The Harmony of Illusions: Inventing Post-Traumatic Stress Disorder

The Harmony of Illusions: Inventing Post-Traumatic Stress Disorder

The Harmony of Illusions: Inventing Post-Traumatic Stress Disorder

The Harmony of Illusions: Inventing Post-Traumatic Stress Disorder


As far back as we know, there have been individuals incapacitated by memories that have filled them with sadness and remorse, fright and horror, or a sense of irreparable loss. Only recently, however, have people tormented with such recollections been diagnosed as suffering from "post-traumatic stress disorder." Here Allan Young traces this malady, particularly as it is suffered by Vietnam veterans, to its beginnings in the emergence of ideas about the unconscious mind and to earlier manifestations of traumatic memory like shell shock or traumatic hysteria. In Young's view, PTSD is not a timeless or universal phenomenon newly discovered. Rather, it is a "harmony of illusions," a cultural product gradually put together by the practices, technologies, and narratives with which it is diagnosed, studied, and treated and by the various interests, institutions, and moral arguments mobilizing these efforts.This book is part history and part ethnography, and it includes a detailed account of everyday life in the treatment of Vietnam veterans with PTSD. To illustrate his points, Young presents a number of fascinating transcripts of the group therapy and diagnostic sessions that he observed firsthand over a period of two years. Through his comments and the transcripts themselves, the reader becomes familiar with the individual hospital personnel and clients and their struggle to make sense of life after a tragic war. One observes that everyone on the unit is heavily invested in the PTSD diagnosis: boundaries between therapist and patient are as unclear as were the distinctions between victim and victimizer in the jungles of Southeast Asia.


As far back as we know, people have been tormented by memories that filled them with feelings of sadness and remorse, the sense of irreparable loss, and sensations of fright and horror. During the nineteenth century, a new kind of painful memory emerged. It was unlike the memories of earlier times in that it originated in a previously unidentified psychological state, called “traumatic,” and was linked to previously unknown kinds of forgetting, called “repression” and “dissociation.”

The new memory is best known today in connection with a psychiatric malady, post-traumatic stress disorder (PTSD). PTSD was adopted by the American Psychiatric Association as part of its official nosology in 1980, and it rapidly attracted the attention of clinicians and researchers throughout the Americas, Britain, Australia, Scandinavia, and Israel. Soon afterward, a contributor to the British Journal of Psychiatry reported that he had discovered evidence of the syndrome in the Diary of Samuel Pepys, in the pages where Pepys describes his mental condition following the Great Fire of London in 1666 (Daly 1983:67). Pepys's self-reported symptoms are said to correspond to the diagnostic features listed in the official nosology—intrusive images of his frightening experience, feelings of detachment and estrangement, survivor's guilt, memory impairment, and so on— and the Diary is said to establish that PTSD existed in the past. In the following years, writers uncovered progressively earlier historical evidence of PTSD. The shadow of traumatic memory was spied beneath the surface of this passage from Shakespeare's King Henry IV, Part One (Trimble 1985:86):

Tell me, sweet lord, what is't that takes from thee Thy stomach, pleasure and golden sleep? Why dost thou bend thine eyes upon the earth, And start so often when thou sit'st alone? Why hast thou lost the fresh blood in thy cheeks, And given my treasures and my rights of thee To thick-eyed musing and cursed melancholy?

More recently, evidence of PTSD has been discovered in the Epic of Gilgamesh, which takes the disorder and its memory back to the dawn of recorded history (Boehnlein and Kinzie 1992:598; also Parry-Jones and Parry-Jones 1994).

In the following chapters, I argue that none of these writers—neither Pepys, nor Shakespeare, nor the author of Gilgamesh—was referring to the . . .

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