Note that ACOUP argues that there probably wasn't much PTSD resulting from ancient or medieval wars: https://acoup.blog/2020/04/24/fireside-friday-april-24-2020/. If this is true, there may be some characteristic of modern civilization that shapes how we respond to trauma, or perhaps trauma tends to result only from experiences that are atypical for a particular society.
Fighting in a modern war is qualitatively different than fighting in an ancient war. Ancient wars didn't have exploding artillery shells endlessly raining arbitrary death on the battlefield in a way that individual soldiers had little control over whether they lived or died.
Sadly, there's some compelling evidence to the contrary:
A study of contemporary Turkana warriors from Kenya, in a traditional society where armed cattle-raiding is a universal male experience and an immense source of social prestige, found that they were much less likely to experience *guilt and depression* compared to US combat veterans, but if anything slightly *more* likely to experience hyperarousal, nightmares, and flashbacks to combat. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8054015/
I've seen it suggested -- uh, I wish I remember the source for this, sorry, just going off of memory here -- that what seems to have possibly resulted in what we'd call PTSD back in Ancient Rome was not fighting in wars but fighting in civil wars, not killing but dishonorable killing. I have zero idea how supported this is, though, and can't even remember right now where I saw the claim...
”I think it is worth noting that the evidence really does seem to suggest to me that combatants in different societies and time periods experience the emotional turmoil and trauma of war quite differently. Apparent PTSD symptoms are very rare in ancient or medieval literature and where they do appear they are often confined to specific and unusual types of wars (civil wars, for instance, in the Roman context. All of the medieval European examples of PTSD-like symptoms I have seen come in the context of crusading).”
I had a vague memory of someone describing Roman soldiers as ”haunted by ghosts” — at first I thought it *was* one of the ACOUP posts, and that’s why I was rereading them — but it was that Reddit comment. Not a lot of sources/citations in the comment itself, but it seems there are some in the later replies.
I can think of several plausible theories, and I feel fairly sure they're all true to some extent, but not at all sure if any are the most important part of the answer:
* Sometimes having a bad experience *no one else can relate to* can screw you up worse. Like depression maybe being more of a disease in people who have purposeless lives than in people who don't have food and shelter.
* Maybe older society converged on culture/strategies that helped people function past the bad things
* Maybe people *had* to function, and if not they got put in a different box ("mad" or "madhouse" or "convent" or "troublemaker" or "nervous" or "disturbed") and not really counted among what "people experience"
* Maybe humans are "designed" to be somewhat resilient to "occasion really bad things" but something else like "constant apprehension" is actually worse. Like we have a model for "grief" that does involve grieving, sometimes for a long time, but (usually but not always) recovering, which probably fits an older world better than the current one.
* Maybe a big minority of people were screwed up, but it became more stark with things like shell shock in WWI suddenly affecting a much bigger proportion than immediately before, and modern society being less awful overall the people who are screwed up stand out more?
* Maybe the people who got screwed up weren't in a class of people that got listened to when written about
Some of those are contradictory, speculating that some things got better and some bad things got more prevalent. I suspect there's an overlap but I don't know how.
Note #4 confused me at first, because my first expectation of someone proposing orchid/dandelion theory is that they think it's virtuous to be an exotically beautiful orchid even if it makes them higher maintenance.
There's also the Peter Levine theory that going off and shaking for a while prevents PTSD, but modern civilization is less likely to give people a chance to do that. The trauma (say, being in a war) doesn't give the opportunity to get away, or people think shaking is a sign of weakness and don't do it or whatever.
I'm just as confused by these things as you are, and I don't have great answers, but here's some random wild guesses based on what I've got so far.
1. Trauma is mostly overlearning. It makes people dysfunctional when they learn the wrong thing. For example, if a man rapes a woman, the woman might "learn" on an instinctual level that all men are rapists, which makes it hard to engage in positive interactions with men. Or if a soldier is shelled, he might "learn" that loud noises = high risk of death.
2. The maladaptive effects of trauma are just maladaptive effects of anxiety (eg panic attacks). If you overlearn that all men are rapists, and then you spend time with a man, you'll be very anxious, and high anxiety causes panic attacks in susceptible people. Being very anxious is the correct response if you're spending time with someone who will probably rape you.
3. People overlearn because instinctual learning is hard; instinctual learning algorithms are hard-wired from before we evolved rationality, and they have to use dumb heuristics to decide what to learn when.
