Desire and Fate
The original medical definition of post-traumatic stress disorder (PTSD) was first defined by the American Psychiatric Association in 1980 in the third edition of its Diagnostic and Statistical Manual of Mental Disorders, commonly referred to as DSM-III, as as a catastrophic stressor that was outside the range of usual human experience. The framers of the original PTSD diagnosis had in mind events such as war, torture, rape, the Nazi Holocaust, the atomic bombings of Hiroshima and Nagasaki, natural disasters (such as earthquakes, hurricanes, and volcano eruptions), and human-made disasters (such as factory explosions, airplane crashes, and automobile accidents). On this account, traumatic events were clearly different what what psychiatrists and psychologists at that time thought of as the very painful “stressors” - to use the term of art - that are part and parcel of all human lives such as divorce, failure, rejection, serious illness, financial reverses, and the like. But by the 2013, when DSM-V was published, a diagnosis of PTSD no longer required exposure to what were now referred to as “high magnitude catastrophic events” of the original definition, such as combat exposure or violent rape, but also was also held to be warranted by so-called “lower magnitude events” such as learning that a family member had died or witnessing a fight.* In other words, not only were events that are a normal part of the vicissitudes of life and are experienced at some point between birth and death by almost everyone now included, but such events did not even have to be experienced directly.
This “grade inflation” of what constitutes trauma is the new normal for the educational, public health, and psychoanalytic and therapeutic bureaucracies. The widely reported (and largely uncritically accepted) recent finding of a University of Alabama-Birmingham study published in the Journal of the American Medical Association (JAMA) had increased by 4.1% between 2017 and 2022 and now affected 7.5% of US college students is an emblem of the current consensus. The authors of the study suggested that “the loss of loved ones during the pandemic” and “racial trauma” had contributed to the rise.** Another student went further, asserting that “in 2020–2021, >60% of students met criteria for one or more mental health problems, a nearly 50% increase from 2013,”*** all of this in a context where, according to the 2021 National College Health Assessment of the American College Health Association, in terms of strictly physical health, 87% of college students described their health as “good, very good, or excellent.”****
If these accounts are correct, then mental illness rather than mental health is increasingly becoming the norm among young people in the United States. Given some of the more lunatic expressions of the pro-Palestine student demonstrations that have erupted during the Gaza War, it may be tempting to believe this. But in reality what has occurred is a general lowering of the bar for what is and is not traumatizing. Given the increasing hegemony throughout the culture of a radical subjectivity in which, in the specific instance of mental health, as with that of gender identity, how one feels and how one is are asserted to be indistinguishable, and, indeed, that it is a moral affront not to take any individual’s self-description at face value, it could hardly be otherwise.
The radical expansion of the definition of what constitutes PTSD to include virtually any unhappy experience is simply the most extreme instance of this new abnormal - one that now bears the imprimatur of the American Psychological Association (APA), According to the APA, which at the end of 2023 issued a report entitled Stress in America ™ [sic] 2023: A Nation grappling with psychological impacts of collective trauma, “College students today are also juggling a dizzying array of challenges, from coursework, relationships, and adjustment to campus life to economic strain, social injustice, mass violence, and various forms of loss related to COVID-19.”***** The reality, however, is that some of this “dizzying array” such as “coursework” and “adjusting to campus life” has always been part and parcel of being a college student, while “relationships” are simply part of being a human being. And while it is certainly possible that today’s college students are more conscious of social injustice and economic strain, they are no worse than in the past; indeed, arguably at least, they are better. In fact, the only element in the APA’s menu of challenges that can indeed be argued to be traumatic in the sense of the original definition of PTSD as a tragedy or shock outside the range of normal human experience is the Covid pandemic.
The likelier explanation for the mental health crisis of the young is that it is a crisis of expectations. And if their response often seems like a form of collective hysteria, if so it is not one for which they can fairly be held responsible. To the contrary, they are the victims of the fusion of the ‘Wellness’ culture that has so dominated the American imagination for so many decades, and contrary to the assumptions of some critics, owes nothing to identitarian politics and woke, with the language of rights that is at the root of these expectations of serenity and psychic well-being which no other generation throughout human history in the USA or anywhere else has ever imagined to be owed to them. The result has indeed been a collective psychological disaster, just not the one that the psychologists think it is. What has really happened is that the young have been sold a bill of goods — the fraudulent promise that their desires should be their fates.
*https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3901120/
**https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2819206?guestAccessKey=bc2533bd-e1d2-4991-8500-1da1a731c2a3
***https://www.sciencedirect.com/science/article/abs/pii/S0165032722002774?via%3Dihub
****https://www.acha.org/documents/ncha/NCHA-III_FALL_2021_REFERENCE_GROUP_EXECUTIVE_SUMMARY.pdf
*****https://www.apa.org/monitor/2022/10/mental-health-campus-care