19 ms·

Was there PTSD in the ancient or medieval world?

216 points by apsec112 7y ago

jka 7y ago
A potential counterpoint - "Post-traumatic stress 'evident in 1300BC'"[1]. The technology, tools and languages available to humans has expanded a huge amount over recent centuries. The question, I guess, is whether the psychological consequences of experiencing and processing reality (and, particularly, trauma) has changed as a result. [1] - https://www.bbc.co.uk/news/health-30957719 https://www.bbc.co.uk/news/health-30957719
- papeda 7y ago
  The featured article's pitch is that there's still way more historical writing about war, including ignoble stuff, and this imbalance still strongly suggests that PTSD was somehow much less common. (It's also funny that the BBC article mentions the strong Herodotus PTSD example that the featured article treats as a repeatedly-rehashed outlier.)
papeda 7y ago
On a related note, a while ago I read a little about how ancient families coped with the deaths of their children. My takeaway, pretty much cribbed from this article [1], was that such deaths produced less trauma than they would today because: (1) More families lost children. This lessened the trauma because a family could talk to other nearby families who had experienced the same thing. Those families would also be able to give advice. In contrast, losing a child is extremely rare (in developed countries) today. This rarity breeds isolation, which makes everything worse. (2) There were established societal and religious ways to deal specifically with the death of a child. Think prescribed ceremonies that grant a form of closure and which pretty much all of your friends and neighbors subscribe to. Nothing like this exists today. To me, this is very similar to the suggested explanation in the featured article for why war used to cause less PTSD: there was less stigma around war, a much larger chunk of society fought in wars, and there were universal and well-defined rituals for processing the experience. The whole thing raises interesting questions about our modern understanding of trauma. I think the most common modern statement on grief is that it's intensely personal and people should never feel that their grieving process is "wrong", at least not for a long time (years?) after the event. That at least seems different than past practice. [1] https://www.jstor.org/stable/642999?seq=1 https://www.jstor.org/stable/642999?seq=1
- cletus 7y ago
  You don't even need to go to the ancient world to see this. A rudimentary look at genealogy will show you that even in the 19th century. If a child under 2 dies, you'll often see reuse of that name for the next child. There were cultural standards, particularly in Europe, around naming children after paternal and maternal grandparents and so forth (such that often you can tell what number a child was by their name if you know the relative's names). Think about that for a second. Let's say you had a child who died at 6 months old. 1-2 years down the track you had another child and you'd use the same name. We have totally different expectations of mortality than a century ago. A child born today in the developed world is incredibly likely to make it to adulthood. It's simply not conceivable than in an era of greater infant mortality that there weren't different attitudes to the death of a child.
  - DyslexicAtheist 7y ago
    that's actually a pretty effective way for overwriting/replacing your bad memories with something new. Less drastic / and practical examples: Say you went through a really bad breakup and your partner let you down by cheating on you with your best friend. You still love them and really want to those memories gone. You got 2 options: 1) stop listening to favorite songs, no longer visit specific restaurants or pubs, stop doing a sport you did together, 2) replace these memories by doing exactly those things with your new partner. soon you will have forgotten about them. Instead what remains is that activity/place now being your memory and not associated to another person (or the 2 of you).
    - SketchySeaBeast 7y ago
      I wouldn't recommend letting your new partner know that you're doing that though.
      - DyslexicAtheist 7y ago
        yes would be a very bad idea :-/ there would probably be better examples (dealing with a breakup was in retrospect a terrible use-case to make my point).
drewbeck 7y ago
Really interesting, tho I wish he cited or talked to some psychologists as well! I wonder if the specific tools of war are a factor as well — the suddenness of explosions and bullets might provide a significantly more traumatic experience than spear sword and trebuchet, the pace of humvees and airplanes more shock than feet and horses.
- LordHeini 7y ago
  I doubt that standing there as a poor peasant with a spear, while getting charged by a horde of knights on massive battle horses in full armour is any less traumatic than the crack of a snipers bullet whizzing over ones head. And medieval combat was quite a gruesome affair, cleaving people into peaces with axes and swords, in an age without proper medical care... What has changed though, is the staying power of armies which nowadays can stay in contact for long times with somewhat low intensity fighting going on all the time. This of course changes the whole psychology aspect, its not the stress of one battle going on for a day or so, but the stress of a battle going on for weeks.
  - XorNot 7y ago
    Mmmm I'm deeply wary of an absence of evidence about a condition which civilization today still can't actually acknowledge properly existing being evidence of its absence. "Gun cleaning" accidents, as the socially accepted cover for male suicide by people everyone wants to ignore were suffering from depression or PTSD.
    - keithnoizu 7y ago
      See fan death in korea.
    - catalogia 7y ago
      > "Gun cleaning" accidents, as the socially accepted cover for male suicide by people everyone wants to ignore were suffering from depression or PTSD. There's no doubt that happens, but on the other hand gun cleaning injuries (e.g. to limbs) are far from unheard of, as well as people accidentally putting holes in their house. Those are doubtlessly accidents, so I have no doubt that some of the "gun cleaning fatal accidents" truly were accidents. Any of these accidents should be prevented by dogmatically following basic safety procedures, but obviously sometimes some people don't. And sometimes, that has fatal consequences.
distances 7y ago
This is such a popular topic that AskHistorians has a whole section [0] in their FAQ devoted for this. [0] https://www.reddit.com/r/AskHistorians/wiki/faq/militaryhistory#wiki_post_traumatic_stress_disorder https://www.reddit.com/r/AskHistorians/wiki/faq/militaryhist...
goodcanadian 7y ago
A video covering the same topic that I thought was reasonably well done: https://www.youtube.com/watch?v=FDNyU1TQUXg https://www.youtube.com/watch?v=FDNyU1TQUXg Edit: one thing covered in the video, but not mentioned in the article is the different experience of what war means in modern times. From WW1 (actually, a bit earlier), modern high explosives mean that soldiers spend days, weeks, even months under high stress and constant threat of death. Ancient soldiers tended to participate in violent, but relatively short battles (a day or two at most). The vast majority of the time, they were not under the same levels of stress.
cletus 7y ago
If you're so inclined to go down a rabbit hole of 100+ hours of content, I highly suggest having a listen to Dan Carlin's Hardcore History [1]. Dan is particularly interested in military history, especially ancient military history. He has an episode on Caesar's conquest of Gaul (which he argues in any kind of modern context would be called a genocide) as well as a series on the great Persian kings, called the King of Kings. This is specifically about the Achaemenid Empire talking about Cyrus II, Darius, Xerxes and the likes. Now as Dan would say, he doesn't find scientific and technological advancements particularly interesting (from a historical perspective). Like if Edison didn't invent the light bulb, someone else would've. What he finds far more interesting is historical events that could've completely changed the course of history and one of those was the Battle of Marathon [2]. This was a battle between the Persians and the Greeks that the Greeks somehow won. Had they lost it would've changed the entire history of Europe given how important Greek culture was to everyone from the Romans on. Bear in mind when this happened, Rome was a small regional power at best. He talks about the psychology of ancient warfare. One thing he notes is that the closer someone is to someone, the harder it is for them to (psychologically) kill them. From a gun at a distance is completely different to hand-to-hand combat. At this time, the Greeks fought with spears that were very broad. Stab someone in the guts with one of those and their insides would literally spill out to the point where the likes of Herodotus described the ground at Marathon as being soaked red in blood. Likewise, ancient culture and justice must be almost incomprehensible to us. Fun fact: the origin of the word "decimate". When a province rebelled against Roman Rule and Rome would crush them, insurrection was punished particularly harshly. People would be put in groups of 10 (hence DECImate) where each group was responsible for choosing which of those 10 would die and for killing that person. How did people cope with these things? How would PTSD fit into this world? EDIT: the way some downvote on HN makes me sad. [1]: https://www.dancarlin.com/ https://www.dancarlin.com/ [2]: https://en.wikipedia.org/wiki/Battle_of_Marathon https://en.wikipedia.org/wiki/Battle_of_Marathon
- Amezarak 7y ago
  Decimation was a military punishment. I cannot think of any time it was used on civilians. It was employed not just for mutiny, but for desertion and cowardice. If your unit panicked and routed during a battle, it might very well be subjected to decimation later - probably a powerful motivator.
forgotmypw16 7y ago
The way I see it, in the ancient world, PTS"D" served a purpose... If you saw "some shit" like your tribesmate getting mauled by a bear/tiger, it was helpful to your survival to be on high alert if you ever encountered a situation similar to the one where that happened. The complex of stimili was imprinted to a certain synapse pathway, and anytime you felt like you were in the same situation as before, you would want to be on extra-high-alert fight or flight mode.
third_I 7y ago
