America, a PTSD nation?

Our media should stop indulging in gratuitous nonstop coverage of violent events and should not intensively publicize mass murders and mass killings.

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It has been more than 13 years since 9/11, and some things that have become routine weren't so in those blissfully ignorant days before that trauma, when the biggest news stories focused more on cheating politicians and shark attacks. With yet another fear-mongering alert that Al-Shabaab (the latest variation on a theme) is somehow targeting every mall in the entire North American continent, our media and other public institutions have kept the war on terror going. Fueled by a changing, Internet-driven culture and shifting profits, the media and political pundits are going for the quick sell; clickbait for people stuck in a post-recession reverie. But they wouldn't be feeding us if we weren't biting. Why are we such easy prey for this kind of ongoing hysteria? What is it about constant premonitions of doom that continue to thrill and excite us as mass media consumers in America?

Post-traumatic stress disorder manifests in some individuals who experience a life-threatening trauma, but it can also show similar signs in a larger culture that has undergone mass trauma as well, such as war or genocide. One might argue that 9/11, despite relatively few casualties compared with major wars, was still a major psychological trauma for America, which had never experienced a civilian domestic attack by an outside threat in its history. And the attack was definitely dramatic in its symbolism: The tallest buildings in Manhattan destroyed, key government buildings in our nation's capital hit or nearly hit, comfortable office workers on a routine day brutally killed. The everyday, safe banality of American life seemed to be over.

Even if most people did not develop severe clinical PTSD like the first responders or the people truly exposed to danger at the scene, our country underwent a psychological reckoning afterward, one we perhaps still haven't fully processed in a healthy, self-aware fashion. Complicating matters has been the concomitant rise of social media culture and technology in the last decade, leading to an interesting mélange of influences and coping mechanisms.

Some of the symptoms of clinical PTSD include re-experiencing and flashbacks that alternate with emotional numbness and dissociation. Persons afflicted with PTSD can be stuck in a vicious cycle of continued panic attacks and hypervigilance, where they perceive a threat in every corner - their "fight or flight" responses are on standby at all times. They interpret danger on a hair trigger. Sometimes they cope by actively planning ways to avoid and/or prevent anything that reminds them of the trauma. For example, some soldiers with PTSD avoid crowded malls because it sets them on edge. They dislike driving because any discarded item on the side of the road reminds them of a roadside bomb.

Conversely, some trauma victims also exhibit paradoxical responses, like a moth to a flame. These survivors seek to revisit or obsess over the trauma in an effort to master or conquer it, or to reignite the adrenaline rush of a panic reaction. In a controlled and carefully supervised therapeutic setting, this re-exposure approach can actually be positive and forms the basis for prolonged exposure therapy (PET) and other treatment modalities designed to revisit the "scene of a crime" in a safer fashion, to redirect and redefine the mental narrative and associated physiological reactions surrounding a trauma. Ideally, the person regains a sense of control over the traumatic events, and they begin to feel safe even as they remember frightening flashbacks. But unleashed in uncontrolled or unexamined ways, this revisiting can be transformed into a toxic, almost addictive form of mental entrapment. It becomes an unhealthy obsession and the "new normal."

I worry that as a culture, America has shifted to a similar, flashback-prone mindset. The media constantly bombards us with "breaking news" (even when there isn't any), usually about something dark and violent: a crime, a shooting, a crash or, of course, a terrorist attack. It's an unfortunate coincidence that the rise of technology in this similar time period has made the news ticker even more prevalent and predominant, a means of providing easy instant gratification.

Twitter updates and social media streaming, as well as portable videos, make news more accessible and democratic, but also far too constant. The only way to break through the information flood and resultant numbing is to heighten the drama of the content, even when it comes at the cost of accuracy or truth. Stories that garner the most drama are the biggest disasters and the biggest attacks, and these in turn garner the biggest audiences. We have become easy gluttons for the addictive thrill of danger, combined with the uneasy artificial detachment of a video screen.

The other dark side of this addiction to violence is our creation of attached narrative and cognitive tropes. That is, the need to blame someone for authoring the violence, the need to assign a bogeyman that we can control and manipulate in our minds, so we can feel we are still in charge of our trauma. Interestingly, the newest diagnostic criteria added to PTSD's definition in DSM-V (the latest version of the published in 2013) involve "negative alterations in cognitions and mood associated with the traumatic event...persistent and exaggerated negative beliefs or expectations about oneself, others, or the world...persistent, distorted cognitions about the cause or consequences...that lead the individual to blame himself/herself or others."

