The PTSD Hustle: A Selection from Rebecca Solnit’s A Paradise Built in Hell (2010)

“The study of disasters makes it clear that there are plural and contingent natures—but the prevalent human nature in disaster is resilient, resourceful, generous, empathic, and brave. The language of therapy speaks almost exclusively of the consequence of disaster as trauma, suggesting a humanity that is unbearably fragile, a self that does not act but is acted upon, the most basic recipe of the victim. Disaster movies and the media continue to portray ordinary people as hysterical or vicious in the face of calamity. . . .

In an era whose sense of the human psyche is dominated by entertainment and consumerism and by therapy culture—that amalgamation of ideas drawn from pop psychology and counseling—the personal and private are most often emphasized to the exclusion of almost everything else. Even the scope of psychotherapy generally leaves out the soul, the creator, and the citizen, those aspects of being human that extend into realms beyond private life. Conventional therapy, necessary and valuable at times to resolve personal crises and suffering, presents a very incomplete sense of self. As a guide to the range of human possibility it is grimly reductive. It will help you deal with your private shames and pains, but it won’t generally have much to say about your society and your purpose on earth. It won’t even suggest, most of the time, that you provide yourself with relief from and perspective on the purely personal by living in the larger world. Nor will it ordinarily diagnose people as suffering from social alienation, meaninglessness, or other anomies that arise from something other than familial and erotic life. It more often leads to personal adjustment than social change . . . . Such a confinement of desire and possibility to the private serves the status quo as well: it describes no role for citizenship and no need for social change or engagement.

Popular culture feeds on this privatized sense of self. A recent movie about political activists proposed that they opposed the government because they had issues with their fathers. The implication was that the proper sphere of human activity is personal, that there is no legitimate reason to engage with public life, that the very act of engaging is juvenile, blindly emotional, a transference of the real sources of passion. What if that government is destroying other human lives, or your own, and is leading to a devastating future? What if a vision of a better world or just, say, a better transit system is a legitimate passion? . . .

The risk for PTSD is far higher, unsurprisingly, for those who are already damaged, fragile, inflexible, which is to say that events themselves, however horrific, have no guaranteed psychic outcome; the preexisting state matters.

The term PTSD is nowadays applied to anyone who is pained at or preoccupied with the memory of a calamity, rather than only those who are so deeply impacted they are overwhelmed or incapacitated by suffering or fear. On September 14, 2001, nineteen psychologists wrote an open letter to the American Psychological Association, expressing concern over ‘certain therapists . . . descending on disaster scenes with well-intentioned but misguided efforts. Psychologists can be of most help by supporting the community structures that people naturally call upon in times of grief and suffering. Let us do whatever we can, while being careful not to get in the way.’ One of the authors of the letter told the New York Times soon after, ‘The public should be very concerned about medicalizing what are human reactions.’ That is, it is normal to feel abnormal in extraordinary situations, and it doesn’t always require intervention. Nevertheless, an estimated nine thousand therapists converged on lower Manhattan to treat everyone they could find.

The Washington Post called the belief that PTSD is ubiquitous among survivors ‘a fallacy that some mental health counselors are perpetuating in the aftermath of this tragedy.’ It was another way to depict survivors as fragile rather than resilient. Kathleen Tierney remarked, ‘It’s been very interesting during my lifetime to watch the trauma industry develop and flower. The idea that disasters cause widespread PTSD is not proven, is highly disputed. It is also highly disputed that disaster victims need any sort of professional help to get better rather than social support to get better.’”—Rebecca Solnit, A Paradise Built in Hell: The Extraordinary Communities That Arise in Disaster (2010)