I'm sorry but this has to be the most un-scientific account I've read on the topic (granted, I read few), and it's incredibly misleading. - Humans did not change biologically enough in 10,000 years, let alone 2,000, to produce a meaningfully different psychology. Take a a child born 2,000 years ago, raise them today, and you'll get just a regular human being. Same thing backwards. - The entirety of the author's 'hypothesis' (sic) rests upon ignoring that nurture, context, is highly determinant in forming psychological references, relative perceptions, hence reactions, profiles. This is wrong, nature isn't 100%, you simply can't take two identical beings, put them in vastly different contexts and hope they present the same behaviors and perceptions. It makes no sense. Hello Darwin, wish you were here. - “the absence of evidence”... Again, wrong. Historical psychology is a thing. Author may be well-meaning, but they should adopt a transdisciplinary approach if they are to talk about multiple disciplines at once. Find a good psychologist, work together as one on the topic long enough to form a legitimate hypotheses, then maybe make some conclusions. - It seems the author also neglected to take into account philosophy, which used to be 99% practical back then. Recipes for good living. Guess why it was widely taught and shared, pretty much the basis of any education, throughout life. Guess why Seneca wrote his letters. What's the point of ignoring just about the closest thing to psychology sessions? Why is Stoicism not in that essay? I feel like I've just read a mathematician trying, painfully, to speak of epidemiology. (forgive the "modern" reference, I think it's fitting as we speak) Whatever your core expertise, armchair-other disciplines is a slippery slope. I guess the author somehow mistook his own intelligence for knowledge in psychology. Say whatever you want about our past, you won't find a psychologist or biologist to tell you we've changed in any way, shape or form "inside". The context, however, ah, the context. Well for that, this thread on HN is much more eloquent, I must say. It's almost as if people collectively had insight! (because this is written: "/s", of course they do, and I wish the author didn't simply write solo or fail to question or quote others. Here's food for thought: the very fact of "talking about your feelings" is very modern, that's a totally different context. We just didn't dwell on that topic as much in history (hence why, perhaps, some literature became so notorious, because it spoke of something that people weren't used to). It was "fluff". Hence why, when we made "emotions" a matter of science, it became a more acceptable topic, not just for a few who dared. It became "mainstream". (I'm NOT a specialist, so don't quote me on this but Freud, Jung, positivism, is probably where/when to look for a major shift; before that it was "magic", fluff, but it doesn't mean it wasn't "real", like belief in supernatural forces is "magic" but real to the psyche). Imagine that, in the future, we turn some (currently) elusive aspect of our psyche (like belief indeed), into a form of science, of applied psycho-bio-model-mechanics (like we do cognitive sciences today, a scientific progress over prior centuries). Now imagine some author versed in history but oblivious to psychology and biology, centuries from now, claiming in some random short post that people in the 21st century did not experience any tension in that regard because they didn't have words for it. Well, we may not have the words indeed, not yet; but we certainly experience the tensions with beliefs (supernatural or otherwise), heck we made wars because of it. Just like kings of old have waged war because their feelings commanded them to. That, my friend, is ethnocentricity of a temporal form (not strictly spatial as is usually the implication with that notion). At best, it's blinding Omphaloskepsis. Edit: lovely downvotes! So, you think PTSD is a modern thing. You think human psychology has changed dramatically in a few centuries. Alright, point taken! FWIW, I've spoken with psychologists explicitly about this question, and my view is informed by their conclusions. You may wish to rethink your modern bias on biology.
rsynnott 7y ago
One thing I'd question here is that conditions during the second Punic War were normal. They very much weren't; it was an existential crisis. My impression was that for most of its history, Rome's armies simply weren't particularly large. And that re-integration into civilian life may not have been as common as all that; terms of military service were very long, and there was a tendency to form soldier colonies as a solution for dealing with pensioned-off soldiers. These societies were also far, far more violent than ours. The sort of random violence that might be attributed to PTSD today would likely be part of the background noise in Medieval Italy, say.
leroy_masochist 7y ago
Another interesting angle on this question comes from the Jaynes bicameral mind hypothesis [0]. Given that a major component of PTSD is moral injury -- e.g., I can't believe someone intentionally did that to me / I can't believe I had to do that to someone else -- I wonder whether (if the bicameral mind theory is true which I think it is) ancient warriors experienced PTSD not as internal angst but rather as a "dialogue among the gods" that happened in one's head following stress. [0]: https://en.wikipedia.org/wiki/Bicameralism_(psychology) https://en.wikipedia.org/wiki/Bicameralism_(psychology)
manishsharan 7y ago
Emperor Ashoka of Magadha (India) fought a bloody war against the kingdom of Kalinga. The carnage wrought by war moved him deeply . He converted to Buddhism and he is responsible for spreading Buddhism to much of Asia. Was this because of PTSD ? The sorrow and remorse he felt was real and changed him from a ambitious emperor to a deeply spiritual person.
aklemm 7y ago
Sometimes I think PTSD is the standard human experience. Industrialization, certain civil/human rights, and psychology insights have changed that some.
gdubs 7y ago
I always wondered if Achilles was struggling with PTSD during The Iliad. He had seen so much fighting and bloodshed that he became depressed and sat in his tent, refusing to budge. Maybe the anger at Paris was just a front.
- goto11 7y ago
  He is "cured" from depression when his friend is killed, and he thrown himself back into battle. So it does sound more like sulking than PTSD.
  - gdubs 7y ago
    He kinda goes into a blind rage though, which could still fit. Further complicating things — they drink wine relentlessly throughout.
- cam- 7y ago
  The first hysterical blindness was documented by Herodotus in the battle of Marathon, "Epizelos the son of Cuphagoras, while fighting in the close combat and proving himself a good man, was deprived of the sight of his eyes, neither having received a blow in any part of his body nor having been hit with a missile, and for the rest of his life from this time he continued to be blind"
yboris 7y ago
I wonder if PTSD is particularly likely when the terrible events occur spontaneously without obvious warning. Modern weaponry that allows one to die without an enemy visible probably exacerbates things. In the olden days you'd be charging towards the enemy for at least a while before you witnessed your comrades getting killed.
- RyJones 7y ago
  On Killing[0] covers some of this. The author argues that extended demob times in WW2 helped; supposedly, this is why people leaving Iraq and elsewhere end up "doing nothing in Kuwait" for weeks on end cleaning equipment. [0]: https://en.wikipedia.org/wiki/On_Killing https://en.wikipedia.org/wiki/On_Killing
  - deleted 7y ago
    [deleted]
  - yboris 7y ago
    I wonder if this is also related to "peak-end rule" https://en.wikipedia.org/wiki/Peak%E2%80%93end_rule https://en.wikipedia.org/wiki/Peak%E2%80%93end_rule People generally seem to remember the 'height' of an experience and the last parts of it. So an experience at a dentist where the last part of the procedure is a mild bit of additional drilling is 'better' than one that ends on a painful 'note'.
throwaway627348 7y ago
One book that explores this topic from a clinical perspective, supported by faithful translations from The Iliad, is "Achilles in Vietnam" [1] by Dr. Jonathan Shay [2]. [1] https://muse.jhu.edu/article/26751 https://muse.jhu.edu/article/26751 [2] https://en.wikipedia.org/wiki/Jonathan_Shay https://en.wikipedia.org/wiki/Jonathan_Shay
crazygringo 7y ago
Excellent counterpoint from r/AskHistorians (paragraph breaks added for legibility): [1] > Cross-cultural psychologists have observed that, regardless of cultural background, people who suffer persistent emotional disturbances in the wake of a traumatic event exhibit intrusive memory symptoms in some form. Here in the US, these are closely related to what we commonly call "flashbacks." For the Romans, people experiencing intrusive memories were said to be haunted by ghosts. These individuals show up in historical, philosophical, and even medical texts. > Josephus, who was an outsider to Roman culture, also describes this phenomenon in his history of The Great Revolt. Those haunted by ghosts are constantly depicted showing many symptoms which would be familiar to the modern PTSD sufferer. Insomnia, depression, mood swings, being easily startled, frequent eye movement, alertness all day and night, paranoia, avoidance of crowds, suicidal thoughts/attempts, loss of appetite, shaking/shivering, self-hatred, and impulsive violence have all turned up in association with these individuals. > Since in almost every case the person experiencing these things had made himself an object of public shame, the "ghosts" in question often came in the form of those he had killed or wronged in the past. These would either appear spontaneously to the sufferer, or would come in the form of vivid, frightening nightmares. > The key component to these experiences, as with modern cases of PTSD, was that the sufferer had no control over his own symptoms. Thoughts or vivid memories would occur unexpectedly and uncontrollably. It is easy to see why the Romans, who were religiously superstitious to begin with, would attribute such things to the foul play of malicious spirits. [1] https://www.reddit.com/r/AskHistorians/comments/1j6ssm/are_there_any_indications_of_combat_ptsd_in/cbbvfib/ https://www.reddit.com/r/AskHistorians/comments/1j6ssm/are_t...
- mattigames 7y ago
  Plus there has been strong indicators that other animals can suffer from PTSD e.g. https://onlinelibrary.wiley.com/doi/abs/10.1111/ejn.12860 https://onlinelibrary.wiley.com/doi/abs/10.1111/ejn.12860
  - kylek 7y ago
    Astounding that we’d think otherwise.
  - 7y ago
sorokod 7y ago