This emphasis on the skewed cognitions and harsh negative thoughts that accompany a trauma corresponds with the way our media and politicians have continued to look for the bad guy to blame in this post-9/11 era. It was unfortunate that a small sect of psychopathic extremists succeeded so well in publicizing their cause, because they knew Americans would take the bait. We would generalize hook, line and sinker and aggrandize these killers into a global phenomenon, because who else would dare to attack our great and noble nation? The enemy of America had to be Darth Vader-scale, not the Hamburgler. It had to be Al Qaeda, Osama Bin Laden, Iraq, Saddam Hussein, the Axis of Evil, Iran, Afghanistan, the Taliban, Syria, Yemen and ISIS. The list just keeps going and going with no end in sight.

Accordingly we've perpetuated more literal trauma in soldiers and local civilians via ongoing wars. In a way, the fact that the WMDs that triggered the Iraq war were fictional makes perfect sense. It was our collective traumatic imagination projecting the worst possible enemy to explain and justify what had happened to us, even when the real answer was much more complex and nuanced, and not without our own contributions (our legacy of prior colonialism and wars, tricky Middle Eastern politics, oil money, etc.). Although certainly—and without question—9/11 itself was unconscionable.

The instant demagoguery assigned to terrorists wasn't lost on us domestically, either, as shown by the quick appearance of copycat terrorists like the anthrax killer and the DC snipers. Mass shootings have gone up in the last decade as easy access to national fame is a simple legal gun purchase and a sprinkle of random gunshots away. Various alienated losers knew Americans were all too hungry to relive the terror, the drama, the hype of another violent attack, would rerun the killer's face and images all over social media and YouTube over and over forever. Even my hometown shopping mall in Maryland was the site of a random mass shooting last year. Sadly, this type of crime has almost run its course. So jaded are many of us that we don't bother to pay attention to these crimes anymore. We've arrived at a point where the numbness after trauma is finally beginning to kick in. (It is also learned helplessness, as we fail to enact any protections such as reasonable gun control regulations.)

Our hypervigilance has also extended to creating "enemies" at home, to quickly perceive threats around us. This is obvious at our airports, but also everywhere in our society now. This environment may have even contributed to a culture of tighter domestic policing and racial profiling and tension, contributing to tragedies such as the killings of Trayvon Martin and Michael Brown, which gave rise to uncomfortable but important discussions and social movements in their wake. Perhaps the balance of policing and safety has tipped too far. We are too ready to pounce, even when people are innocent, even when the realistic terrorist threats are statistically almost nil relative to other public health threats we gladly ignore that kill tens of thousands.

So what can we as Americans do to step back and re-examine this self-destructive pattern? To avoid a continuing, repetitive cycle of retraumatization, of exhausting hyperalertness and ensuing emotional numbness to no good end?

The first step is self-awareness and education, the willingness to look at our patterns from the outside and question what is happening. Patients with PTSD get better when they gently expose themselves to perceived dangers but in a safe, supportive way. Likewise, we need to continue living our lives with some awareness of ongoing threats, but to focus on what is healthy, what is real in the relationships and people around us. Our media should stop indulging in gratuitous nonstop coverage of violent events and should not intensively publicize mass murders and mass killings when they happen. We should acknowledge the tragic loss of life, and the positive aspects of those victims' lives, but that's it. Since it's unlikely our media will begin reporting more responsibly in the near future, as viewers, we should turn away and not overexpose ourselves to this repeated retraumatizing sensationalism.

We should advocate, using whatever means we have, for ongoing reduction of our international involvement in the Middle East and stop embroiling ourselves in a never-ending cycle of para-religious conflict. Yes, the recent beheadings are tragic, but realistically, compared to all the thousands of casualties we've already sacrificed in our wars, should we bother giving sick petty criminals like ISIS an international platform of outrage? Let's stop caving to the extremists' thirst for attention. Otherwise, the anger may bubble over into the kind of chaotic, unchecked and generalized hatred that fueled the recent murders of those talented, bright students in Chapel Hill. Along those lines, we should, as individuals, monitor and question our tendencies to racially profile and blame and target anyone we feel is potentially the bogeyman in our midst. Because in reality, the bogeyman is our own fear.

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