PTSD and the Concept of Human Maliciousness

Late last year I was diagnosed with PTSD. Like many, I read Bessel van der Kolk’s bestseller The Body Holds the Score. I learned a lot. I saw my dissociative symptoms and my panic attacks in a new light. However, something I thought was missing from van der Kolk’s fascinating analysis was an explanation of how the manifestation of a disrupted psychic life comes to be. Looking at the works of Anna Freud, Carl Jung, and Wilhelm Reich, I concluded that in my own case, PTSD is a result of unwanted and unpredictable contact with what could be deemed unexplainable maliciousness.

Psychoanalysts have suggested that PTSD makes the moral border of the world appear fuzzy and vague.

Source: Adrian Kreutz

A caveat: The argument I am going to present stems from my own subjective experience as well as from a historical school of thought: early twentieth-century psychoanalysis. My argument should not be taken as contemporary clinical orthodoxy.

However, despite this, much of the intricate contemporary work on PTSD I personally found either difficult to break down––to make communicable and understandable on a basic level––or else fails to present important philosophical (ethical) presumptions.

PTSD: The Symptoms

According to contemporary diagnostics, besides psychological symptoms such as anxiety, dissociation, and depression, people with PTSD may experience physical symptoms, such as increased blood pressure and heart rate, fatigue, muscle tension, nausea, joint pain, headaches, and other types of pain.

According to The Body Holds the Score, the person in pain may not realize the connections between their soma (the bodily pain) and the reactions of their psyche to traumatic events. Regrettably, van der Kolk says very little about the nature of those connections themselves. The Body Holds the Score suggests a black-box view of the relations between the psychic and embodied life. I found this unsatisfying.

Psychoanalytic Roots

Those on whose shoulders the book stands––especially Anna Freud’s work on defences, Wilhelm Reich’s groundbreaking work on embodiment, and Carl Jung’s theories of “good” and “evil”––had a much more sophisticated and complex theory of the psychoanalytic excavation of the mind-body relation and where it might be disturbed.

This complex view of the mind-body entanglement is important, for all three thinkers suggest that understanding human goodness and badness is an antidote to post-traumatic stress disorder––an understanding that goes beyond the immediate embodied reactions to terror that are commonly associated with PTSD and towards a sophisticated conceptual map of the world.

Broadly speaking, Jung, Reich, and Anna Freud argue that those who suffer from PTSD view the world as if ‘good and ‘evil’ did not (yet) exist. The psychically naïve mind that Jung, Reich, and Anna Freud discuss navigates the world unequipped for situations in which pure (pointless) malevolence strikes. Such a mind operates under the highest order axiom that people are basically good, all the time. Thus, as soon as the unequipped mind encounters senseless evil, it lacks the conceptual apparatus to match the actual event (terror) with the expected outcome (goodness). Note that this "naive orientation" as a baseline belief about an important aspect of human nature is a hallmark of psychoanalytic thinking.

Difference in higher order axioms (i.e., some have a more complex mental map of human benevolence and maliciousness) may help explain why some suffer from PTSD in the aftermath of a traumatic event while others do not. The Jungian-Freudian-Reichian narrative also captures the difference between PTSD that ensues from interpersonal, human-generated trauma vs. the effects of for instance, natural disaster. The randomness of natural catastrophe is easier to integrate with the higher order axiom of universal goodness than is the disruption of trust in the goodness of one’s peers.

To understand and integrate evil is thus to separate out the evil from the good, so that trust in the good can remain stable or be regained.

For Reich, in a situation in which trauma strikes, the individual must create a mental conceptual framework from scratch that allows for the re-integration of pure, pointless malevolence. In other words, the individual will strive towards making the roots of their psychic disruption explainable.

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Per Anna Freud’s account, this struggle for understanding shows itself in defences––unconscious resources by the ego to decrease the psychic conflict between the expectation of goodness and the reality of evil. The Freudian defences are regression, repression, reaction-formation, isolation, undoing, projection, introjection, turning against the self, reversal, and sublimation. In her estimation, these are linked to the symptoms of PTSD. For Jung, the defences are a sign of misaligned (or, indeed, missing) concepts of ‘good’ and ‘evil.’

Psychoanalysis ≠ Clinical State of the Art

The present-day thinking about PTSD is complex, of course. Factors including underlying genetic vulnerability, coping and support mechanisms on the part of survivors, and many others need to be invoked in a discussion of why some people experience PTSD and others do not. Early twentieth-century theories present a much simpler, clinically unsophisticated picture. Those theories fail to consider many other factors. In my own experience, these theories nevertheless ring true.

To ameliorate or cure PTSD, those psychoanalytic thinkers suggest, we must attain a more robust, complex understanding of human benevolence and our capacity for maliciousness. This is far more basic than the current clinical status quo. But I do think there’s still something valuable to be learned from this perspective.