I would suggest that some forms of medieval entertainment would cause PTSD in a modern person. From public executions, through bear baiting[1] and cat torture[2]. The (unstated) assumption the people in the past "were just like us" emotionally, deserves closer scrutiny. I believe that the magnitude of trauma inflicted by a certain experience is relative to what is considered to be the norm in the time and place. The norms of "ancient" people were different from those of the 21st century [1] https://en.wikipedia.org/wiki/Bear-baiting https://en.wikipedia.org/wiki/Bear-baiting [2] https://www.atlasobscura.com/articles/ritualistic-cat-torture-was-once-a-form-of-town-fun https://www.atlasobscura.com/articles/ritualistic-cat-tortur...
- ThrowawayR2 7y ago
  Even butchering livestock for food, more or less a routine household chore in the past, is sufficiently alien today to most that it would likely cause PTSD if they had to do it.
  - Ididntdothis 7y ago
    On the other hand a lot of people today can watch super intense horror movies which probably would have traumatized ancient people.
    - ThrowawayR2 7y ago
      One is real, with sights and smells linked to millennia of instinct and the knowledge that you yourself are the primary agent of what is occurring to the livestock. The other you know is fiction which you can criticize the script, special effects, and cinematography of from a comfortable chair, often with friends. I don't think the two really compare.
      - Ididntdothis 7y ago
        I think they compare for some people. I can handle real world situations better than movies. I think it's because the movie only stimulus some senses (sight and hearing) whereas the real world experience is complete.
tapland 7y ago
I didn't see anyone mentioning this but it would partially explain both the "there wasn't more in a violent world so it's weakness/was normal" arguments as well as the "we haven't changed genetically so!" arguments. Today we have much less violence than ever before, we live more comfortable lives, people are healthier and mistreating others is often illegal and pushed back against from both governments and the population itself. Because of that people who experience horrible events are less likely to have anyone around them with that shared experience. We have, afaik, less occurrence of PTSD when something horrible happens to an entire community, and less mental illness when an entire community is facing a difficult situation. But for an individual experiencing horrible and horrifying events you not only have the event itself, but a total lack of anyone even remotely close to having had the same experience. I have a relative with diagnosed (you really have to specify it) PTSD and I have absolutely no experience remotely close to the ones this person has faced, in an environment where there was no escape (family). Afterwards noone seem to understand their reactions, fears (people, loud noises) and feelings, but apparently feel that they are qualified to give advice and to just do things because 'there is no way you are actually physically being limited by your body and I know exactly how you feel because I have the exact same because my dad used to yell at me when I refused to take out the trash now and then'. This reaction is of course commonplace online, and online help groups have plenty of undiagnosed people who don't seem to be limited in any unusual way or have had any traumatic event, but who then cause stress for those who don't have coworkers or friends or can go do things in public and who really need the online space. But it's also closer to the reaction and acting most people in real life have to it, and in some cases even mental health professionals, than it is to having had a similar experience. There just seems to be a too large gap between people who have it average by todays standards and thise who've faced horrible traumas. I notice a lot of stress in my daily life today with the covid-19 pandemic, where I'm in Sweden where life seems to be going along as normal, while I'm in three separate risk groups, two for serious illnesses and one for the immunosupressants used to treat them, and where I get questioned by my doctors, friends and family as to why I don't want to go to thr clinic or socialize. I can't walk further than a block away because noone keeps any distance and joggers come brushing by from behind. It feels like this is also caused by the different experience. "Why can't they keep their distance, aren't we supposed to do that? Why do they assume I'm not in a risk group and assume that none they see could possibly be?". And this is still an experience they know a lot of people are having and know a lot about through media. I just think having others that you share your overall experience with helps a lot, and with much better lives in average the distance between those who have it OK and those who have it the worst has increased.
valuearb 7y ago
Is there PTSD in the modern world? Reproducibility crisis says dunno?
stared 7y ago
Animals do feel PTSD, see https://www.frontiersin.org/articles/10.3389/fnbeh.2012.00026/full https://www.frontiersin.org/articles/10.3389/fnbeh.2012.0002... (an evolutionary advantage, to avoid things that an organism barely survived). There are rat models, in which there are similarities up to particular neurobiological changes. Anecdotally, quite a few friends who took a dog from a shelter, and it had PTSD (likely due to maltreatment by the previous owners, or abandonment) triggered by certain actions (leaving along, shouting, raising one's hand, the smell of alcohol, etc). In this context, the presumption that humans a few hundreds, or thousands, years ago didn't experience PTSD is... strange.
- en-us 7y ago
  To add to this, there is a book called The Body Keeps the Score that dedicates several of its chapters to exploring the physiological consequences of trauma. Some of the changes are quite profound and I have a hard time believing that just one or two hundred years of evolution would have an appreciable effect in this matter. We can't teleport a combat veteran from antiquity into an fMRI but either the findings would be the same or something very profound changed in the human brain in a very short period of time and it went unnoticed. I think it is far more likely that people either didn't discuss these things due to stigma, or they conceptualized it as the haunting of demons and ghosts since severe cases of PTSD can cause split personalities and convulsions and things like that.
SubiculumCode 7y ago
It would be off to not be in historical humans but in animals: https://pubmed.ncbi.nlm.nih.gov/28070873/ https://pubmed.ncbi.nlm.nih.gov/28070873/
pdubs1 7y ago
The ancient world exposed people to more stress and more events of stress compared to developed world inhabitants. More stress => get used to stress => stress has less of an effect. Just like any form of mental or physical training: Get challenged => Grow to meet challenge => The same challenges as before are now less challenging. See: Stress inoculation "The stress inoculation hypothesis presupposes that brief intermittent stress exposure early in life induces the development of subsequent stress resistance in human and nonhuman primates." "People with the capacity to maintain healthy emotional functioning in the aftermath of stressful experiences are said to be resilient, or stress resistant (1, 2). "Researchers have sought to identify attributes associated with stress resistant individuals, with the expectation that understanding the etiology of stress resistance may lead to the prevention of stress-related psychiatric disorders. "One intriguing finding to emerge from this retrospective research has been that stress resistance is associated with childhood exposure to mildly stressful events (1, 3)." https://www.pnas.org/content/103/8/3000 https://www.pnas.org/content/103/8/3000
- papeda 7y ago
  I get that large sample sizes are impractical for experiments with monkeys, but I'm reluctant to draw conclusions from a study where all relevant groups have <= 10 participants.
  - pdubs1 7y ago
    Again, "See: Stress inoculation". Don't worry about one particular study. Search for The Concept. Deduce for yourself its validity.
rv-de 7y ago
https://youtu.be/FSDvF6H0cks?t=6 https://youtu.be/FSDvF6H0cks?t=6
PTSDthrowaway 7y ago
I am an United States Navy Corpsman and a veteran of a combat deployment. I am very thankful to see comments here disputing the author's claim that there are no signs of PTSD in the ancient world. I do not have the classic "first page" symptoms from the DSM-V, as I like to call them. These are the flashbacks, intrusive memories, noise sensitivity - the common image of classic PTSD. I believe I do not have them because I never personally compromised my own value system and caused harm to innocent people. I did, however, witness milder events to an extent frequent and prolonged enough to cause a deep unmovable certainty that the world is tragically fucked up. That lead me to have all kinds of angsty aggressions in the direction of "the system" or "the world" at large. This anxious, overdriven fearful discontent lead me to be fully certain that life was tragic, and all around convinced that there was a conspiracy to make it so. It has taken over a decade for those certainties to subside. Some of it was immaturity, most of it was evidence. My Marine battalion made front page NYT news for its suicide rate. Many Marines have not had the experience I had. I believe this is because they were younger than I was (25) and many went on one or even two combat deployments to Iraq prior to ours. They have done a sadly effective job at killing themselves. I believe the reason for this (with no evidence) is because these men were prone to enjoying and seeking opportunities to kill. Apart from that guessing game, I also believe that the symptoms of PTSD are all-around easy to suppress and make look like other things. Most of the behavior associated with "toxic masculinity" as it is currently being called can be instead directed towards a PTSD diagnosis or some kind of traumatic reaction. I am sure of this. So the fact that the ancient world had all these orders and so forth with vows and tight-knit little clans are all a sign to me that they were just like the soldiers returning from WWII who became bikers; they were rattled badly. They had to put on that cold, tightly-wound demeanor by force of the nervousness that lay underneath. All those sovereign military orders and all that? They were all PTSD clubs. In opposition to this ideal, there is a book titled "On Killing" which describes why not all killers are susceptible to PTSD. I believe the book is fairly accurate in its claim, however it does exactly what those old military orders did: it creates a warrior ethos which allows for an in-group admission of the experiences while keeping the out-group afraid of the warriors. According to the book, there is a subsection of humanity that are naturally capable of killing without it being contrary to their values. They do not revel in it as some do. They are not triggered by it as many are. This is the chivalrous vision of being a trigger-puller. My experience of events which ought to be traumatic is mostly that they only return to bother us if there is some behavior that was contrary to the individuals values. Those vary. To move the slider as far to the (?) as is necessary to justify killing on moral, religious, personal, political/tribal/cultural grounds, and showering killers in rewards after the fact, including great tales of valour, etc that make all those sacrifices worthy: that is the means of shielding the society from the reality of there being a fraction of the people who are extremely fucked up from having hacked/shot/blown people to pieces. One final note: it was far more common to die from wounds and disease. Many people just plain didn't survive the wars due to wounds and plagues. Or they were assimilated somewhat into their enemies worlds and never returned to exactly the same place where people could say: "holy shit, you're different."
