That's pretty much a perfect article. Thank you so much.

Have you encountered Ethan Watters' Crazy Like Us (http://http://www.crazylikeus.com)? He raises some interesting issues about PTSD—specifically in relation to the surprisingly inappropriate treatment thereof in the wake of the Sri Lanka Tsunami—with an interesting comparison of the phenomena of PTSD as a diagnosis versus earlier trends in clinical psychology. The relation between the popularity of PTSD and the popularity of "female hysteria" have some interesting analogies.

The book is not without its detractors; take it with however many grains of salt you like, but I found it a useful analysis (and an insightful statement about human nature).

(I'd date a lot of the rape tropes back to Richardson's Clarissa, actually, or at least Les Liaisons Dangereuses, but I realize that not everyone wants to define that sort of seduction as rape, and really it's a derail from your important main points.)

I have wondered about PTSD sometimes, whether it will turn out to be several different things which are currently lumped together under one label. I was talking with my parents yesterday about the disaster at Aberfan. It happened three years before I was born, but a lot of the legal and investigatory activity culminated when I was three and so it was all over the news again for weeks. I was three and we didn't even have a telly, but that event had a huge impact on me. Mum says I slept in the bathroom where there was no window, for six months. In 1989 I was living in Santa Cruz when the Loma Prieta quake hit, and it's very difficult to even talk about with people who weren't there. But there's a shared element to those traumas which differentiates them from individual, private experiences. The former was part of the cultural zeitgeist of England in the 1960s. The latter was part of the cultural zeitgeist of California in the 1980s...but for me it is personal, and I find myself dismissive of the experience of people who were even 50 miles away.

But these huge experiences that affect whole communities and ripple out to extended communities seem to me to be fundamentally qualitatively different from individual traumas. They are not the same in their long-term effects as unshared traumas. My friend who went over a cliff and lay on a ledge with a broken back for six hours before he was found has a different damage than the friend whose house collapsed around her and was trapped for seven hours. Because - for better and worse - no-one shared his experience, and many shared hers.

It's also interesting to me to draw comparisons with chronic physical illness. I've had lung disease for 40+ years, and bone disease for nearly 20 years. It's amazing to me the kinds of conclusions people leap to about me when they know that. I'm not for instance, brave. I don't have choices about living with these conditions. I figure out how to mitigate their effects. Sometimes I make choices not to participate in activities because of the impact the activities will have. Sometimes I decide I want to do something anyway, even though by now I have a pretty good idea of the consequences. It's in no way admirable; my choices are circumscribed and I work around that as best I can.

Edited at 2012-08-06 03:07 pm (UTC)

I think Americans like to romanticize brokenness in general. Which is interesting given how quick we are to throw away anything that doesn't work as advertised, but I suppose the two things probably go together.

I'm not sure I agree with you.

I mean, yes, its done badly and cheaply a lot. But there's a lot of people with untreated, undiagnosed PTSD in this culture ... assuming we count the 1/6 to 1/3 of women who experience sexual assault and rape, plus all the child and domestic abuse survivors, then add the veterans of Vietnam, the Gulf, Bosnia/Kosovo, Iraq and Afghanistan ...

... that's a HUGE number of people experiencing a disability that still carries with it an enormous stigma.

Seems to me that presenting PTSD sufferers as heroic either because of or despite their disability is no better or worse than heroic portrayals of people with Aspergers or in wheelchairs or who grew up poor in Appalachia or any other thing that is a hard part of real life. Better, really in a way because it is so hidden, and so misunderstood ... and fiction might be the only way some sufferers would come into contact with a hint about what might be happening to them.

(Yes I have it too, so I don't mean to discount your experience, just to offer my own perspective)

Yes.

I specifically write at least one character who has been through tremendous trauma, and for whatever reason has not developed post-traumatic distress (compensations, yes, but those are clinically different) and there are readers who just will not believe that he's not reacting out of PTSD.