4. These algorithms take something like cultural context into account, somehow. If your whole tribe's way of life is based on gathering honey, and a few bee stings a month is considered normal, you don't want to overlearn a terror of bees - but if snakes in your area are very dangerous and often kill people, you do want to overlearn a terror of snakes. Maybe a modern equivalent would be having a very bad experience at the dentist vs. getting raped - these might involve similar amounts of physical pain, but cultural context tells you that the dentist is a normal and useful experience you should let pass, but the rape isn't. In the past, "everyone knew" that fighting in wars and having kids die was normal, and so people's brains didn't consider these to be shocking events that were worth making giant updates on.
I realize 3 and 4 sort of contradict each other - like I said, I'm really fuzzy on this and just making guesses.
I suspect that the massive death rates of the past helped "cover up" many problems.
We keep alive a lot of people who would've died in the olden days. And while they live, they visibly suffer from the things that would've killed them. This looks bad, but it's actually a good thing.
To be clear, I'm not just talking about people saved by modern medicine: a subsistence farmer who can't farm can't subsist. Nowadays there's a lot more food to go around, and society is much more able to carry "unproductive" citizens.
The common bro advice after a breakup (to a man, at least) is to dive into some all-consuming activity, ideally involving travel. A more controversial piece of advice is to find a new girl ASAP for a rebound, which sometimes works and sometimes really doesn't.
I think a lot of cultures have anti-trauma immune systems that prevent people from dwelling on it and reinforcing it, in a "neurons that fire together wire together" kind of way. Perhaps a premodern mindset also helps - if everything is about your tribe or God or whatever the fuck, what happened to you last night isn't that big of a deal.
Thank you for posting this, I certainly have opinions.
Bessel Van Der Kolk wrote the first "canonical" book on PTSD, and Scott Alexander has reviewed that - AFluffleOfRabbits has already posted the link. It doesn't fully answer the "why?" question but at least sketches out an operational mechanism that it seems one can sometimes address with therapy: trauma causing the mind to disconnect from the body in some ways.
If another book Scott Alexander reviewed is correct, namely The Secret of Our Success (https://slatestarcodex.com/2019/06/04/book-review-the-secret-of-our-success/) then social effects are certainly strong enough to reinterpret signals from pain receptors as pleasure - the example in the book (not in Scott's review, but page 110 in the original) is how chili peppers, whose capsicum produces a pain response, are nonetheless part of some cultures' diet and they enjoy the sensation. And then there's the whole bit in Ch. 14 called "it hurts so good". So the idea that PTSD could be culturally mediated in some ways - WITHOUT of course this putting any blame or moral weight on the victims of abuse - seems possible.
It seems like our brains have the ability to go into "trauma mode", and some combination of traumatic events, possibly mediated by cultural expectations, can flip the switch.
But what I really came here to say is that, according to The Life Recovery Method, a short book by one Robert Cox, there is a group of people whose brains are either born in trauma mode or spontaneously enter it in the first years of their lives without any of the events we'd normally consider traumatic - in particular, this happens even when these children are not abused. And it seems to me that in this case the "trauma" cannot be culturally or socially mediated.
Cox's argument is that this condition is the one we diagnose as autism, and that from his personal experience, trauma therapies work on autistic kinds in many cases where behaviourist ones like ABA fail. Indeed, his book's subtitle is "Autism treatment from a trauma perspective."
I like this theory because it is both compassionate, suggests an action that seems to work at least sometimes (try autistic kids on the therapies you'd give traumatised kids), and explains some points like sensory issues and stimming as coming from the disconnect-with-the-body model of PTSD. Nancy Leibovitz mentions the theory that going off and shaking for a while prevents or lessens PTSD - entirely plausible in the body-keeps-the-score model - so maybe stimming is partly autistic people discovering for themselves a way to mitigate the effects of their "trauma"?
That sounds like group selection. Orchid genes have to benefit the individual (strictly the gene) to thrive- it's not use them benefiting the species as a whole. Unless I'm misunderstanding the point?
Note that ACOUP argues that there probably wasn't much PTSD resulting from ancient or medieval wars: https://acoup.blog/2020/04/24/fireside-friday-april-24-2020/. If this is true, there may be some characteristic of modern civilization that shapes how we respond to trauma, or perhaps trauma tends to result only from experiences that are atypical for a particular society.
Fighting in a modern war is qualitatively different than fighting in an ancient war. Ancient wars didn't have exploding artillery shells endlessly raining arbitrary death on the battlefield in a way that individual soldiers had little control over whether they lived or died.
