The Dish

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’.

by Matthew Sitman

In a long review of three recent books about John Quincy Adams and his wife, Louisa Catherine, Susan Dunn considers the accomplishments of his post-presidential career, which saw Adams return to public life as a member of the House of Representative and take up the abolitionist cause:

Though launched anew upon what he called “the faithless wave of politics,” Adams had a guiding star, a clear path forward: the battle against American slavery. In 1831 and again in 1832, he dined with an impressive young Frenchman who queried him about the culture of democracy in America. “Do you look on slavery as a great plague for the United States?” asked Alexis de Tocqueville. “Yes, certainly,” Adams replied. “That is the root of almost all the troubles of the present and fears for the future.”

Ending slavery became Adams’s great mission. But because he understood that slavery was the one issue that could tear apart the union, he decided that, instead of taking it on frontally, he would attack it on the flanks. He aggressively defended the right of abolitionists to petition Congress and denounced the “gag resolution” that mandated the tabling of all petitions and propositions relating in any way to slavery, and he opposed Texas’s admission to the union as a slave territory. Invoking the immortal values of the Declaration of Independence, taunting his foes, barely surviving a censure resolution, he became known to sympathizers, as Robert Remini noted in his excellent short biography of Adams, as “Old Man Eloquent” and to southerners as “the Madman from Massachusetts.”

In 1847, Abraham Lincoln, a freshman congressman from Illinois, took his seat alongside Adams in the House of Representatives. John Quincy, whose mother had taken him more than seventy years before to watch the Battle of Bunker Hill from atop Penn’s Hill in Quincy, was a living link between the revolutionary generation that created a republic tragically flawed by its compromise with slavery and Abraham Lincoln, who would end slavery and rescue the republic from its own undoing.

Focusing on Fred Kaplan’s biography, John Quincy Adams: American Visionary, Carol Berkin emphasizes that “John Quincy did not find his independent voice until he was in his 70s,” when his anti-slavery activism reached its peak:

As Kaplan lays out the events that heightened Adams’ commitment to abolition, the narrative’s tempo increases and the story unfolds more powerfully. It culminates with the Amistad trials, which revolved around 53 Africans seized by Portuguese slave traders. Sold to Spanish planters, they were loaded onto the Amistad to be sent to Caribbean plantations. They rebelled, killed the captain and attempted to sail to Africa, but the ship was seized by an American brig off the U.S. coast. The Africans were imprisoned in New Haven, Connecticut. As the planters, the Spanish government and the brig captain argued over who owned this human property, abolitionists insisted the Amistad passengers were free individuals, kidnapped illegally.

When the case came to the Supreme Court, it was Adams who argued — and won — the defendants’ case. This, at last, was Adams’ moment — not a tribute to his father’s memory but a declaration of his own commitment to human equality and justice.

(Image: John Quincy Adams in 1843, via Wikimedia Commons)

by Matthew Sitman

Arguing that “American conservatives are in danger of appearing as though they had no positive idea of government at all,” Roger Scruton makes the case for the necessity and goodness of government:

The truth is that government, of one kind or another, is manifest in all our attempts to live in peace with our fellows. We have rights that shield us from those who are appointed to rule us—many of them ancient common-law rights, like that defined by habeas corpus. But those rights are real personal possessions only because government is there to enforce them—and if necessary to enforce them against itself. Government is not what so many conservatives believe it to be, and what people on the left always believe it to be when it is in hands other than their own—namely a system of power and domination. Government is a search for order, and for power only insofar as power is required by order. It is present in the family, in the village, in the free associations of neighbors, and in the “little platoons” extolled by Burke and Tocqueville. It is there in the first movement of affection and good will, from which the bonds of society grow. For it is simply the other side of freedom, and the thing that makes freedom possible.

Rousseau told us that we are “born free,” arguing that we have only to remove the chains imposed by the social order in order to enjoy our full natural potential. Although American conservatives have been skeptical of that idea, and indeed stood against its destructive influence during the time of the ’60s radicals, they nevertheless also have a sneaking tendency to adhere to it. They are heirs to the pioneer culture. They idolize the solitary entrepreneur, who takes the burden of his projects on his own shoulders and makes space for the rest of us as we timidly advance in his wake. This figure, blown up to mythic proportions in the novels of Ayn Rand, has, in less fraught varieties, a rightful place in the American story. But the story misleads people into imagining that the free individual exists in the state of nature, and that we become free by removing the shackles of government. That is the opposite of the truth.