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When It’s Not PTSD

Jessie Roberts —  May 26 2014 @ 3:36pm
by Jessie Roberts

Lynne Jones questions the spread of the diagnosis, which entered the DSM-III in 1980. She recalls that, while working as a psychatrist in Sarejevo during the Bosnian War, “what immediately struck all of us living under siege at that time was the irrelevance of describing anything as ‘post-traumatic’”:

One researcher found that almost 94 per cent of displaced Bosnian children living in collective centres met the criteria for PTSD. But he wondered if some of those symptoms might be adaptive in the midst of continuing conflict. The children had been repeatedly shelled during the two-month research period. The hyper-vigilance that made a child startle at a sudden sound might actually keep them alert enough to take cover.

Jones went on to run a mental health clinic in Gorazde, Bosnia in 1996. She remembers that “most of the problems people brought to the clinic simply did not fit [the PTSD] pattern of symptoms”:

The most common problem among the ex-soldiers was chest pain. Bojan arrived at the clinic short of breath and trembling with anxiety. A short chubby man, slightly balding, he sat down and talked without stopping. The problem had begun during the war. After the funeral of a close friend, who had died in fighting, Bojan had collapsed with chest pain. Everyone thought he was having a heart attack. He had been sent to Sarajevo and put in intensive care with chest monitors and blood tests. After a few days, they told him it was his ‘nerves’ and sent him back to his unit in Gorazde. He was angry at doctors who had mishandled his problem and terrified of dying of a heart attack like his father. But he did not have nightmares or tend to relive painful memories from the war. He enjoyed his six-year-old child, his wife, his work; and whatever he had, it was not PTSD.

Some of my colleagues at home argued that the PTSD construct should be adjusted to include all post-conflict reactions, in both adults and children. But the point of a diagnosis is to distinguish problems that require different approaches. What is gained by extending the frame to include different symptom patterns, when all they have in common is exposure to the same supposed triggering event? A patient who has a persistent cough and is diagnosed with pulmonary tuberculosis requires a quite different treatment from a chronic smoker with a cough. If no distinction is made, one may end up giving the psychological equivalent of cough mixture: the ubiquitous, undefined ‘counselling’.

Fightin’ Words

Jessie Roberts —  May 26 2014 @ 11:11am
by Jessie Roberts

Andrew Bacevich argues that Tom Clancy “was among the first to intuit that the antimilitary mood spawned by Vietnam represented an opportunity”:

What Clancy did was seize the role of Reagan’s literary doppelgänger—what the Gipper might have become had he chosen writing instead of politics after ending his acting career. Clancy’s own career took off when President Reagan plugged Red October as “my kind of yarn.” As well he might: Clancy shared Reagan’s worldview. His stories translated that worldview into something that seemed “real” and might actually become real if you believed hard enough. Reagan was famous for transforming the imagined into the actual; despite never having left Hollywood during World War II, he knew, for example, that he had personally witnessed the liberation of Nazi death camps. Similarly, Clancy, who never served in the military, imagined a world of selfless patriots performing feats of derring-do to overcome evil—a world that large numbers of Americans were certain had once existed. More to the point, it was a world they desperately wanted to restore. Clancy, like Reagan, made that restoration seem eminently possible.

Soon after Clancy’s death, the Washington Post published an appreciation entitled “How Tom Clancy Made the Military Cool Again,” written by a couple of self-described Gen-Xer policy wonks. “Clancy’s legacy lives on in the generations he introduced to the military,” they gushed, crediting Clancy with having “created a literary bridge across the civil-military divide.” His “stories helped the rest of society understand and imagine” the world of spooks and soldiers. Perhaps not surprisingly, those who served or aspired to serve found those stories to be especially gratifying. Clancy depicted American soldiers and would-be soldiers precisely as they wished to see themselves.

Punnin’ Games

Jessie Roberts —  May 26 2014 @ 9:27am
by Jessie Roberts

“In mixed company, puns are, along with politics and religion, best left alone,” states Ted Trautman, who traveled to Austin, Texas, to compete in the O. Henry Pun-Off World Championships:

Contestants in the “Punslingers” bracket, facing off in pairs onstage, are given a theme—Disney, weather, et cetera—and forced to make thematically relevant puns every ten seconds or so until one contestant runs out of ideas. … Just as a slam-dunk in basketball earns the same number of points as a layup, this portion of the Pun-Off rewards a contestant for the quantity of her puns rather than their quality. As the moderators explained several times, in a refrain later echoed by desperate contestants defending their ripostes, “It doesn’t have to be good. It just has to be a pun.” The Punslingers event may be the only sport on Earth in which the highest level of play is the most painful to watch. …

[M]y favorite moment of the day occurred during a round in which players had to pun on the theme of “Groups (human and animal)”—e.g., flock, herd, choir, and the like.