Sadly, there's some compelling evidence to the contrary:
A study of contemporary Turkana warriors from Kenya, in a traditional society where armed cattle-raiding is a universal male experience and an immense source of social prestige, found that they were much less likely to experience *guilt and depression* compared to US combat veterans, but if anything slightly *more* likely to experience hyperarousal, nightmares, and flashbacks to combat. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8054015/
I was about to post that link - but also to mention, that ACOUP has also done a series debunking the myth of the universal warrior: https://acoup.blog/2021/01/29/collections-the-universal-warrior-part-i-soldiers-warriors-and/ . Modern war is very unlike ancient war in many ways.
I've seen it suggested -- uh, I wish I remember the source for this, sorry, just going off of memory here -- that what seems to have possibly resulted in what we'd call PTSD back in Ancient Rome was not fighting in wars but fighting in civil wars, not killing but dishonorable killing. I have zero idea how supported this is, though, and can't even remember right now where I saw the claim...
I had a similar memory and reread the Universal Warrior posts, and found something here: (https://acoup.blog/2021/02/12/collections-the-universal-warrior-part-iib-a-soldiers-lot/)
”I think it is worth noting that the evidence really does seem to suggest to me that combatants in different societies and time periods experience the emotional turmoil and trauma of war quite differently. Apparent PTSD symptoms are very rare in ancient or medieval literature and where they do appear they are often confined to specific and unusual types of wars (civil wars, for instance, in the Roman context. All of the medieval European examples of PTSD-like symptoms I have seen come in the context of crusading).”
And he gives a link to this comment on a reddit post: https://www.reddit.com/r/AskHistorians/comments/1j6ssm/are_there_any_indications_of_combat_ptsd_in/cbbvfib/
I had a vague memory of someone describing Roman soldiers as ”haunted by ghosts” — at first I thought it *was* one of the ACOUP posts, and that’s why I was rereading them — but it was that Reddit comment. Not a lot of sources/citations in the comment itself, but it seems there are some in the later replies.
I can think of several plausible theories, and I feel fairly sure they're all true to some extent, but not at all sure if any are the most important part of the answer:
* Sometimes having a bad experience *no one else can relate to* can screw you up worse. Like depression maybe being more of a disease in people who have purposeless lives than in people who don't have food and shelter.
* Maybe older society converged on culture/strategies that helped people function past the bad things
* Maybe people *had* to function, and if not they got put in a different box ("mad" or "madhouse" or "convent" or "troublemaker" or "nervous" or "disturbed") and not really counted among what "people experience"
* Maybe humans are "designed" to be somewhat resilient to "occasion really bad things" but something else like "constant apprehension" is actually worse. Like we have a model for "grief" that does involve grieving, sometimes for a long time, but (usually but not always) recovering, which probably fits an older world better than the current one.
* Maybe a big minority of people were screwed up, but it became more stark with things like shell shock in WWI suddenly affecting a much bigger proportion than immediately before, and modern society being less awful overall the people who are screwed up stand out more?
* Maybe the people who got screwed up weren't in a class of people that got listened to when written about
Some of those are contradictory, speculating that some things got better and some bad things got more prevalent. I suspect there's an overlap but I don't know how.
Note #4 confused me at first, because my first expectation of someone proposing orchid/dandelion theory is that they think it's virtuous to be an exotically beautiful orchid even if it makes them higher maintenance.
AFAIK Scott Alexander hasn't tried to answer this question (yet) but he has touched on it before in his review of The Body Keeps the Score:
https://slatestarcodex.com/2019/11/12/book-review-the-body-keeps-the-score/#:~:text=better%20than%20that.-,Why%20does%20PTSD%20exist%3F,-%E2%80%9CThe%20brain%20isn%E2%80%99t
There's also the Peter Levine theory that going off and shaking for a while prevents PTSD, but modern civilization is less likely to give people a chance to do that. The trauma (say, being in a war) doesn't give the opportunity to get away, or people think shaking is a sign of weakness and don't do it or whatever.
I'm just as confused by these things as you are, and I don't have great answers, but here's some random wild guesses based on what I've got so far.
1. Trauma is mostly overlearning. It makes people dysfunctional when they learn the wrong thing. For example, if a man rapes a woman, the woman might "learn" on an instinctual level that all men are rapists, which makes it hard to engage in positive interactions with men. Or if a soldier is shelled, he might "learn" that loud noises = high risk of death.
2. The maladaptive effects of trauma are just maladaptive effects of anxiety (eg panic attacks). If you overlearn that all men are rapists, and then you spend time with a man, you'll be very anxious, and high anxiety causes panic attacks in susceptible people. Being very anxious is the correct response if you're spending time with someone who will probably rape you.