carapace 7y ago
Dude is resting his shoe-clad feet on a stack of Babylon 5 DVDs like an ottoman. Excuse me while I go wash my eyes. WTF dude!? - - - - > I’d say there is vanishingly little evidence that people in the ancient Mediterranean or medieval Europe experienced PTSD from combat experience in the way that modern soldiers do. Yeah, no shit Sherlock! The entirety of civilization back the was a horror show. People have been psychotic since the Younger Dryas. The reason there's "vanishingly little evidence" of PTSD is because everybody had it, all the time.
yters 7y ago
There is the idea that warriors could get infected by bloodlust. Also, the berserkers who would be placed in an altered state of consciousness and obliterate anyone near them, friend or foe. Also, in a culture where public toture and execution were the norm, they might have had different tolerances.
irrational 7y ago
>I tend to think the difference lies in part on the moral weight placed on warfare – it was viewed not generally a necessary evil in these societies, but a positive good – which may have meant there was less sense that what had taken place was trauma at all. If that is the case, the emergence of PTSD would speak to improvement in our society: we have become more averse to violence and do it less, and as a consequence, feel it more. This seems to be the heart of his argument as to why this might be. When we look at the artwork that decorated public buildings in the ancient world (I'm specifically thinking of Egypt and Assyria) we see a lot of torture, warfare, abasement of enemies, etc. I'm trying to imagine going to my local public buildings and seeing scenes of, say, North Koreans being flayed alive carved in stone on the walls. It does seem like we view violence in a different way than they did in the ancient millennia.
autokad 7y ago
did anyone get to the bit about fighting shield to shield? > "I particularly wonder about this given Lloyd’s dismissal of fighting ‘shield to shield.’ The issue is, we have sources – Tyrtaeus most notably – who tell us that happened. If we cannot understand why, I might suggest that it is we, and not the Greeks, who are missing something." I personally agree with Lloyd (Lindybeige). I dont think he was saying it never happened, just that it was uncommon.
GurnBlandston 7y ago
As a counterpoint, I'll recommend the excellent book Achilles in Vietnam. It explores Achilles' story in The Illiad and how it illustrates the stages he goes through while processing what he has experienced as a soldier.
- blacksqr 7y ago
  Second that this is an excellent book, written by a doctor whose practice was treating PTSD in Vietnam veterans.
speeder 7y ago
One thing I read today might contribute to this, I found it rather interesting. I was reading about Black Death, and ended reading also about the Great Famine that happened a bit before it, and the two are attributed to be part of the reason why Chivalrious warfare ended, before these two events, professional soldiers (knights for example) usually died in training accidents than in actual battle... But the deep changes caused by these two events, caused among other things, the start of a more destructive kind of warfare, where instead of winning by making the enemy retreat, you would win by completely destroying the enemy forces. I suspect in some periods of history there was less PTSD because war was just less violent. After Black Death, and increasing since, we got closer and closer to the idea of total war, that ended happening for real in the World Wars.
seph-reed 7y ago
Was surprised not to see any mention of guns. Even within a very limited life-experience of playing paintball, vs larping it's apparent the two lend themselves to different mental states. Obviously this is not the true experience of these things, but it seems safe to say gun warfare is vastly less perceivable/predictable than classic warfare. Even arrows are something you can at least see. Bullets are invisible and can hit you anywhere that isn't encased in concrete, rock, or metal. And then there's bombs... How could anyone feel even a moment of agency or relief amongst bombs and bullets?
bbsanon 7y ago
I am a person who was physically and emotionally abused by peers as a child, who had a horrible, life changing experience on a psychedelic as a minor, and who has tinnitus and hyperacusis as a result of overexposure before 20. I am now decades older and my life turned out horribly. I have many of the symptoms of PTSD, so it’s reasonable to self diagnose as such. I’m self destructive and suicidal, in constant mental torment, alone and bitter. I’ve often thought that my life outcome was the result of bad luck, and sensitive genes. Then, at times, I figured this was the result of bad choices. It’s probably a combination of the above. Genetics, environment, luck, and poor decisions all factored into my experiences and how they’ve formed my resultant life. To ‘tough it out’ is perhaps a great filter for those who are actually tough enough to do so, but some aren’t equipped for this. I’ve often seen my life outcome as indicative of a fundamental weakness in my genes, and there’s truth to this. Others went through similar circumstances and didn’t develop horrible tinnitus nor have a bad reaction to drugs, or childhood abuse. From an evolutionary standpoint, that I haven’t procreated is a success for the species. I will die off alone and the species will be stronger for it. Perhaps in old times this was done more silently.
- john-radio 7y ago
  I'm glad that you are here for now. Thanks for sharing about your experiences with PTSD, and sorry that you have had them.
  - bbsanon 7y ago
    Yeah me too. It was basically a suicide note.
anm89 7y ago
Am I wrong to think this is a nonsensical question? I mean PTSD is just a term. I'm not saying there is not a real phenomenon underlying it but it's not something that can be objectively tested for in the sense of a blood test or something. It seems to essentially mean a subjective evaluation of "severe emotional trauma with lasting consequences" So if you ask: "Was there severe emotional trauma with lasting consequences in the medieval world" and assuming that people 600 years ago were not biologically incapable of having emotional trauma, than yes of course, if we tested some of those people using the procedures and criteria we use today to diagnose PTSD, of course yes, we would conclude that they did have it. Hearing psychology professionals take tautologically nonsensical questions like this seriously really makes me lose faith in modern psychology.
shaunxcode 7y ago
Yes.
mcguire 7y ago
"We should expect to see signs of PTSD everywhere. It should be absolutely pervasive in a source-base produced almost entirely by, for and about combat veterans, in societies where military mortality exceeded modern rates by a robust margin. And it simply isn’t there." Or perhaps it's so ubiquitous it's not mentioned. There are many about everyday life that don't appear in the historical record simply because they are so common.
suthakamal 7y ago
The mechanisation of war changed the very nature of war. In the first world war, row upon row upon row of men got off of landing boats, to be mowed down, row after row, by machine gun fire. It's not comparable to hundreds of soldiers going in to armed combat. In earlier times, having a calvary was a strategic, forceful asset. It was, right up until mechanised warfare. Suddenly, there was no utility to a calvary. It's impossible to talk about the human consequences of war without understanding how very different war was to a Roman soldier vs an American in Vietnam, or today's asymmetric battlefield.
jonnycomputer 7y ago
An underwhelming argument by the blogger. Introspection about motivation and emotion is also lacking in ancient texts; should we take that to imply that people didn't introspect, or have complex emotional lives? The role of literature has changed; if I look at a corpus of C++ and fail to see mentions of trauma, should I assume that no trauma occurred in the lives of the programmers who wrote and maintained the code? No, because one does not usually talk about such things in code. And, how easy would it be to miss evidence of psychological distress when it is described as visions and visitations of demons and angels? Read medieval hagiographic literature!
golemiprague 7y ago
I see here a lot of interesting assumptions as of why and whether differences exists between our days and the past but for any practical solution you don't need to go so far back to ponder the existence of PTSD, even today the rate of PTSD is very different among different societies. For example Israeli soldiers tend to have much less PTSD than Americans and the ones that have it are affected in different ways. It will be more interesting to test the theories brought here on those different societies and see if any of them make sense and what other differences might exist.
stblack 7y ago
One seminal work on the subject is No More Heroes: Madness and Psychiatry In War by Richard A. Gabriel. One facet of difference, according to Gabriel, is range. In the Ancient and Medieval world, a mile or two from the enemy was a comfort zone, at least for awhile. You could sleep soundly, there. In more modern times, the comfort zone gets progressively and massively, further away. Today, depending on armaments, can you sleep soundly when you're 50 or 100 miles from an enemy army? Are you safe, there? A fighter jet, presently 50 miles away, could strafe you and everyone around you mere minutes from now, in an incident that's over before you can get out of your sleeping bag.

