Tuesday, September 6, 2011

Does America Have PTSD?

This Sunday marks 10 years since the September 11th attacks. Everyone, it seems, is doing some kind of memorial or retrospective to mark this solemn anniversary. Some are focused on remembering those who died, others on service to the community and still others on looking at how America has changed over the last decade. This last theme intrigues me. We know that trauma changes people as individuals. Can trauma change a whole country?

I have a friend who is a mental health professional who suggests that it can and it did. In a blog post several months ago, she proposed that American society is showing many signs of post-traumatic stress.

Now, let's not take this too literally. American society does not have a single brain that can contract a mental illness. But Post Traumatic Stress Disorder (PTSD) is a very symptom-based disorder. You know someone has it by how they act. In my friend's opinion, American society isn't behaving in a very adaptive manner. Over the next several days in this space, I'll be laying out a detailed look at the ways in which our current society is showing signs of trauma.

Symptoms of PTSD fall into three categories: Intrusive Recollection, Numbing and Hyper-Arousal. Today I'd like to look at the first of these, the so-called "Criterion B Symptoms" (named after the letter in the description in the diagnostic manual) of intrusive recollection. People with PTSD have at least one of these symptoms, and many have more:

Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. On the day after Osama bin Laden was caught, news outlets ran all kinds of 9-11 retrospectives. Some of them were horrifically graphic and would never have made it past the editors under other circumstances. Telephone recordings of dying people and video footage of people jumping out of windows was played without even the basic "viewer discretion is advised" warning. Not only do we remember, but we do not have mastery over our memories enough to modify how and when we process them.

Recurrent distressing dreams of the event.
Obviously it's somewhat difficult for an entire society to have distressing dreams. There is some argument to be made, though, that works of art, literature and movies represent the "dreams" of society. If that is the case, the tremendous popularity of the Harry Potter series is telling. With each installment in the series, the foreboding message that there is a great evil "out there" that can strike anyone at any time and that we don't really know who can be trusted gets stronger. In each book, we look to Harry to master the terrifying unknown because we can't.

Acting or feeling as if the traumatic event were recurring Perhaps the best example of this is the media coverage of the infamous "balloon boy" incident last year. A kid supposedly trapped in a balloon got national breaking news coverage. Even if it were true (which we know now it wasn't), how do we explain that? I think we learned, on 9-11, what it was like to scramble news coverage and all have our attention focused in one place, and we have become very bad at figuring out when that's actually necessary. Everything that is generally newsworthy is Big News. When something we think may be important happens, we go into 9-11 mode.

Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event. For much of our society, Muslims as a group have come to symbolize 9-11. When people get so upset about the so-called "Ground Zero Mosque," they are getting upset about something that reminds them of the trauma. Even for those who don't blame all Muslims, the anger against those who do may also be a symptom. One group is furious at Muslims for supposedly desecrating the memory of those who died, while the other is furious at the first group for supposedly desecrating the memory by being hateful.

Physiologic reactivity upon exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
Can a whole society have a physical reaction? Society can certainly change its physical set-up. What in individuals manifests as a rapid heartbeat or excessive sweating, in society shows up as barriers, scanners, metal detectors and, more importantly, over-focus of security measures on people based on their ethnicity. Something reminds us of the attacks -- someone's religion or skin color -- and as a society we physically try to defend ourselves, even though we have no real evidence that religion or skin color is very predictive.

We need only one of these symptoms, but we have more than that. September 11 was 10 years ago, but in a very real way, as trauma victims often do, we are still reliving the attacks.

Tomorrow: America's symptoms of numbing


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Naomi Zikmund-Fisher
is a clinical social worker, former school Principal and a Crisis Consultant for schools and community organizations. You can learn more about her at www.SchoolCrisisConsultant.com
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