3. People overlearn because instinctual learning is hard; instinctual learning algorithms are hard-wired from before we evolved rationality, and they have to use dumb heuristics to decide what to learn when.
4. These algorithms take something like cultural context into account, somehow. If your whole tribe's way of life is based on gathering honey, and a few bee stings a month is considered normal, you don't want to overlearn a terror of bees - but if snakes in your area are very dangerous and often kill people, you do want to overlearn a terror of snakes. Maybe a modern equivalent would be having a very bad experience at the dentist vs. getting raped - these might involve similar amounts of physical pain, but cultural context tells you that the dentist is a normal and useful experience you should let pass, but the rape isn't. In the past, "everyone knew" that fighting in wars and having kids die was normal, and so people's brains didn't consider these to be shocking events that were worth making giant updates on.
I realize 3 and 4 sort of contradict each other - like I said, I'm really fuzzy on this and just making guesses.
I suspect that the massive death rates of the past helped "cover up" many problems.
We keep alive a lot of people who would've died in the olden days. And while they live, they visibly suffer from the things that would've killed them. This looks bad, but it's actually a good thing.
To be clear, I'm not just talking about people saved by modern medicine: a subsistence farmer who can't farm can't subsist. Nowadays there's a lot more food to go around, and society is much more able to carry "unproductive" citizens.
The common bro advice after a breakup (to a man, at least) is to dive into some all-consuming activity, ideally involving travel. A more controversial piece of advice is to find a new girl ASAP for a rebound, which sometimes works and sometimes really doesn't.
I think a lot of cultures have anti-trauma immune systems that prevent people from dwelling on it and reinforcing it, in a "neurons that fire together wire together" kind of way. Perhaps a premodern mindset also helps - if everything is about your tribe or God or whatever the fuck, what happened to you last night isn't that big of a deal.
Thank you for posting this, I certainly have opinions.
Bessel Van Der Kolk wrote the first "canonical" book on PTSD, and Scott Alexander has reviewed that - AFluffleOfRabbits has already posted the link. It doesn't fully answer the "why?" question but at least sketches out an operational mechanism that it seems one can sometimes address with therapy: trauma causing the mind to disconnect from the body in some ways.
If another book Scott Alexander reviewed is correct, namely The Secret of Our Success (https://slatestarcodex.com/2019/06/04/book-review-the-secret-of-our-success/) then social effects are certainly strong enough to reinterpret signals from pain receptors as pleasure - the example in the book (not in Scott's review, but page 110 in the original) is how chili peppers, whose capsicum produces a pain response, are nonetheless part of some cultures' diet and they enjoy the sensation. And then there's the whole bit in Ch. 14 called "it hurts so good". So the idea that PTSD could be culturally mediated in some ways - WITHOUT of course this putting any blame or moral weight on the victims of abuse - seems possible.
It seems like our brains have the ability to go into "trauma mode", and some combination of traumatic events, possibly mediated by cultural expectations, can flip the switch.
But what I really came here to say is that, according to The Life Recovery Method, a short book by one Robert Cox, there is a group of people whose brains are either born in trauma mode or spontaneously enter it in the first years of their lives without any of the events we'd normally consider traumatic - in particular, this happens even when these children are not abused. And it seems to me that in this case the "trauma" cannot be culturally or socially mediated.
Cox's argument is that this condition is the one we diagnose as autism, and that from his personal experience, trauma therapies work on autistic kinds in many cases where behaviourist ones like ABA fail. Indeed, his book's subtitle is "Autism treatment from a trauma perspective."
I like this theory because it is both compassionate, suggests an action that seems to work at least sometimes (try autistic kids on the therapies you'd give traumatised kids), and explains some points like sensory issues and stimming as coming from the disconnect-with-the-body model of PTSD. Nancy Leibovitz mentions the theory that going off and shaking for a while prevents or lessens PTSD - entirely plausible in the body-keeps-the-score model - so maybe stimming is partly autistic people discovering for themselves a way to mitigate the effects of their "trauma"?
If there were no orchids, maybe abuse among dandelions would get out of hand, which would be bad for reproductive success.
That sounds like group selection. Orchid genes have to benefit the individual (strictly the gene) to thrive- it's not use them benefiting the species as a whole. Unless I'm misunderstanding the point?
You're correct. I was unaware that group selection isn't a mainstream view: https://en.wikipedia.org/wiki/Group_selection#Criticism