216 points by apsec112 7y ago

jka 7y ago

A potential counterpoint - "Post-traumatic stress 'evident in 1300BC'"[1]. The technology, tools and languages available to humans has expanded a huge amount over recent centuries. The question, I guess, is whether the psychological consequences of experiencing and processing reality (and, particularly, trauma) has changed as a result. [1] - https://www.bbc.co.uk/news/health-30957719 https://www.bbc.co.uk/news/health-30957719

papeda 7y ago
The featured article's pitch is that there's still way more historical writing about war, including ignoble stuff, and this imbalance still strongly suggests that PTSD was somehow much less common. (It's also funny that the BBC article mentions the strong Herodotus PTSD example that the featured article treats as a repeatedly-rehashed outlier.)

papeda 7y ago

On a related note, a while ago I read a little about how ancient families coped with the deaths of their children. My takeaway, pretty much cribbed from this article [1], was that such deaths produced less trauma than they would today because: (1) More families lost children. This lessened the trauma because a family could talk to other nearby families who had experienced the same thing. Those families would also be able to give advice. In contrast, losing a child is extremely rare (in developed countries) today. This rarity breeds isolation, which makes everything worse. (2) There were established societal and religious ways to deal specifically with the death of a child. Think prescribed ceremonies that grant a form of closure and which pretty much all of your friends and neighbors subscribe to. Nothing like this exists today. To me, this is very similar to the suggested explanation in the featured article for why war used to cause less PTSD: there was less stigma around war, a much larger chunk of society fought in wars, and there were universal and well-defined rituals for processing the experience. The whole thing raises interesting questions about our modern understanding of trauma. I think the most common modern statement on grief is that it's intensely personal and people should never feel that their grieving process is "wrong", at least not for a long time (years?) after the event. That at least seems different than past practice. [1] https://www.jstor.org/stable/642999?seq=1 https://www.jstor.org/stable/642999?seq=1

cletus 7y ago
You don't even need to go to the ancient world to see this. A rudimentary look at genealogy will show you that even in the 19th century. If a child under 2 dies, you'll often see reuse of that name for the next child. There were cultural standards, particularly in Europe, around naming children after paternal and maternal grandparents and so forth (such that often you can tell what number a child was by their name if you know the relative's names). Think about that for a second. Let's say you had a child who died at 6 months old. 1-2 years down the track you had another child and you'd use the same name. We have totally different expectations of mortality than a century ago. A child born today in the developed world is incredibly likely to make it to adulthood. It's simply not conceivable than in an era of greater infant mortality that there weren't different attitudes to the death of a child.
- DyslexicAtheist 7y ago
  that's actually a pretty effective way for overwriting/replacing your bad memories with something new. Less drastic / and practical examples: Say you went through a really bad breakup and your partner let you down by cheating on you with your best friend. You still love them and really want to those memories gone. You got 2 options: 1) stop listening to favorite songs, no longer visit specific restaurants or pubs, stop doing a sport you did together, 2) replace these memories by doing exactly those things with your new partner. soon you will have forgotten about them. Instead what remains is that activity/place now being your memory and not associated to another person (or the 2 of you).
  - SketchySeaBeast 7y ago
    I wouldn't recommend letting your new partner know that you're doing that though.
    - DyslexicAtheist 7y ago
      yes would be a very bad idea :-/ there would probably be better examples (dealing with a breakup was in retrospect a terrible use-case to make my point).

drewbeck 7y ago

Really interesting, tho I wish he cited or talked to some psychologists as well! I wonder if the specific tools of war are a factor as well — the suddenness of explosions and bullets might provide a significantly more traumatic experience than spear sword and trebuchet, the pace of humvees and airplanes more shock than feet and horses.

LordHeini 7y ago
I doubt that standing there as a poor peasant with a spear, while getting charged by a horde of knights on massive battle horses in full armour is any less traumatic than the crack of a snipers bullet whizzing over ones head. And medieval combat was quite a gruesome affair, cleaving people into peaces with axes and swords, in an age without proper medical care... What has changed though, is the staying power of armies which nowadays can stay in contact for long times with somewhat low intensity fighting going on all the time. This of course changes the whole psychology aspect, its not the stress of one battle going on for a day or so, but the stress of a battle going on for weeks.
- XorNot 7y ago
  Mmmm I'm deeply wary of an absence of evidence about a condition which civilization today still can't actually acknowledge properly existing being evidence of its absence. "Gun cleaning" accidents, as the socially accepted cover for male suicide by people everyone wants to ignore were suffering from depression or PTSD.
  - keithnoizu 7y ago
    See fan death in korea.
  - catalogia 7y ago
    > "Gun cleaning" accidents, as the socially accepted cover for male suicide by people everyone wants to ignore were suffering from depression or PTSD. There's no doubt that happens, but on the other hand gun cleaning injuries (e.g. to limbs) are far from unheard of, as well as people accidentally putting holes in their house. Those are doubtlessly accidents, so I have no doubt that some of the "gun cleaning fatal accidents" truly were accidents. Any of these accidents should be prevented by dogmatically following basic safety procedures, but obviously sometimes some people don't. And sometimes, that has fatal consequences.

distances 7y ago

This is such a popular topic that AskHistorians has a whole section [0] in their FAQ devoted for this. [0] https://www.reddit.com/r/AskHistorians/wiki/faq/militaryhistory#wiki_post_traumatic_stress_disorder https://www.reddit.com/r/AskHistorians/wiki/faq/militaryhist...

goodcanadian 7y ago

A video covering the same topic that I thought was reasonably well done: https://www.youtube.com/watch?v=FDNyU1TQUXg https://www.youtube.com/watch?v=FDNyU1TQUXg Edit: one thing covered in the video, but not mentioned in the article is the different experience of what war means in modern times. From WW1 (actually, a bit earlier), modern high explosives mean that soldiers spend days, weeks, even months under high stress and constant threat of death. Ancient soldiers tended to participate in violent, but relatively short battles (a day or two at most). The vast majority of the time, they were not under the same levels of stress.

cletus 7y ago

If you're so inclined to go down a rabbit hole of 100+ hours of content, I highly suggest having a listen to Dan Carlin's Hardcore History [1]. Dan is particularly interested in military history, especially ancient military history. He has an episode on Caesar's conquest of Gaul (which he argues in any kind of modern context would be called a genocide) as well as a series on the great Persian kings, called the King of Kings. This is specifically about the Achaemenid Empire talking about Cyrus II, Darius, Xerxes and the likes. Now as Dan would say, he doesn't find scientific and technological advancements particularly interesting (from a historical perspective). Like if Edison didn't invent the light bulb, someone else would've. What he finds far more interesting is historical events that could've completely changed the course of history and one of those was the Battle of Marathon [2]. This was a battle between the Persians and the Greeks that the Greeks somehow won. Had they lost it would've changed the entire history of Europe given how important Greek culture was to everyone from the Romans on. Bear in mind when this happened, Rome was a small regional power at best. He talks about the psychology of ancient warfare. One thing he notes is that the closer someone is to someone, the harder it is for them to (psychologically) kill them. From a gun at a distance is completely different to hand-to-hand combat. At this time, the Greeks fought with spears that were very broad. Stab someone in the guts with one of those and their insides would literally spill out to the point where the likes of Herodotus described the ground at Marathon as being soaked red in blood. Likewise, ancient culture and justice must be almost incomprehensible to us. Fun fact: the origin of the word "decimate". When a province rebelled against Roman Rule and Rome would crush them, insurrection was punished particularly harshly. People would be put in groups of 10 (hence DECImate) where each group was responsible for choosing which of those 10 would die and for killing that person. How did people cope with these things? How would PTSD fit into this world? EDIT: the way some downvote on HN makes me sad. [1]: https://www.dancarlin.com/ https://www.dancarlin.com/ [2]: https://en.wikipedia.org/wiki/Battle_of_Marathon https://en.wikipedia.org/wiki/Battle_of_Marathon

Amezarak 7y ago
Decimation was a military punishment. I cannot think of any time it was used on civilians. It was employed not just for mutiny, but for desertion and cowardice. If your unit panicked and routed during a battle, it might very well be subjected to decimation later - probably a powerful motivator.

forgotmypw16 7y ago

The way I see it, in the ancient world, PTS"D" served a purpose... If you saw "some shit" like your tribesmate getting mauled by a bear/tiger, it was helpful to your survival to be on high alert if you ever encountered a situation similar to the one where that happened. The complex of stimili was imprinted to a certain synapse pathway, and anytime you felt like you were in the same situation as before, you would want to be on extra-high-alert fight or flight mode.

