
Was there PTSD in the ancient or medieval world? - apsec112
https://acoup.blog/2020/04/24/fireside-friday-april-24-2020/
======
crazygringo
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_t...](https://www.reddit.com/r/AskHistorians/comments/1j6ssm/are_there_any_indications_of_combat_ptsd_in/cbbvfib/)

~~~
palimpsests
Thanks for this. I’m a trauma therapist, I work with many people who have
PTSD. Reading this article all I could think was:

Trauma is a sophisticated concept. As a society and species, we are pretty
“trauma naive” in that we have just recently come to this understanding of the
very complex web of psychological, somatic, emotional, sociological,
intergenerational, and cultural aspects of this experience. Because of this,
we are refining the therapeutic modalities that are most efficacious for
treating trauma. See all the latest literature by Peter Levine, Bessel van der
Kolk, Gabor Maté.

So I wouldn’t really expect these societies to know what to look for - in
fact, it could have been so ubiquitous that the symptoms (and/or suppression
of them e.g. regular intoxication) were normalized.

Given how warlike they were as he described in the article, it could be like
asking a fish to describe water.

We know for a fact that mammals get PTSD after being in highly stressful
experiences that they are unable to metabolize. I can’t see why humans would
be any different.

Also, many different cultures have historically had taboos around the
expression and natural resolution of PTSD. I don’t know about the culture of
society around the age he is speaking of in this regard, but I wouldn’t be
surprised if that was a normal aspect of life back then, too.

~~~
clairity
> "We know for a fact that mammals get PTSD after being in highly stressful
> experiences that they are unable to metabolize."

my otherwise wonderful dog, adopted from a rescue org when she was ~3 years
old, plainly has PTSD from prior trauma. she spent the first 3 months with me
going through frequent cycles of fear diarrhea, usually in the very early
morning hours.

i can only guess that she was treated badly by a very overbearing/masculine
person in tight quarters, based on her uncontrollable fear reactions, which
almost always happen at home. outside, she's generally friendly toward women,
mildly curious/cautious of kids, and fearful/cautious of men. we've largely
worked through the diarrhea, though sometimes it triggers if she thinks i'm
mad at her for any period of time, even if i get angry for reasons totally
unrelated to her.

she still sometimes exhibits extended bouts of panting, scratching, and self-
nibbling as she tries to regulate the autonomous fear reaction. distraction,
petting, hugging, and other countermeasures sometimes but often don't work in
calming her down. it still breaks my heart every time, even 2 years on.

~~~
BurningFrog
> >fearful/cautious of men

As a complete side note, I've always wondered how dogs tell human males from
females.

Are we even sure they do?

~~~
wayoutthere
Almost certainly by smell.

I'm a trans woman, and when I started hormones, one of the first things my
partner noticed was that my odor went from overpowering and musty to just kind
of "stale". I can get away with wearing shirts 2 or 3 times between washings,
or go without bathing for a day or two. That was definitely not possible
before hormones (at least without offending the people around me).

So I'd say yeah, if even humans can tell the difference in most cases then a
dog definitely would.

~~~
blahbhthrow3748
Same here, after transition I smell very noticeably different. It's awesome to
wash my clothes less often

------
papeda
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
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
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).

~~~
saiya-jin
That's... pretty dumb way of dealing with breakup, and I can't see it reliably
working as you describe. Humans are way more complicated than that.

What has at least a reasonable chance of working in similar situation - come
to peace with whatever happened and simply move on. It doesn't matter anymore.
Don't cover bad memories with new shiny ones and pretend those old ones aren't
there - of course they are, till your last breath they will be.

It really doesn't matter who did what and who hurt who once things are over,
it's over. Process things, expose yourself to them (at least for me it works,
weird as it may sounds smoking weed and mulling things over and over makes
them closed quite effectively in relatively short time - but that's my own
unique mindset, no clue why it works like that). They are your emotions after
all, part of you. No point trying to act differently.

How to know you really processed them? For example meeting your ex won't
trigger any stupid emotional reaction. Imagine granny meeting grandpa when
they are 80, would they still hold grudges? What would be the point?

~~~
cthalupa
I think I have to at least somewhat agree with GP here. Obviously you need to
come to terms with the relationship ending and move on in general, but I think
there's some truth to making new memories in these places being beneficial. I
would argue it isn't necessarily specific to a partner, however.

I don't frequently meet up with my ex's, but have caught up with them for
lunch or other things from time to time. I don't really have any sort of
emotional reaction to those - the relationship is over, I've got no desire to
get back together with them, etc. And it's easy for me, because I know and
accept that who we are now wouldn't work out, and that's why we broke up.

But memories don't always have that same perspective. They're a crystallized
point in time, and maybe that point in time is before whatever happened or
changed that resulted in the relationship not working out. To me those
"ghosts" can be significantly tougher to deal with than interacting with the
person in present day. Making more memories in those places doesn't make me
forget, but it does help redefine it as just another memory in a long list of
them. It gives me options of other things to remember.

------
sorokod
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-
tortur...](https://www.atlasobscura.com/articles/ritualistic-cat-torture-was-
once-a-form-of-town-fun)

