PTSD calls for collective healing

Sebastian Junger writes: In two American studies of middle-class families during the 1980s, 85 percent of young children slept alone — a figure that rose to 95 percent among families considered “well-educated.” Northern European societies, including America, are the only ones in history to make very young children sleep alone in such numbers. The isolation is thought to trigger fears that make many children bond intensely with stuffed animals for reassurance. Only in Northern European societies do children go through the well-known developmental stage of bonding with stuffed animals; elsewhere, children get their sense of safety from the adults sleeping near them.

More broadly, in most human societies, almost nobody sleeps alone. Sleeping in family groups of one sort or another has been the norm throughout human history and is still commonplace in most of the world. Again, Northern European societies are among the few where people sleep alone or with a partner in a private room. When I was with American soldiers at a remote outpost in Afghanistan, we slept in narrow plywood huts where I could reach out and touch three other men from where I slept. They snored, they talked, they got up in the middle of the night to use the piss tubes, but we felt safe because we were in a group. The Taliban attacked the position regularly, and the most determined attacks often came at dawn. Another unit in a nearby valley was almost overrun and took 50 percent casualties in just such an attack. And yet I slept better surrounded by those noisy, snoring men than I ever did camping alone in the woods of New England.

Many soldiers will tell you that one of the hardest things about coming home is learning to sleep without the security of a group of heavily armed men around them. In that sense, being in a war zone with your platoon feels safer than being in an American suburb by yourself. I know a vet who felt so threatened at home that he would get up in the middle of the night to build fighting positions out of the living-room furniture. This is a radically different experience from what warriors in other societies go through, such as the Yanomami, of the Orinoco and Amazon Basins, who go to war with their entire age cohort and return to face, together, whatever the psychological consequences may be. As one anthropologist pointed out to me, trauma is usually a group experience, so trauma recovery should be a group experience as well. But in our society it’s not.

“Our whole approach to mental health has been hijacked by pharmaceutical logic,” I was told by Gary Barker, an anthropologist whose group, Promundo, is dedicated to understanding and preventing violence. “PTSD is a crisis of connection and disruption, not an illness that you carry within you.”

This individualizing of mental health is not just an American problem, or a veteran problem; it affects everybody. A British anthropologist named Bill West told me that the extreme poverty of the 1930s and the collective trauma of the Blitz served to unify an entire generation of English people. “I link the experience of the Blitz to voting in the Labour Party in 1945, and the establishing of the National Health Service and a strong welfare state,” he said. “Those policies were supported well into the 60s by all political parties. That kind of cultural cohesiveness, along with Christianity, was very helpful after the war. It’s an open question whether people’s problems are located in the individual. If enough people in society are sick, you have to wonder whether it isn’t actually society that’s sick.”

Ideally, we would compare hunter-gatherer society to post-industrial society to see which one copes better with PTSD. When the Sioux, Cheyenne, and Arapaho fighters returned to their camps after annihilating Custer and his regiment at Little Bighorn, for example, were they traumatized and alienated by the experience — or did they fit right back into society? There is no way to know for sure, but less direct comparisons can still illuminate how cohesiveness affects trauma. In experiments with lab rats, for example, a subject that is traumatized — but not injured — after an attack by a larger rat usually recovers within 48 hours unless it is kept in isolation, according to data published in 2005 in Neuroscience & Biobehavioral Reviews. The ones that are kept apart from other rats are the only ones that develop long-term traumatic symptoms. And a study of risk factors for PTSD in humans closely mirrored those results. In a 2000 study in the Journal of Consulting and Clinical Psychology, “lack of social support” was found to be around two times more reliable at predicting who got PTSD and who didn’t than the severity of the trauma itself. You could be mildly traumatized, in other words—on a par with, say, an ordinary rear-base deployment to Afghanistan — and experience long-term PTSD simply because of a lack of social support back home.

Anthropologist and psychiatrist Brandon Kohrt found a similar phenomenon in the villages of southern Nepal, where a civil war has been rumbling for years. Kohrt explained to me that there are two kinds of villages there: exclusively Hindu ones, which are extremely stratified, and mixed Buddhist/Hindu ones, which are far more open and cohesive. He said that child soldiers, both male and female, who go back to Hindu villages can remain traumatized for years, while those from mixed-religion villages tended to recover very quickly. “PTSD is a disorder of recovery, and if treatment only focuses on identifying symptoms, it pathologizes and alienates vets,” according to Kohrt. “But if the focus is on family and community, it puts them in a situation of collective healing.” [Continue reading…]

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