There is a popular conception that PTSD mostly affects veterans, and a recent Internet posting sought to spread more awareness of the widespread nature of PTSD. The graph that was reblogged presented the following statistics for PTSD frequency:
Suburban police- 13%
Military veterans- 30%
Raped adults- 36%
Battered women- 45%
Abused children- 50%
The reference for these numbers doesn’t seem to exist any more, and I think this was more of a compilation of statistics. Either way, I took a look at individual studies by the NIH on PTSD and the numbers seem to be generally true.
Some people have looked at this study and said, look, soldiers are not by far the only ones who get PTSD, despite the popular narrative that says PTSD is mostly a military affliction. Yes, that’s a very good point, but I think there’s a lot more to look at here.
One thing I find particularly interesting is that, in almost all these cases except firefighters, we’re talking about situations where the people who get PTSD are in a position of complete lack of self-determinism:
* Abused children and battered women are being psychologically and physically controlled by someone who is generally stronger than they are.
* Raped adults may not be in constant relation with their rapist, but the situation again is one where the victim has little to no control.
* Soldiers and policemen have more control over themselves, but they are subservient to a strict hierarchy which imposes codes of conduct on them in a quite absolute way. Please do not interpret this as sympathy for such people, I am merely stating facts (incidentally, 40% of policemen are violent at home, which means they themselves inflict more PTSD on their wives and children).
To this list, I would also add cult members and prisoners, with the caveat that we don’t have clear statistics in either case. I have been unable to find any study regarding PTSD inflicted by cults, but it seems prevalent. In the case of prisoners, we have statistics ranging all the way from 4% to 48%, so the case isn’t clear. But these are both settings in which, again, people have no self-determinism and where PTSD occurrence is at least much higher than the average.
So what is the nature of this connection? I don’t think lack of self-determinism itself gives people PTSD, but what people make others do once they take control of them. You don’t take control over people to make them do things they’d do anyway, you take control over them to brainwash them, brutalize them or make them brutalize others. They say it takes religion to make good people do evil things, but I think any system that removes your self-determinism can do the trick. Religion just happens to be the most widespread one.
So that’s one perspective, but there’s another interesting set of studies concerning other primate species. Here they’re measuring stress levels, not PTSD. We find that they experience stress in a way that depends on their place in the hierarchy and how much control they have over their lives, in the same general way that humans do.
But there’s one interesting addendum. In his observation of baboon troops, Robert Sapolsky saw a troop get decimated by tuberculosis, killing the dominant males. The troop reorganized itself around a flatter and less aggressive hierarchy, and all the members saw their normal stress levels go down.
Another experiment done by Frans de Waal consisted of mixing up individuals from two species, one that lives under a strict hierarchy, rhesus macaques, and one that lives under a more loose hierarchy, stump tail macaques. The result was that the rhesus macaques eventually adopted the stump tail macaques’ social attitudes. This is only one experiment, but it seems that, at least in this case, lower stress was more appealing.
In general, the more strict the hierarchy, the more stressful, and one’s position in the hierarchy determines how stressful it gets (in profoundly unequal hierarchies, the subordinates are more stressed, while in flatter hierarchies the elite are more stressed).
In light of these results, the position that humans are hierarchical by nature doesn’t make much sense. If we were adapted to be in hierarchies, then they wouldn’t cause us so much stress. It seems more likely that some level of organization was adaptive but that stricter hierarchies arose from that out of purely social processes. Strict hierarchies cause stress because they put pressure on the individual to conform, to struggle for dominance, and to constantly keep one’s interests in check.
The connection between hierarchies and lack of self-determinism is not too surprising. Hierarchies are held together by control mechanisms, and control is only needed in order to make people do things they otherwise would not do. You can’t control someone into having more self-determinism, you can only control them into having less.
Now, there are plenty of cases where self-determinism can be momentarily taken away without there being a stable hierarchy behind it: usually small-scale crimes like a mugging or a break-in, for example. Likewise, not all cases of PTSD originate in hierarchies, and not all hierarchies cause PTSD. The more likely connection is that strict hierarchies are needed to bring into effect the attacks on self-determinism needed to put people in situations where they will get PTSD.
I imagine non-radicals may argue that there’s nothing inherently wrong with hierarchies, and that this is just a result of “excessive” hierarchies. I have argued for the nature of hierarchies being fundamentally evil before.
But beyond that, the hierarchies I’ve listed at the beginning are all commonplace: parenting and families, the police, and the military. These are all widely accepted as necessary for the functioning of society, and as generally beneficial. And they are all the source of incredible brutality (in fact, the brutality is the desired end result, despite complaints by advocates that it’s just “bad apples” perpetrating it).
When I talk about a strict hierarchy, I mean a hierarchy where there is a (relatively) greater power differential between the top and the bottom, where the superiors are able to exert (relatively) greater control over their inferiors, and where there is greater surveillance/coercion/regimentation over people’s lives.
Strict hierarchies are the most unegalitarian and therefore the most undesirable. Even if we assume that hierarchies are desirable in select cases (an assumption which remains completely unproven in practice), we still have a strong incentive to search for the most egalitarian solutions. People’s self-determinism is always more important than whatever controlling people is supposed to achieve.