third_I 7y ago

I'm sorry but this has to be the most un-scientific account I've read on the topic (granted, I read few), and it's incredibly misleading. - Humans did not change biologically enough in 10,000 years, let alone 2,000, to produce a meaningfully different psychology. Take a a child born 2,000 years ago, raise them today, and you'll get just a regular human being. Same thing backwards. - The entirety of the author's 'hypothesis' (sic) rests upon ignoring that nurture, context, is highly determinant in forming psychological references, relative perceptions, hence reactions, profiles. This is wrong, nature isn't 100%, you simply can't take two identical beings, put them in vastly different contexts and hope they present the same behaviors and perceptions. It makes no sense. Hello Darwin, wish you were here. - “the absence of evidence”... Again, wrong. Historical psychology is a thing. Author may be well-meaning, but they should adopt a transdisciplinary approach if they are to talk about multiple disciplines at once. Find a good psychologist, work together as one on the topic long enough to form a legitimate hypotheses, then maybe make some conclusions. - It seems the author also neglected to take into account philosophy, which used to be 99% practical back then. Recipes for good living. Guess why it was widely taught and shared, pretty much the basis of any education, throughout life. Guess why Seneca wrote his letters. What's the point of ignoring just about the closest thing to psychology sessions? Why is Stoicism not in that essay? I feel like I've just read a mathematician trying, painfully, to speak of epidemiology. (forgive the "modern" reference, I think it's fitting as we speak) Whatever your core expertise, armchair-other disciplines is a slippery slope. I guess the author somehow mistook his own intelligence for knowledge in psychology. Say whatever you want about our past, you won't find a psychologist or biologist to tell you we've changed in any way, shape or form "inside". The context, however, ah, the context. Well for that, this thread on HN is much more eloquent, I must say. It's almost as if people collectively had insight! (because this is written: "/s", of course they do, and I wish the author didn't simply write solo or fail to question or quote others. Here's food for thought: the very fact of "talking about your feelings" is very modern, that's a totally different context. We just didn't dwell on that topic as much in history (hence why, perhaps, some literature became so notorious, because it spoke of something that people weren't used to). It was "fluff". Hence why, when we made "emotions" a matter of science, it became a more acceptable topic, not just for a few who dared. It became "mainstream". (I'm NOT a specialist, so don't quote me on this but Freud, Jung, positivism, is probably where/when to look for a major shift; before that it was "magic", fluff, but it doesn't mean it wasn't "real", like belief in supernatural forces is "magic" but real to the psyche). Imagine that, in the future, we turn some (currently) elusive aspect of our psyche (like belief indeed), into a form of science, of applied psycho-bio-model-mechanics (like we do cognitive sciences today, a scientific progress over prior centuries). Now imagine some author versed in history but oblivious to psychology and biology, centuries from now, claiming in some random short post that people in the 21st century did not experience any tension in that regard because they didn't have words for it. Well, we may not have the words indeed, not yet; but we certainly experience the tensions with beliefs (supernatural or otherwise), heck we made wars because of it. Just like kings of old have waged war because their feelings commanded them to. That, my friend, is ethnocentricity of a temporal form (not strictly spatial as is usually the implication with that notion). At best, it's blinding Omphaloskepsis. Edit: lovely downvotes! So, you think PTSD is a modern thing. You think human psychology has changed dramatically in a few centuries. Alright, point taken! FWIW, I've spoken with psychologists explicitly about this question, and my view is informed by their conclusions. You may wish to rethink your modern bias on biology.

rsynnott 7y ago

One thing I'd question here is that conditions during the second Punic War were normal. They very much weren't; it was an existential crisis. My impression was that for most of its history, Rome's armies simply weren't particularly large. And that re-integration into civilian life may not have been as common as all that; terms of military service were very long, and there was a tendency to form soldier colonies as a solution for dealing with pensioned-off soldiers. These societies were also far, far more violent than ours. The sort of random violence that might be attributed to PTSD today would likely be part of the background noise in Medieval Italy, say.

leroy_masochist 7y ago

Another interesting angle on this question comes from the Jaynes bicameral mind hypothesis [0]. Given that a major component of PTSD is moral injury -- e.g., I can't believe someone intentionally did that to me / I can't believe I had to do that to someone else -- I wonder whether (if the bicameral mind theory is true which I think it is) ancient warriors experienced PTSD not as internal angst but rather as a "dialogue among the gods" that happened in one's head following stress. [0]: https://en.wikipedia.org/wiki/Bicameralism_(psychology) https://en.wikipedia.org/wiki/Bicameralism_(psychology)

manishsharan 7y ago

Emperor Ashoka of Magadha (India) fought a bloody war against the kingdom of Kalinga. The carnage wrought by war moved him deeply . He converted to Buddhism and he is responsible for spreading Buddhism to much of Asia. Was this because of PTSD ? The sorrow and remorse he felt was real and changed him from a ambitious emperor to a deeply spiritual person.

aklemm 7y ago

Sometimes I think PTSD is the standard human experience. Industrialization, certain civil/human rights, and psychology insights have changed that some.

gdubs 7y ago

I always wondered if Achilles was struggling with PTSD during The Iliad. He had seen so much fighting and bloodshed that he became depressed and sat in his tent, refusing to budge. Maybe the anger at Paris was just a front.

goto11 7y ago
He is "cured" from depression when his friend is killed, and he thrown himself back into battle. So it does sound more like sulking than PTSD.
- gdubs 7y ago
  He kinda goes into a blind rage though, which could still fit. Further complicating things — they drink wine relentlessly throughout.
cam- 7y ago
The first hysterical blindness was documented by Herodotus in the battle of Marathon, "Epizelos the son of Cuphagoras, while fighting in the close combat and proving himself a good man, was deprived of the sight of his eyes, neither having received a blow in any part of his body nor having been hit with a missile, and for the rest of his life from this time he continued to be blind"

yboris 7y ago

I wonder if PTSD is particularly likely when the terrible events occur spontaneously without obvious warning. Modern weaponry that allows one to die without an enemy visible probably exacerbates things. In the olden days you'd be charging towards the enemy for at least a while before you witnessed your comrades getting killed.

RyJones 7y ago
On Killing[0] covers some of this. The author argues that extended demob times in WW2 helped; supposedly, this is why people leaving Iraq and elsewhere end up "doing nothing in Kuwait" for weeks on end cleaning equipment. [0]: https://en.wikipedia.org/wiki/On_Killing https://en.wikipedia.org/wiki/On_Killing
- deleted 7y ago
  [deleted]
- yboris 7y ago
  I wonder if this is also related to "peak-end rule" https://en.wikipedia.org/wiki/Peak%E2%80%93end_rule https://en.wikipedia.org/wiki/Peak%E2%80%93end_rule People generally seem to remember the 'height' of an experience and the last parts of it. So an experience at a dentist where the last part of the procedure is a mild bit of additional drilling is 'better' than one that ends on a painful 'note'.

throwaway627348 7y ago

One book that explores this topic from a clinical perspective, supported by faithful translations from The Iliad, is "Achilles in Vietnam" [1] by Dr. Jonathan Shay [2]. [1] https://muse.jhu.edu/article/26751 https://muse.jhu.edu/article/26751 [2] https://en.wikipedia.org/wiki/Jonathan_Shay https://en.wikipedia.org/wiki/Jonathan_Shay

crazygringo 7y ago

Excellent counterpoint from r/AskHistorians (paragraph breaks added for legibility): [1] > Cross-cultural psychologists have observed that, regardless of cultural background, people who suffer persistent emotional disturbances in the wake of a traumatic event exhibit intrusive memory symptoms in some form. Here in the US, these are closely related to what we commonly call "flashbacks." For the Romans, people experiencing intrusive memories were said to be haunted by ghosts. These individuals show up in historical, philosophical, and even medical texts. > Josephus, who was an outsider to Roman culture, also describes this phenomenon in his history of The Great Revolt. Those haunted by ghosts are constantly depicted showing many symptoms which would be familiar to the modern PTSD sufferer. Insomnia, depression, mood swings, being easily startled, frequent eye movement, alertness all day and night, paranoia, avoidance of crowds, suicidal thoughts/attempts, loss of appetite, shaking/shivering, self-hatred, and impulsive violence have all turned up in association with these individuals. > Since in almost every case the person experiencing these things had made himself an object of public shame, the "ghosts" in question often came in the form of those he had killed or wronged in the past. These would either appear spontaneously to the sufferer, or would come in the form of vivid, frightening nightmares. > The key component to these experiences, as with modern cases of PTSD, was that the sufferer had no control over his own symptoms. Thoughts or vivid memories would occur unexpectedly and uncontrollably. It is easy to see why the Romans, who were religiously superstitious to begin with, would attribute such things to the foul play of malicious spirits. [1] https://www.reddit.com/r/AskHistorians/comments/1j6ssm/are_there_any_indications_of_combat_ptsd_in/cbbvfib/ https://www.reddit.com/r/AskHistorians/comments/1j6ssm/are_t...

mattigames 7y ago
Plus there has been strong indicators that other animals can suffer from PTSD e.g. https://onlinelibrary.wiley.com/doi/abs/10.1111/ejn.12860 https://onlinelibrary.wiley.com/doi/abs/10.1111/ejn.12860
- kylek 7y ago
  Astounding that we’d think otherwise.
- 7y ago

sorokod 7y ago

I would suggest that some forms of medieval entertainment would cause PTSD in a modern person. From public executions, through bear baiting[1] and cat torture[2]. The (unstated) assumption the people in the past "were just like us" emotionally, deserves closer scrutiny. I believe that the magnitude of trauma inflicted by a certain experience is relative to what is considered to be the norm in the time and place. The norms of "ancient" people were different from those of the 21st century [1] https://en.wikipedia.org/wiki/Bear-baiting https://en.wikipedia.org/wiki/Bear-baiting [2] https://www.atlasobscura.com/articles/ritualistic-cat-torture-was-once-a-form-of-town-fun https://www.atlasobscura.com/articles/ritualistic-cat-tortur...