~~~
ThrowawayR2
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
On the other hand a lot of people today can watch super intense horror movies
which probably would have traumatized ancient people.

~~~
ThrowawayR2
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
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.

------
distances
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/militaryhist...](https://www.reddit.com/r/AskHistorians/wiki/faq/militaryhistory#wiki_post_traumatic_stress_disorder)

------
goodcanadian
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.

------
rsynnott
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.

------
yboris
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
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)

~~~
yboris
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'.

------
bbsanon
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
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
Yeah me too. It was basically a suicide note.

------
jka
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
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.)

------
anm89
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.

------
jonnycomputer
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!

------
gdubs
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
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
He kinda goes into a blind rage though, which could still fit. Further
complicating things — they drink wine relentlessly throughout.

------
carapace
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._

------
mcguire
" _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.

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

------
manishsharan
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.

------
irrational
>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.

------
drewbeck
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
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
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.

~~~
catalogia
> _" 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.

------
speeder
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.

------
stared
Animals do feel PTSD, see
[https://www.frontiersin.org/articles/10.3389/fnbeh.2012.0002...](https://www.frontiersin.org/articles/10.3389/fnbeh.2012.00026/full)
(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
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.

------
GurnBlandston
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
Second that this is an excellent book, written by a doctor whose practice was
treating PTSD in Vietnam veterans.

------
leroy_masochist
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_\(psychology\))

------
stblack
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.

------
suthakamal
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.

------
seph-reed
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?

------
SubiculumCode
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/)

------
forgotmypw16
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.

------
throwaway627348
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)

------
yters
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.

------
autokad
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.

------
PTSDthrowaway
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."

~~~
jbotz
> [traumatic events] only return to bother us if there is some behavior that
> was contrary to the individuals values.

Or perhaps, a bit more generally, if the event causes a significant degree of
cognitive dissonance. This would include behavior by one who later suffers
PTSD, as you say, but it might also include events that were simply totally
outside what a victim expected could possibly happen to them.

------
rv-de
[https://youtu.be/FSDvF6H0cks?t=6](https://youtu.be/FSDvF6H0cks?t=6)

------
tapland
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.

------
cletus
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)

~~~
rsynnott
> 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.

This is incorrect. Decimation was a form of military discipline, not civilian,
and it was _extremely_ rare for most of Rome's history. It was usually used
for mass desertion. Thousands of people were executed for individual desertion
during WW1, so you could argue that it's not THAT exotic a punishment.

The Roman Empire _did_ do various nasty things to rebellious provinces (Judea
is particularly notable), but again, really nothing that we haven't seen in
20th century wars, unfortunately.

~~~
Spooky23
The poster was trying to make a point that I think stands even if there are
some technical definitional issues.

Roman history is long and practices vary. I don't think that you can
critically look at the campaigns to conquer and pacify Gaul or Carthage
without walking away with the understanding that mass killing (or enslavement)
wasn't a tool wielded by the Romans.

~~~
rsynnott
Oh, sure; they did awful things. I'm just not sure that decimation is
reasonable evidence for "Likewise, ancient culture and justice must be almost
incomprehensible to us."; the Nazis did far, far worse, say.

For that matter, their behavior in Gaul isn't evidence of it either; again, we
unfortunately have many recent parallels.

------
shaunxcode
Yes.

------
third_I
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.

~~~
mkl
> 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.

Huh? The author's hypothesis is that nurture and context were all-important in
helping people avoid PTSD.

~~~
third_I
And I claim, or rather parrot, that it's wrong to think that because words
were not spoken or did not exist, the thing they would eventually come to
designate ("PTSD") did not exist.

Romantic love is another good example. It never was spoken in modern terms
before the 16th century give or take. Which is far from being equivalent to
say "nope, they didn't speak of it like that, so people never experienced
romantic love before the 16th century!"

The author's view is just as flawed, afaik. PTSD and every other psychological
trait known in modern times did exist for much longer than recorded history,
that's what most historical psychologists have concluded (it's not open to
debate...), just in different terms (words), perceptions, value (in a larger
hierarchy).

Edit: think of it this way. Were feelings "important" in the past? Certainly
nowhere near as much as they are today, in our perception. Most were not even
spoken, there simply were no words most of the time (or unknown to layman
people). Did feelings exist forever, however? Absolutely, yes.

------
pdubs1
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
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
Again, "See: Stress inoculation".

Don't worry about one particular study. Search for The Concept. Deduce for
yourself its validity.

------
valuearb
Is there PTSD in the modern world?

Reproducibility crisis says dunno?