The two men on stage had exhausted most of the obvious words in the category, and were beginning to butt heads with the moderators…. After a healthy volley one of the contestants offered an invalid answer, and then another, courting disqualification. And then he rebounded with the perfect pun—not the most clever, not the most original, but one that managed to both keep the round going and poke fun at the increasingly strict moderators: “Next year,” he said, “this topic ought to be band.” Despite the limits on both time and topic, this contestant delivered a pun in the heat of the moment that, against all odds, actually made sense. The crowd went wild, perhaps forgetting for a moment that on Monday they would have to return to a world where words mean just one thing at a time.

The Humanity Of Evil

Jessie Roberts —  May 25 2014 @ 7:26pm
by Jessie Roberts

dish_duch

In his book The Master of Confessions, Thierry Cruvellier details his experience as witness to the war crime trial of Kaing Guek Eav, or Duch, the Khmer Rouge leader who oversaw the torture and killing of at least 12,000 people from 1975 to 1979. Philip Gourevitch talked to Cruvellier about the psychology of mass murder:

[Y]ou say that what Duch’s trial revealed to you was … his humanity. You write, “Duch is not a psycho or a monster and that’s the problem.” Why, or for whom, is that a problem?

The humanity of individuals who become mass murderers like Duch is a repulsive notion to many people. I can assure you that the predominant reaction, regardless of social and educational background, is to say that they are not one of us. In fact, many people do not even understand how someone can go and defend them in court. … Refusing Duch as one of us may give us peace of mind. It keeps us in the safe belief that if, God forbid, we happened to face extraordinary historical circumstances we would behave like heroes. But it doesn’t help us better understand how mass crimes develop and succeed through mass participation.

At the genocide museum in Phnom Penh, Duch’s victims are presented as victims, which they certainly were. But eighty per cent of them were themselves Khmer Rouge, and if they instead had been asked to be perpetrators the overwhelming majority would have obeyed. To accept that Duch tells us something about ourselves doesn’t mean we accept his crimes, and it doesn’t mean we risk showing him sympathy. It makes us think in more realistic terms about how mass murder operates and how it relies on people like us.

(Image of Duch in November 2009, on the first day of closing statements during his trial, courtesy of Extraordinary Chambers in the Courts of Cambodia.)

An Artistic Habit

Jessie Roberts —  May 25 2014 @ 4:48pm
by Jessie Roberts

Whitney Burkhalter sheds light on the medieval artistic tradition called Nonnenarbeiten, or Nuns’ Works:

There is a large body of frankly weird artwork made by medieval nuns, almost all personal devotional drawings or paintings of broken and bloody Jesus, flaming hearts, dish_Hildegard and the like. To modern eyes, they do look childlike. They’re often disturbing. Something you might have going for you that medieval scholars don’t is that right now you’re probably thinking, Doesn’t all medieval art look childlike and disturbing? Entire websites (and entire scholarly careers) are devoted to bizarre details from medieval manuscripts. It’s called marginalia, which basically means doodles, and it ranges from the bizarre (rocket cats?) to the offensive (for example, nuns picking penises off a penis tree.) … While we don’t really know why some nuns made art like Nonnenarbeiten, there are a lot of theories…. Jeffrey Hamburger is a professor at Harvard who writes beautifully about the conditions medieval nuns lived in, which is called enclosure, and how enclosure may have influenced their artwork. Theories on why Nonnenarbeiten look so strange, even against the background of generally strange medieval art, usually revolve around issues of access and agency acting on the nuns externally, such as their lack of formal artistic training or dialogue with the outside world. Not much consideration is given to what the nuns were thinking or how much of their isolation was self-imposed. For example, a convent in Wienhausen painted their own choir rather than allow men to enter their sanctuary. Hamburger argues that the Nonnenarbeiten style indicates a conscious choice on the part of the nuns to express their devotion in an unconventional yet deeply personal artistic vocabulary. Their art isn’t crude, it’s emotional; it’s not naïve, it’s intentional.

