PTSD in history, other cultures

[AmericanPride]

The National Institute of Mental Health defines PTSD as "an anxiety disorder that can develop after exposure to one or more terrifying events in which grave physical harm occurred or was threatened". What I would like to find out is the relationship between culture, the nature of modern war, and PTSD, if there is a significant relationship at all.

(1) Is PTSD prevalent in other cultures/countries? Is it a major issue primarily in industrialized countries, or is it present in all cultures engaged in conflict? Russia has a serious problem managing PTSD among combat veterans returning from Chechnya, but this would seem to indicate that PTSD is a consequence of industrialized war.

(2) Are there historical references to PTSD in history prior to modern warfare? How was it perceived and managed? Was it particular to certain cultures or present throughout the history of war? The Iliad makes a reference to what appears to be PTSD -- Ajax loses a duel, comes under a "spell" from Athena, slaughters a herd of sheep thinking they are the enemy, and then kills himself. Is this an ancient reference to PTSD? If so, it would seem, so far, that PTSD is a product of Western culture.

(3) If PTSD is particular to a certain cultural arch-type or form of warfare, is it therefore a product of social construction?

(4) If it's a social construct, would PTSD treatment be more effective by addressing the underlying cultural variables rather than specific individuals (not to say, of course, that those individuals suffering from it should be refused treatment on a case-by-case basis).

[Tom Odom]

(1) Is PTSD prevalent in other cultures/countries? Is it a major issue primarily in industrialized countries, or is it present in all cultures engaged in conflict? Russia has a serious problem managing PTSD among combat veterans returning from Chechnya, but this would seem to indicate that PTSD is a consequence of industrialized war.

Answer part one: yes

Answer supposition part two: no

Case Studies: Rwanda -- hardly industrial

Congo -- Ditto

There are plenty of others.

Do cultural mores help define what constitutes trauma? Probably in that what is terribly horrific in one place could be a minor hiccup in another.

[AmericanPride]

Answer part one: yes

Answer supposition part two: no

Case Studies: Rwanda -- hardly industrial

Congo -- Ditto

There are plenty of others.

Do cultural mores help define what constitutes trauma? Probably in that what is terribly horrific in one place could be a minor hiccup in another.

Well, I think that has more to do with the how PTSD is defined. It seems to me that there are only a handful of effects that can occur to people as far as stress and trauma are concerned, but that there are a myriad reasons/triggers for why they happen. Are there historical references to PTSD prior to the 19th century? I think an interesting case study would be the Thirty Years War, the Crusades, or any of the Roman or Mongol campaigns.

[Steve Blair]

You may have trouble finding any information on this, simply because the definition of PTSD is itself pretty recent. I can name any number of PTSD-type cases from the Civil War in the US alone, and I'm also sure you could find a huge number of anecdotal stories from many cultures predating that.

I suspect (though I'm not an anthro type...Marc's better qualified to speak to this possibly) that many tribal cultures had their own cultural mechanisms to deal with what we now call PTSD. Warrior societies, vision/spirit quest rituals, and even something as seemingly unrelated as the berserkers might all have been tools to deal with those who were shocked or disturbed by combat. Some tribal cultures also had social "outs" for those who weren't keen on combat (and in many cases the actual demand for warriors was low enough that it was a self-selecting process).

[AmericanPride]

You may have trouble finding any information on this, simply because the definition of PTSD is itself pretty recent. I can name any number of PTSD-type cases from the Civil War in the US alone, and I'm also sure you could find a huge number of anecdotal stories from many cultures predating that.

I suspect (though I'm not an anthro type...Marc's better qualified to speak to this possibly) that many tribal cultures had their own cultural mechanisms to deal with what we now call PTSD. Warrior societies, vision/spirit quest rituals, and even something as seemingly unrelated as the berserkers might all have been tools to deal with those who were shocked or disturbed by combat. Some tribal cultures also had social "outs" for those who weren't keen on combat (and in many cases the actual demand for warriors was low enough that it was a self-selecting process).

Do you think American society in general lacks any of those "outs", whether for those who are not "keen on combat", or for those who have mental injuries because of combat?

