSD. As a nation, we reexperience our national trauma by means of Rove, Cheney, Coulter, Beck, O’Reilly, Hannity and dozens of other commentators in print and broadcast media. Rove, Cheney, Coulter, Beck et al. manifest the symptom of reexperiencing. They embody one major symptom – expression of our national PTSD.
Reexperiencing through media imagery and actual reenactments induces a state of hypervigilance in the PTSD nation as well as in individuals with PTSD. As a nation, we obsess on security because we do not feel safe and see threats everywhere. Hypervigilance is the condition of maintaining an abnormal awareness of environmental stimuli, and it includes a heightened startle response that often accompanies the flashbacks. America’s obsessive hypervigilance manifests in electronic surveillance of its own citizens through wire-taps, cameras, spy satellites, bank account tracking and domestic spying using informants. The same techniques are employed in countries around the world. Reagan’s Strategic Defense Initiative comprised a form of hypervigilance that America under Bush and Obama continues to experience through the missiles we are placing around Russia.
Avoidance is the second major symptom of PTSD. In individuals, avoidance takes the form of persistent attempts to steer clear of reminders of the traumatic event. PTSD nation mobilizes powerful forces to avoid arousal of recollections of the traumatic events. The George W. Bush administration’s refusal to allow photographs of the coffins of soldiers killed in Iraq constituted a national avoidance, as did Bush’s own refusal, in his iconic function as the nation’s leader, to visit wounded soldiers or to salute the returning coffins. Recently the nation convulsed in avoidance when an image of a bleeding, mortally wounded soldier appeared on the Internet.
"Psychic numbing" is a manifestation of avoidance in which a person experiences diminished responsiveness to the external world. America has become numb to the devastation it has wreaked in Iraq and Afghanistan, for example, through its violent acting out. PTSD Nation is not outraged by the fact that we have killed over a million Iraqi citizens, many of them women and children. Americans have an emotional anesthesia for the deaths of more than 5,000 of our own citizens in Iraq or for the Traumatic Brain Injuries and catastrophic amputations soldiers have suffered. PTSD Nation marginalizes the wounded soldiers and servicemen and women driven insane by the horrors they have perpetrated and participated in. Homelessness is marginalization. Emotional anesthesia in America is a manifestation of avoidance of trauma-coded memories.
Fragmentation and Loss of Behavioral Control
PTSD induces a state of fragmentation in individuals and in a nation. Fragmentation means that the structure of the self breaks up into parts that are called "ego states" or "part selves." Dissociative Identity Disorder, which was formerly known as Multiple Personality Disorder, exemplifies the most severe form of fragmentation. When fragmentation occurs in an individual, coherence among the parts of the personality is lost. America is increasingly fragmented, and coherent communication among its parts is rapidly disappearing. The Tea Party claque represents a fragment of the PTSD Nation’s psyche that is not communicating coherently with the society as a whole. The Sarah Palin phenomenon and the fragmenting off of the "Party of No" within the Republicans and the "Blue Dog" faction within the Democrats illustrate how America has split into parts that no longer communicate. Limbaugh, Beck and their ilk are the "crazy voices" manifesting the delusions of the fanatical fragments.
PTSD engenders a loss of behavioral control in individuals and in PTSD Nation. Among PTSD service persons, loss of behavioral control manifests as domestic violence, alcoholism, addiction and suicide. PTSD Nation has experienced wave after wave of aberrant behavior. America has lost control of its financial behavior. As a nation, we are trillions of dollars in debt to foreign investors, notably China.
America lost control of the SEC, the Fed, Fannie Mae, Freddy Mac and its other financial institutions, creating the financial bubble that burst in 2009. PTSD Nation lost control of its housing and mortgage market, and many people are homeless now. Legions of examples illustrate our national loss of behavioral control: the national infrastructure is crumbling; water supplies are contaminated; our national health system is broken and millions have no health care; education is collapsing, and we have lost control of our electoral system, our Congress, our judiciary, our executive, our media, and our agriculture to the corporations that now operate the country for their benefit
Healing PTSD Nation
America suffers from Post-Traumatic Stress Disorder. As a nation, we’ve been diagnosable for generations. Our national symptoms are worsening with each passing year. The prognosis for the nation is poor.
What does it do for us to say that America has PTSD? It tells us that as individuals and as a nation we need treatment. We need therapy. We need a recovery program, and we could do well to start with the 12 Steps that were originally formulated by AA. An accurate diagnosis is the first step in treatment of any mental disorder. My article has summarized the diagnosis and given an accurate and complete enough Case Report to enable us to go forward with treatment. PTSD Nation must begin treatment by admitting that it has been powerless over its behavior and that its life is unmanageable.
This is Step One. Having admitted to its powerlessness, PTSD Nation can stop reenacting. America can withdraw from Iraq and Afghanistan and Pakistan and the 168 other nations where we have established bases to perpetuate our violent acting out. America can stop reexperiencing through violent movies and talk shows that serve only to maintain that hypervigilant state. It is time to focus on healing America.
National therapy for national PTSD also demands that we stop avoiding. We have avoided making reparations to Native Americans for the genocide we perpetrated on them. We have avoided promoting reconciliation with the African-American people brought here as slaves. We have never made amends to the Vietnamese, Laotians and Cambodians for the destruction we wreaked on them. We need to cease avoiding the horror and terror we are perpetrating on Iraq, Afghanistan and Pakistan. We must raise to national consciousness the trauma we have enacted worldwide.
Step Two tells us that a power greater than ourselves can restore us to sanity. For America, that power is not a theological power, it is the Declaration of Independence, the Constitution and the Bill of Rights. As citizens of PTSD Nation, we must thoroughly examine our insane behavior. We must rediscover the sanity of the Declaration, the Constitution and the Bill of Rights. In recovery from national PTSD, we must surrender our thoughts and our actions, "our will and our life" as the 12 Steps have it, to the principles of the Constitution and the Declaration of Independence, where it tells us that all people are created equal and endowed with the inalienable right to life, liberty and the pursuit of happiness. Following the 12-Step approach, America can begin local meetings, hundreds of meetings in every city, every day, meetings where citizens can talk through and work through the application of these principles in their daily lives, guided always by a surrender to the Constitution and the Declaration. We must not be seduced into forming yet another national organization to carry out the healing. This must be a populist phenomenon, a movement of, by and for the people. Forming another bureaucratic or corporate entity to provide the healing will only perpetuate the PTSD. There must be no corporate sponsorship, no advertising. Like AA, we must be self-supporting through our own contributions, our donations of a few dollars to support the local meeting and mostly by giving of our time, our intention and our honesty, open-mindedness and willingness. Through our own collective action, we can restore America to sanity.
America is PTSD Nation, and America is also a nation of citizens, all of whom have been affected by our national PTSD. To recover, we must stop acting out. To recover, we must come together to support each other in working through the trauma that has impacted each of our lives and all of us as a nation. We must stop reenacting and stop reexperiencing and cease avoiding. In order to form a more perfect union, it is time to begin the recovery process.
John Omaha, Ph.D. is a psychotherapist living in Northern California. He can be reached at email@example.com.
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