Saturday, October 1

America's PTSD

I must admit that I was going to write this post a while ago, closer to the 9/11 decade anniversary.  But I didn't, because I assumed that surely someone else already wrote about it.  While I'm sure that someone did, I can't find anything.  It's true though; The United States of America has Posttraumatic Stress Disorder.  Posttraumatic Stress Disorder (PTSD) is an anxiety disorder and the good ol' USA has it and is in need of treatment.  I'm going to break down the DSM IV-TR criteria (in a vague non-copyright infringement kind of way) for PTSD and show you just what I mean.  Examination, after the jump.
 Right off the bat it should be noted that the United States used to have Acute Stress Disorder, the month after 9/11 . . . but it has been a decade and that diagnosis is no longer valid; we've had a full decade of PTSD.  Follow along at home with your own DSM on pages 467-468!

The diagnosis: 309.81 Posttraumatic Stress Disorder, Chronic
A. Exposure to an event with both of the following:
          (1)  The person (here forth meaning 'country') experienced/witnessed an event which threatened death or serious injury.  I will ask that you remember the full week of news coverage which resulted on the major networks.  Hardly a soul alive in the United States wasn't exposed to it via television images or the radio broadcasts.
         (2)  The person's response involved intense fear, helplessness, or horror.  Let's say all three were pretty ubiquitous.

B. The trauma is reexperienced in at least one of the following ways:
        (1)  Recurrent, intrusive, distressing images.  Remember how MSNBC and others play 'anniversary' footage?  Not to mention this recent news story about ads being pulled as too upsetting . . . a decade later.
        (2)  Recurrent dreams.  No, not the premonitions, we're talking more like this information Tuft's about how the central idea of 9/11 infiltrated many individual's dreams.
        (3) & (4)  Flashbacks and distressing cues.  Everything sparks a debate.  Images, audio that has to be removed, censored, taken down, etc.  Please note that of course no one should be subject to undue distress, but the fact is that when things in one's every day life prevent one from functioning or needing special accommodations . . . it's pathological.
       (5) Reactivity to distressing cues.  A mosque at ground zero?  Heresy.  This writer at breaks it down beautifully.

C.  General repression of aspects of the event, avoiding things (conversations, people, places, thoughts, feelings) associated with the event, loss of interest in activities, estrangement from others, sense of foreshortened future.  Like I mentioned above, people have been active in removing all things which might remind them of the event, the airline industry took a huge hit when people refused to step foot in an airport, people suddenly became outrageously suspicious of one another, refused to engage in enjoyable activities (especially in NYC), and immediately felt the crushing weight of a failing economy.  This left many feeling like this event was, in fact, the end of the United States and people continue to refer to the post 9/11 culture because of all the ongoing changes as a result of the reactions and accommodations following the attacks.  Remember when you could meet someone at the airport gate?

D.  Increased arousal:
         (1)  Sleep disturbance.  The 24 hour news networks were nothing until 9/11.
         (2), (4), & (5) Angry outbursts, irritability, hypervigilance and exaggerated startle response.  See above, plus, all the stories about TSA wigging out, making mothers drink breast milk, patting down toddlers, the military flinching left and right, people pushing one another's buttons on asinine and unimportant issues (see any political debate since 9/11).
         (3)  Poor concentration.  The government, wall street, schools, and people . . . all have incredibly poor follow through.  The Daily Show also illustrates the new cycle's inattention here.

E.  The symptoms last longer than one month.  Check.

F.  The symptoms impact functioning.  I'm pretty sure that the economy, social service agencies, and people who can't so much as see images of the burning towers a decade later illustrate this point satisfactorily. 

So, the United States has an illness, a disease, a pathology.  It is unwell and unhealthy.  But unfortunately, not seeking treatment.  We need some desensitization (not derealization, which is what we get from just watching the footage over and over).  We need some exposure therapy (not merely over exposure), we need to be exposed to the small pieces so we learn how to manage.  Just like how kids allergic to peanuts need to live in a world with peanuts so that they learn how to manage their symptoms (well, unless you ask @peanutfreemom).  We need some relaxation.  We need some anti-anxiety medication.  We need to feel the exhilaration of success.  We need to internalize the confidence that the United States of America is a great place.  Too often the PTSD response takes the course that the United States has; making extreme shows of power, just to ward of everyone.  Clients do it all the time.  They don't come across as brave, confident, and relieved of their symptoms.  They come across as terrified of everything and unstable.  The problem is that, just like a real person, the United States has too many moving parts.  Too many sides to every story.  Too many different parts that need to work together in order to move forward.  See Adam Chapman's video of drawings with starlings moving together to demonstrate the loveliness in separate movements working together.  Think Fleet Foxes, hey, are those starlings in that video?