Steve Volk

Steve Volk

Working the Margins

Trauma City

What ails our cities isn't a refusal to cater to the creative class.

Posted Dec 04, 2013

About 19 months ago, I sat across a large conference table with a young adolescent boy named Joseph. A hard case, 13-year old Joseph suffered the rough indignities of growing toward manhood in one of Philadelphia’s most notorious neighborhoods—North Philly’s Norris Square. The faded manses of Norris Square testify to what once was, and what so much of the rest of Philadelphia still enjoys: wealth, achievement, relative safety. But the neighborhood remains largely poverty stricken, afflicted by society’s greatest ills of drug use, dealing and violence.

When we met, Joseph sat at the beginning of one of Philly’s most difficult obstacle courses. At 13, he faced peer pressure to join a gang. His school performance suffered. His mom sometimes discovered his bed empty in the middle of the night—no still, sleeping form there to unsettle the covers. There was a battle going on for the boy’s soul, and the streets were.

I wrote a story about Joseph, and his neighborhood, for Philadelphia magazine, and never shook the experience off.

We often ask the wrong question about people with Joseph’s background. We read about a teen involved in a gang or someone older than him, a 21-year old gunman, and we wonder: “What’s wrong with him?”

Consider Joseph’s story again: He regularly slipped out from under his covers, at just 13 years old, fleeing his Playstation and his loving mother and the safety of their home to go stand with his friends on the corner, hard by the neighborhood bad guys slinging dope.

We read, on a regular basis here, about young men, usually African-American, shot and killed or shooting and killing at tender ages, like 19 and 21.

Surely, we reflexively think, there must be something wrong with a young man who would throw shots all over a city block. But if we focused instead on the events that preceded all the mayhem, on the circumstances that shaped these people and the decisions they made, we would see that something did happen that produced these sad, often blood-drenched and fatal outcomes. We would see that the violence we shake our heads at is predictable, and stoppable, and because of this, in some very real sense, we are all culpable.

I will be posting here on a regular basis, and on a variety of topics—from curious anomalies and neuroscience to this subject, the topic of the book I’m working on: Post-traumatic City: How Doctors, Activists and Law Enforcement Are Battling to Save the American Mind. Because as I researched the city’s violence, I found a small but powerful squadron of Philadelphians—doctors, prosecutors and activists—who believe our city, and most American cities, are suffering from Post Traumatic Stress Disorder.

The list of symptoms associated with PTSD, and any economically disadvantaged neighborhood in America, run in parallel: difficulty maintaining relationships, learning new skills, and holding jobs; a propensity toward divorce, substance abuse and violence; and overreaction to any perceived threat.

Too many of us remain ignorant of what life is like in this country’s most violent communities. But these are environments seemingly constructed to traumatize their residents. Gunfire occurs regularly enough that the people here operate according to well-understood protocols: Parents don’t have to teach their children, in any circumscribed fashion, to duck under windows and flee toward the back of the house (a bathtub is a great place to hide). Why? Because the kids learn by watching, by being dragged when they are babies and toddlers, to the safest space in the house.

The upshot is that a lot of people in these neighborhoods develop active cases of PTSD. Those that don’t are anything but free of the condition, however, because living in a community where 20- to 25-percent of the population does have PTSD creates a kind of secondary condition: What the researchers I interviewed call “toxic stress.”

The people who suffer from toxic stress endure many of the same symptoms as those with full-blown cases of PTSD, only to a lesser degree. And the whole culture of the community shifts, to some degree, as people adjust their behavior to try and function amidst all this volatility, poverty and tension.

The good news about this medical condition is that it can be effectively treated. And so, over time, there will be much more for me to say. But for now I just wanted to plant a flag, particularly in the community that reads Psychology Today, precisely because you’re among the foremost people that can—and I suspect will—ultimately do something to help.