ThrowawayR2 7y ago
Even butchering livestock for food, more or less a routine household chore in the past, is sufficiently alien today to most that it would likely cause PTSD if they had to do it.
- Ididntdothis 7y ago
  On the other hand a lot of people today can watch super intense horror movies which probably would have traumatized ancient people.
  - ThrowawayR2 7y ago
    One is real, with sights and smells linked to millennia of instinct and the knowledge that you yourself are the primary agent of what is occurring to the livestock. The other you know is fiction which you can criticize the script, special effects, and cinematography of from a comfortable chair, often with friends. I don't think the two really compare.
    - Ididntdothis 7y ago
      I think they compare for some people. I can handle real world situations better than movies. I think it's because the movie only stimulus some senses (sight and hearing) whereas the real world experience is complete.

tapland 7y ago

I didn't see anyone mentioning this but it would partially explain both the "there wasn't more in a violent world so it's weakness/was normal" arguments as well as the "we haven't changed genetically so!" arguments. Today we have much less violence than ever before, we live more comfortable lives, people are healthier and mistreating others is often illegal and pushed back against from both governments and the population itself. Because of that people who experience horrible events are less likely to have anyone around them with that shared experience. We have, afaik, less occurrence of PTSD when something horrible happens to an entire community, and less mental illness when an entire community is facing a difficult situation. But for an individual experiencing horrible and horrifying events you not only have the event itself, but a total lack of anyone even remotely close to having had the same experience. I have a relative with diagnosed (you really have to specify it) PTSD and I have absolutely no experience remotely close to the ones this person has faced, in an environment where there was no escape (family). Afterwards noone seem to understand their reactions, fears (people, loud noises) and feelings, but apparently feel that they are qualified to give advice and to just do things because 'there is no way you are actually physically being limited by your body and I know exactly how you feel because I have the exact same because my dad used to yell at me when I refused to take out the trash now and then'. This reaction is of course commonplace online, and online help groups have plenty of undiagnosed people who don't seem to be limited in any unusual way or have had any traumatic event, but who then cause stress for those who don't have coworkers or friends or can go do things in public and who really need the online space. But it's also closer to the reaction and acting most people in real life have to it, and in some cases even mental health professionals, than it is to having had a similar experience. There just seems to be a too large gap between people who have it average by todays standards and thise who've faced horrible traumas. I notice a lot of stress in my daily life today with the covid-19 pandemic, where I'm in Sweden where life seems to be going along as normal, while I'm in three separate risk groups, two for serious illnesses and one for the immunosupressants used to treat them, and where I get questioned by my doctors, friends and family as to why I don't want to go to thr clinic or socialize. I can't walk further than a block away because noone keeps any distance and joggers come brushing by from behind. It feels like this is also caused by the different experience. "Why can't they keep their distance, aren't we supposed to do that? Why do they assume I'm not in a risk group and assume that none they see could possibly be?". And this is still an experience they know a lot of people are having and know a lot about through media. I just think having others that you share your overall experience with helps a lot, and with much better lives in average the distance between those who have it OK and those who have it the worst has increased.

valuearb 7y ago

Is there PTSD in the modern world? Reproducibility crisis says dunno?

stared 7y ago

Animals do feel PTSD, see https://www.frontiersin.org/articles/10.3389/fnbeh.2012.00026/full https://www.frontiersin.org/articles/10.3389/fnbeh.2012.0002... (an evolutionary advantage, to avoid things that an organism barely survived). There are rat models, in which there are similarities up to particular neurobiological changes. Anecdotally, quite a few friends who took a dog from a shelter, and it had PTSD (likely due to maltreatment by the previous owners, or abandonment) triggered by certain actions (leaving along, shouting, raising one's hand, the smell of alcohol, etc). In this context, the presumption that humans a few hundreds, or thousands, years ago didn't experience PTSD is... strange.

en-us 7y ago
To add to this, there is a book called The Body Keeps the Score that dedicates several of its chapters to exploring the physiological consequences of trauma. Some of the changes are quite profound and I have a hard time believing that just one or two hundred years of evolution would have an appreciable effect in this matter. We can't teleport a combat veteran from antiquity into an fMRI but either the findings would be the same or something very profound changed in the human brain in a very short period of time and it went unnoticed. I think it is far more likely that people either didn't discuss these things due to stigma, or they conceptualized it as the haunting of demons and ghosts since severe cases of PTSD can cause split personalities and convulsions and things like that.

SubiculumCode 7y ago

It would be off to not be in historical humans but in animals: https://pubmed.ncbi.nlm.nih.gov/28070873/ https://pubmed.ncbi.nlm.nih.gov/28070873/

pdubs1 7y ago

The ancient world exposed people to more stress and more events of stress compared to developed world inhabitants. More stress => get used to stress => stress has less of an effect. Just like any form of mental or physical training: Get challenged => Grow to meet challenge => The same challenges as before are now less challenging. See: Stress inoculation "The stress inoculation hypothesis presupposes that brief intermittent stress exposure early in life induces the development of subsequent stress resistance in human and nonhuman primates." "People with the capacity to maintain healthy emotional functioning in the aftermath of stressful experiences are said to be resilient, or stress resistant (1, 2). "Researchers have sought to identify attributes associated with stress resistant individuals, with the expectation that understanding the etiology of stress resistance may lead to the prevention of stress-related psychiatric disorders. "One intriguing finding to emerge from this retrospective research has been that stress resistance is associated with childhood exposure to mildly stressful events (1, 3)." https://www.pnas.org/content/103/8/3000 https://www.pnas.org/content/103/8/3000

papeda 7y ago
I get that large sample sizes are impractical for experiments with monkeys, but I'm reluctant to draw conclusions from a study where all relevant groups have <= 10 participants.
- pdubs1 7y ago
  Again, "See: Stress inoculation". Don't worry about one particular study. Search for The Concept. Deduce for yourself its validity.

rv-de 7y ago

https://youtu.be/FSDvF6H0cks?t=6 https://youtu.be/FSDvF6H0cks?t=6

PTSDthrowaway 7y ago

I am an United States Navy Corpsman and a veteran of a combat deployment. I am very thankful to see comments here disputing the author's claim that there are no signs of PTSD in the ancient world. I do not have the classic "first page" symptoms from the DSM-V, as I like to call them. These are the flashbacks, intrusive memories, noise sensitivity - the common image of classic PTSD. I believe I do not have them because I never personally compromised my own value system and caused harm to innocent people. I did, however, witness milder events to an extent frequent and prolonged enough to cause a deep unmovable certainty that the world is tragically fucked up. That lead me to have all kinds of angsty aggressions in the direction of "the system" or "the world" at large. This anxious, overdriven fearful discontent lead me to be fully certain that life was tragic, and all around convinced that there was a conspiracy to make it so. It has taken over a decade for those certainties to subside. Some of it was immaturity, most of it was evidence. My Marine battalion made front page NYT news for its suicide rate. Many Marines have not had the experience I had. I believe this is because they were younger than I was (25) and many went on one or even two combat deployments to Iraq prior to ours. They have done a sadly effective job at killing themselves. I believe the reason for this (with no evidence) is because these men were prone to enjoying and seeking opportunities to kill. Apart from that guessing game, I also believe that the symptoms of PTSD are all-around easy to suppress and make look like other things. Most of the behavior associated with "toxic masculinity" as it is currently being called can be instead directed towards a PTSD diagnosis or some kind of traumatic reaction. I am sure of this. So the fact that the ancient world had all these orders and so forth with vows and tight-knit little clans are all a sign to me that they were just like the soldiers returning from WWII who became bikers; they were rattled badly. They had to put on that cold, tightly-wound demeanor by force of the nervousness that lay underneath. All those sovereign military orders and all that? They were all PTSD clubs. In opposition to this ideal, there is a book titled "On Killing" which describes why not all killers are susceptible to PTSD. I believe the book is fairly accurate in its claim, however it does exactly what those old military orders did: it creates a warrior ethos which allows for an in-group admission of the experiences while keeping the out-group afraid of the warriors. According to the book, there is a subsection of humanity that are naturally capable of killing without it being contrary to their values. They do not revel in it as some do. They are not triggered by it as many are. This is the chivalrous vision of being a trigger-puller. My experience of events which ought to be traumatic is mostly that they only return to bother us if there is some behavior that was contrary to the individuals values. Those vary. To move the slider as far to the (?) as is necessary to justify killing on moral, religious, personal, political/tribal/cultural grounds, and showering killers in rewards after the fact, including great tales of valour, etc that make all those sacrifices worthy: that is the means of shielding the society from the reality of there being a fraction of the people who are extremely fucked up from having hacked/shot/blown people to pieces. One final note: it was far more common to die from wounds and disease. Many people just plain didn't survive the wars due to wounds and plagues. Or they were assimilated somewhat into their enemies worlds and never returned to exactly the same place where people could say: "holy shit, you're different."