[marct]

Do you think American society in general lacks any of those "outs", whether for those who are not "keen on combat", or for those who have mental injuries because of combat?

I'd second Tom's suggestion of looking at Rwanda and the Congo. There is also some very good material from South Africa.

Part of the problem with all of this is that the definition of PTSD is too fluffy - it's based on a phenotypic definition rather than on a neurological one. From my (rather limited) reading of the literature, PTSD appears to refer to a neurological process that bypasses the neo-cortex and stores memories, or associations, directly in the hipocampus of the brain (or, at least, with a strong connection to that area).

Let me tell you a story (Anthropologists are ALWAYS telling stories ). In a certain tribe living nowadays in South Africa and Tanzania, the manhood ritual involved circumcision - usually with a rather dull iron knife at the age of 12 or so. This was followed with a requirement hat the "candidate" stand immersed in a cold stream for about an hour or so. No, to my mind, having parts of your anatomy slowly sawed off and then being put into cold water for an hour or so will, in all probability, induce a major system shock. Someone who had a genetic predisposition to PTSD, i.e. a likelihood of pain bypassing their neo-cortex, would probably die as a result of this ritual. So, in his culture, PTSD would not be as prevalent as in other cultures that don't select against it.

Marc

[Tom Odom]

Well, I think that has more to do with the how PTSD is defined. It seems to me that there are only a handful of effects that can occur to people as far as stress and trauma are concerned, but that there are a myriad reasons/triggers for why they happen. .

That is what I just said with:

Do cultural mores help define what constitutes trauma? Probably in that what is terribly horrific in one place could be a minor hiccup in another.

Again you don't have to look far for a non-industrial scenario. Rwanda and the Congo are current examples where psychological trauma is rampant and long lasting.

Steve is on the mark in suggesting the Civil War. Try Jerry Linderman's Embattled Courage.

[Darksaga]

The National Institute of Mental Health defines PTSD as "an anxiety disorder that can develop after exposure to one or more terrifying events in which grave physical harm occurred or was threatened". What I would like to find out is the relationship between culture, the nature of modern war, and PTSD, if there is a significant relationship at all.

(1) Is PTSD prevalent in other cultures/countries? Is it a major issue primarily in industrialized countries, or is it present in all cultures engaged in conflict? Russia has a serious problem managing PTSD among combat veterans returning from Chechnya, but this would seem to indicate that PTSD is a consequence of industrialized war.

(2) Are there historical references to PTSD in history prior to modern warfare? How was it perceived and managed? Was it particular to certain cultures or present throughout the history of war? The Iliad makes a reference to what appears to be PTSD -- Ajax loses a duel, comes under a "spell" from Athena, slaughters a herd of sheep thinking they are the enemy, and then kills himself. Is this an ancient reference to PTSD? If so, it would seem, so far, that PTSD is a product of Western culture.

(3) If PTSD is particular to a certain cultural arch-type or form of warfare, is it therefore a product of social construction?

(4) If it's a social construct, would PTSD treatment be more effective by addressing the underlying cultural variables rather than specific individuals (not to say, of course, that those individuals suffering from it should be refused treatment on a case-by-case basis).

The first real description of PTSD like symptoms is read in the account of the aftermath of the Battle of Thermopalye.

PTSD is more than just a single or multiple experiences. PTSD can also be learned behavior that was positive at the time in that it allowed for survival but does not translate well when the individual returns to a "safe" environment. This learned behavior also has a physical presence where the fight or flight reaction is instaneous and bypasses normal though process.

PTSD treatment needs to be specific to the individual and the way each individual processes their experience is personal and unique. For some working through the issues in one on one counseling is key. With others the transition to group therapy is extremely important. Sometimes cognitive behavioral approach or reality therapy may be the model to use. In all truth there is no outright cure for PTSD. The focus of treatment is learning to live with it.

Frankly there is no one blanket treatment for PTSD either but it can be allieviated somewhat by the learning of new coping skills and with the stigma associated with it minimalized. The Army is making strides in this area by fielding Combat Stress Control Units to provide counseling and psychiatric care for soldiers and to debrief units after critical incidents.