Because we see it both pathologized and glamorized, and treated as inevitable.

Er, its true of some people. Not the glamorous part. The destroys your life part. Untreated PTSD kills people. Sometimes fast and sometimes slow.

:)

But I said untreated PTSD.

Sorry, I know a bunch of people (read: men) who are being Proud and Lonely like a Prince of Amber about their experiences. I worry about their safety.

Having the military stigmatize people suffering from these illnesses doesn't help anything.

What?

Okay, whatever. I just know some veterans is all. If being concerned that they are hung up on their tough guy image and not getting the help they need is *mythologizing* PTSD to you, then ... gosh, hon, don't know what to say.

I don't think its *comfortably tragic* to be concerned about someone who is drinking too much, or driving too fast, or playing with guns or courting risks in other ways that is not MYTHOLOGICALLY dangerous but ACTUALLY dangerous and honestly, that kind of behavior is not even limited to men or to veterans ... oh honestly, really? You really think I read that in a book? Are you kidding me?

That was an excellent discussion.

As someone who has PTSD (along with a couple of other diagnoses) and as someone who is in the process of writing a thesis examining real world data to depictions of mental illness in YA speculative literature, I tend to struggle with how illnesses are depicted in popular literature and culture.

I've read too many books, where PTSD is ignored as in "And Everyone Lives Happily Ever After" even though there's just been a terrible war, then there are others where I've seen PTSD done cheaply or sort of romantically to enhance a character (although I've noticed this less than the first).

One of the reasons I love Mockingjay, and am using it as one of the three central texts to my thesis, is that it is a tad more gritty than most. I know people who don't like it for that reason. It might not be the best book on the face of the planet, but it shows much more of the reactions and grit especially how many different ways there are of reacting to horrible situations.

I've yet to see a text, however, in which the long term difficulties with friends, week long panic attacks, complete need to adjust to a different (and not quite accepted) lifestyle, or any of the other not so fun reactions are shown to the full extent.

I think we are thinking of two different things when we refer to fun/not so fun aspects. I wouldn't say that there are any fun aspects to PTSD. I was trying to be vague in there are a number of different ways in which a person's reaction can fit within DSM-IV-TR criteria. I was likely overly vague by saying "not so fun" as opposed to say terrible, horrible, or very bad.

I was trying to say not that there are fun bits, but rather that all too often people simply ignore the traumatic responses having life go on, in a normal fashion, to how things were before the events occurred.

I think I've read at least part of Judith Herman's work. I'll see if I can find it for a reread. I would agree that people don't include PTSD, or even lesser stress reactions, because people don't want to look dig into it. People don't want to write the gritty realities of war. I get that. I, however, think that when people do write traumatic experiences, they need to account for them in the form of some sort of stress reaction regardless of whether or not it's full blown PTSD.

I was floored by the portrayal of PTSD in West Wing when it came out (Josh, as aftereffects of being shot). An unglamorous portrayal of it that matched my experience, and no quick fix.

I haven't gotten that far on my re-watch, so it may have come to suck in the meantime, but then? One of the best portrayals I'd seen.

I do have a certain guilty fondness for the unrealistic portrayals where someone comes in and fixes everything. Those provided a lot of comfort to me when I needed it (though friends don't understand how some of the more graphic of those can possibly be comfort reading), but they're so utterly unrealistic. I think it's important to have mythological and non-mythological portrayals.

Oh yes, CM does a good job, and in a subtle way.

For me as a young teen, the escapist fantasies were very important, and again as, oh, a college student with issues. Like all escapist fantasies, I knew it didn't work that way, but it helped me to be able to pretend for a bit.

Like all of *everything*, there's no universal response.

For what it's worth, I do agree with you that the heavy societal emphasis on the mythologized portrayals of PTSD has had consequences. A broader and more realistic range of experiences would be better: if all someone has is the mythology, they're less likely to really understand themselves or others, I think.