carapace 7y ago

Dude is resting his shoe-clad feet on a stack of Babylon 5 DVDs like an ottoman. Excuse me while I go wash my eyes. WTF dude!? - - - - > I’d say there is vanishingly little evidence that people in the ancient Mediterranean or medieval Europe experienced PTSD from combat experience in the way that modern soldiers do. Yeah, no shit Sherlock! The entirety of civilization back the was a horror show. People have been psychotic since the Younger Dryas. The reason there's "vanishingly little evidence" of PTSD is because everybody had it, all the time.

yters 7y ago

There is the idea that warriors could get infected by bloodlust. Also, the berserkers who would be placed in an altered state of consciousness and obliterate anyone near them, friend or foe. Also, in a culture where public toture and execution were the norm, they might have had different tolerances.

irrational 7y ago

>I tend to think the difference lies in part on the moral weight placed on warfare – it was viewed not generally a necessary evil in these societies, but a positive good – which may have meant there was less sense that what had taken place was trauma at all. If that is the case, the emergence of PTSD would speak to improvement in our society: we have become more averse to violence and do it less, and as a consequence, feel it more. This seems to be the heart of his argument as to why this might be. When we look at the artwork that decorated public buildings in the ancient world (I'm specifically thinking of Egypt and Assyria) we see a lot of torture, warfare, abasement of enemies, etc. I'm trying to imagine going to my local public buildings and seeing scenes of, say, North Koreans being flayed alive carved in stone on the walls. It does seem like we view violence in a different way than they did in the ancient millennia.

autokad 7y ago

did anyone get to the bit about fighting shield to shield? > "I particularly wonder about this given Lloyd’s dismissal of fighting ‘shield to shield.’ The issue is, we have sources – Tyrtaeus most notably – who tell us that happened. If we cannot understand why, I might suggest that it is we, and not the Greeks, who are missing something." I personally agree with Lloyd (Lindybeige). I dont think he was saying it never happened, just that it was uncommon.

GurnBlandston 7y ago

As a counterpoint, I'll recommend the excellent book Achilles in Vietnam. It explores Achilles' story in The Illiad and how it illustrates the stages he goes through while processing what he has experienced as a soldier.

blacksqr 7y ago
Second that this is an excellent book, written by a doctor whose practice was treating PTSD in Vietnam veterans.

speeder 7y ago

One thing I read today might contribute to this, I found it rather interesting. I was reading about Black Death, and ended reading also about the Great Famine that happened a bit before it, and the two are attributed to be part of the reason why Chivalrious warfare ended, before these two events, professional soldiers (knights for example) usually died in training accidents than in actual battle... But the deep changes caused by these two events, caused among other things, the start of a more destructive kind of warfare, where instead of winning by making the enemy retreat, you would win by completely destroying the enemy forces. I suspect in some periods of history there was less PTSD because war was just less violent. After Black Death, and increasing since, we got closer and closer to the idea of total war, that ended happening for real in the World Wars.

seph-reed 7y ago

Was surprised not to see any mention of guns. Even within a very limited life-experience of playing paintball, vs larping it's apparent the two lend themselves to different mental states. Obviously this is not the true experience of these things, but it seems safe to say gun warfare is vastly less perceivable/predictable than classic warfare. Even arrows are something you can at least see. Bullets are invisible and can hit you anywhere that isn't encased in concrete, rock, or metal. And then there's bombs... How could anyone feel even a moment of agency or relief amongst bombs and bullets?

bbsanon 7y ago

I am a person who was physically and emotionally abused by peers as a child, who had a horrible, life changing experience on a psychedelic as a minor, and who has tinnitus and hyperacusis as a result of overexposure before 20. I am now decades older and my life turned out horribly. I have many of the symptoms of PTSD, so it’s reasonable to self diagnose as such. I’m self destructive and suicidal, in constant mental torment, alone and bitter. I’ve often thought that my life outcome was the result of bad luck, and sensitive genes. Then, at times, I figured this was the result of bad choices. It’s probably a combination of the above. Genetics, environment, luck, and poor decisions all factored into my experiences and how they’ve formed my resultant life. To ‘tough it out’ is perhaps a great filter for those who are actually tough enough to do so, but some aren’t equipped for this. I’ve often seen my life outcome as indicative of a fundamental weakness in my genes, and there’s truth to this. Others went through similar circumstances and didn’t develop horrible tinnitus nor have a bad reaction to drugs, or childhood abuse. From an evolutionary standpoint, that I haven’t procreated is a success for the species. I will die off alone and the species will be stronger for it. Perhaps in old times this was done more silently.

john-radio 7y ago
I'm glad that you are here for now. Thanks for sharing about your experiences with PTSD, and sorry that you have had them.
- bbsanon 7y ago
  Yeah me too. It was basically a suicide note.

anm89 7y ago

Am I wrong to think this is a nonsensical question? I mean PTSD is just a term. I'm not saying there is not a real phenomenon underlying it but it's not something that can be objectively tested for in the sense of a blood test or something. It seems to essentially mean a subjective evaluation of "severe emotional trauma with lasting consequences" So if you ask: "Was there severe emotional trauma with lasting consequences in the medieval world" and assuming that people 600 years ago were not biologically incapable of having emotional trauma, than yes of course, if we tested some of those people using the procedures and criteria we use today to diagnose PTSD, of course yes, we would conclude that they did have it. Hearing psychology professionals take tautologically nonsensical questions like this seriously really makes me lose faith in modern psychology.

shaunxcode 7y ago

Yes.

mcguire 7y ago

"We should expect to see signs of PTSD everywhere. It should be absolutely pervasive in a source-base produced almost entirely by, for and about combat veterans, in societies where military mortality exceeded modern rates by a robust margin. And it simply isn’t there." Or perhaps it's so ubiquitous it's not mentioned. There are many about everyday life that don't appear in the historical record simply because they are so common.

suthakamal 7y ago

The mechanisation of war changed the very nature of war. In the first world war, row upon row upon row of men got off of landing boats, to be mowed down, row after row, by machine gun fire. It's not comparable to hundreds of soldiers going in to armed combat. In earlier times, having a calvary was a strategic, forceful asset. It was, right up until mechanised warfare. Suddenly, there was no utility to a calvary. It's impossible to talk about the human consequences of war without understanding how very different war was to a Roman soldier vs an American in Vietnam, or today's asymmetric battlefield.

jonnycomputer 7y ago

An underwhelming argument by the blogger. Introspection about motivation and emotion is also lacking in ancient texts; should we take that to imply that people didn't introspect, or have complex emotional lives? The role of literature has changed; if I look at a corpus of C++ and fail to see mentions of trauma, should I assume that no trauma occurred in the lives of the programmers who wrote and maintained the code? No, because one does not usually talk about such things in code. And, how easy would it be to miss evidence of psychological distress when it is described as visions and visitations of demons and angels? Read medieval hagiographic literature!

golemiprague 7y ago

I see here a lot of interesting assumptions as of why and whether differences exists between our days and the past but for any practical solution you don't need to go so far back to ponder the existence of PTSD, even today the rate of PTSD is very different among different societies. For example Israeli soldiers tend to have much less PTSD than Americans and the ones that have it are affected in different ways. It will be more interesting to test the theories brought here on those different societies and see if any of them make sense and what other differences might exist.

stblack 7y ago

One seminal work on the subject is No More Heroes: Madness and Psychiatry In War by Richard A. Gabriel. One facet of difference, according to Gabriel, is range. In the Ancient and Medieval world, a mile or two from the enemy was a comfort zone, at least for awhile. You could sleep soundly, there. In more modern times, the comfort zone gets progressively and massively, further away. Today, depending on armaments, can you sleep soundly when you're 50 or 100 miles from an enemy army? Are you safe, there? A fighter jet, presently 50 miles away, could strafe you and everyone around you mere minutes from now, in an incident that's over before you can get out of your sleeping bag.