(Image: Liber Divinorum Operum by Hildegard von Bingen via Wikimedia Commons)

by Jessie Roberts

In an interview about his new novel, To Rise Again at a Decent Hour, Joshua Ferris suggests they do. He reflects on how an indistinct religious upbringing shaped his writing:

[G]rowing up I looked in on Catholicism as a non-Catholic, and I looked in on Judaism as a non-Jew. I was an outsider, this mutt-y white kid who had no tradition or belief. I wanted a religious community for myself, probably because I didn’t have one. If I’d had one, I probably would have spurned it.

To Rise Again At a Decent Hour starts from the question of whether there’s a kind of private language and intimacy to religion that the mutt-y white guys like me are missing out on. And to some extent, I’m also thinking about the question of whether as a writer there’s something I’ve missed out on. When you’re an American novelist in 2014, at a point when Philip Roth has had a kind of apotheosis—has ascended to heaven even though he’s still on earth—you realize the extraordinary richness he found in Judaism. I didn’t grow up within that richness. I simply didn’t have it. It cuts both ways, of course. There are writers who happen to be Jewish who get labeled as “Jewish writers” and would much rather be just writers. And here I am, lamenting the fact that I’m not a Jew! But religion offers a writer a tradition both to be nurtured in and to fight against, and that nurturing and that conflict can produce great literature. Roth was given a lifetime of material from the fights he picked with Judaism—with the generation of Jews that he raised him, with the generation that excoriated him, and finally with the generation that celebrated him. Whereas I got a few potluck dinners and some basement training in Noah.

In another interview, Ferris expands on his attitudes toward religion:

Is there a God-shaped hole in your own life?

Yes. The general impression of Americans is that we’re all believers. But there are quite a few of us, obviously, across the vast swath of this crazy country who don’t have a God. I think of myself, like my character in the book, as a “non-practising atheist”. At the witching hour there is a hell of lot to say for divine comfort. I feel excluded from that. There are some aspects of religion – its community, its certainty – that I long for.

Part of your plot takes the character back, through a faked online identity, to the Old Testament. What was the experience of immersing yourself in those verses?

Well, I gained a lot of respect for the Bible. I never knew it first-hand before. The best stories there remove all inessentials, and what you’re left with is something extremely efficient. It’s almost like a divinely inspired Hemingway writing in those parts.

Listen to another recent interview with Ferris here.

by Jessie Roberts

dish_churchattendance

That’s the clever title of a new study that reveals Americans exaggerate how often they go to church:

The study, by the Public Religion Research Institute, used an intriguing method to try to measure exaggeration: It asked the same set of questions in telephone interviews, and in an online survey, and compared the results. Researchers say that online surveys, with their lack of human questioners, significantly reduce “social desirability bias” in polling — the tendency of people to exaggerate behaviors that they think will impress others. In this study, the group that took the online surveys reported much lower levels of worship attendance than those interviewed by telephone.

Jessica Schulberg elaborates on the study’s sneaky methodology:

Why the difference in results?

Talking to another human, even an anonymous one, can cause respondents to exaggerate the truth. “It is a rather unconscious cognitive bias,” says John R. Shook, a professor in the Science and the Public EdM online program at the University of Buffalo. “Even if you talk to a live human voice, someone you will never see, someone in Zaire, the brain rationalizes and tries to present itself in the most positive light possible. You can’t help it.”

But it seems that when it comes to worship attendance, liberals are more inclined to do so. PRRI found that over the phone, only 27 percent of self-identified liberals admitted that religion is not important to them; the number jumped to 40 percent of liberals who responded to an online questionnaire. Conservatives were much more consistent: Only 4 percent of telephone respondents and 6 percent of online respondents said the same.

Last month, Brandon Ambrosino looked at an earlier study that suggested people overreport their actual religious practices. He pondered their motives:

According to [researcher Philip] Brenner, overreporting Muslims and Christians are not maliciously lying on surveys — they’re mishearing the question. Here’s Brenner:

“Like the overreporting of church attendance in North America, the overreporting of prayer in the Muslim world is strongly associated with the individual’s sense of what is central to his or her self-concept. The respondent interprets the conventional survey question about prayer pragmatically rather than semantically, allowing the question to become one about the respondent’s identity, rather than actual behavior.”

In other words, when a religious person is asked, “Do you do religious stuff?” the question she actually hears is, “Are you the kind of person who does religious stuff?” If [Brenner’s] research is any indication, lots of people in North America and the Middle East perceive themselves as the kind of people who do religious stuff — even when they’re not actually doing anything.