Evil Hours, by David J. Morris

The Evil Hours, by David J. Morris
Narrated by Michael Chamberlain

In this important work, Morris traces the history of what we now call post-traumatic stress disorder (PTSD), even back into the ancient days. He begins the book with his own experiences with PTSD. He experienced many traumatic events when he was a war journalist in Iraq, most notably “the time he was blown up.” He remembers shortly before, one of the men asked him tentatively “Have you ever been blown up, sir?” Although the rest of the group chastised the man, it was too late. Morris had been “cursed.” When he was “blown up,” one of the men turned to him and yelled “What are you doing here?! We all want to go home and you’re here voluntarily?! What are you doing here?” Morris couldn’t answer that question. He understood that this moment had torn a rift between himself and this angry soldier – because Morris had chosen to put himself in danger. To be honest, I’ve often felt that way about war correspondents. Not that they deserve PTSD, no one deserves that. But if they repeatedly and purposely put themselves in danger, something will eventually happen.

In his book, Morris discusses not only his own PTSD & the history of PTSD, he talks about how PTSD affects the lives of its sufferers. He also discusses the major treatments for PTSD, many of which he has tried out himself. He apparently interviewed quite a few people for the book – at least he claims he did – though those interviews are generally chiseled down into two or three sentence mentions.

One point that Morris brought up about “PTSD” in ancient culture is his suggesting that Epic of Gilgamesh and The Odyssey could be interpreted as allegories for PTSD. This was a fascinating new way to interpret an epic that I have been spending a lot of time thinking about lately (Gilgamesh, of course). The way he interpreted it, travel is good for the war-ravaged brain – seeing new places and having new experiences can release the trauma so that you can eventually return home to your life. I interpret it differently. I say that the voyage itself is in the mind. The voyage itself is the PTSD. Gilgamesh’s desperate hunts for immortality – whether by glory, by physical longevity, or by wisdom – they’re different stages in his growth and healing from a trauma. I’d have to think about it more, but it’s definitely workable.

Morris also had an interesting section on treatments. The first he discussed was one that is highly lauded as the most successful treatment for PTSD: prolonged exposure (PE). In PE, the patient is made to relive his trauma in exact detail over and over. The theory is that after reliving it so many times, the mind becomes immune to the trauma, and is able to move on. This treatment has fantastic success rates. Problem is, the “success rates” of these studies don’t generally include people who drop out of treatment. And most people drop out of treatment because it makes their symptoms worse (at least at first). So is this a highly successful therapy? Or a potentially harmful one? Morris dropped out of PE because he became much, much worse. Morris also tried a form of cognitive behavioral therapy which worked out much better for him – though Morris thought the idea of meshing out his cognitive distortions to be pointless and annoying. Morris also briefly talked about antidepressants. He pointed out that there is no proof that antidepressants have any effect at all on the symptoms of PTSD, but they might help the depression and suicidal ideation that often accompany PTSD.

One thing that disappointed me is that this is not a book about PTSD in general – it is a book about PTSD in military. PTSD is suffered more by women than by men. Most Americans with PTSD are women who have been raped or beaten or otherwise traumatized during a non-war setting. One review I read said “rape is also discussed extensively.” It wasn’t. Rape got a side comment every once in a while – generally in the form of a quote from Alice Sebold’s memoir. However, most of the research on PTSD, and Morris’ own personal experience with PTSD, is military-related, therefore it is understandable that he would focus on military PTSD.

The book also tended to wander and get a bit dull at times. And every once in a while there was a little touch of ignorance that the snobby intellectual will cringe at. Such as saying “as soon as I left PE, my stress almost mathematically declined.” That sentence is meaningless. Every decline can be modeled mathematically. I suppose he meant “exponentially declined.” But…sorry….I know….I’m a snob.

In the end, I thought this was a good book that could have been an amazing book if he had taken that extra step to include womens’ experiences a little more. Women are the majority of the sufferers of PTSD in the US, and a great journalist would certainly have the resources to look into this subject as well.

A generous 4 stars for important content and good personal tie-ins

Dark Eden, by Chris Beckett

Dark Eden, by Chris Beckett; narrated by Matthew Frow, Jayne Entwistle, Ione Butler, Robert Hook, Heather Wilds, Nicholas Guy Smith, Hannah Curtis, Bruce Mann

When a group of four people have to land on an unknown planet to regroup and repair their ship, they decide to split into two groups – a man and woman who do not want to risk the flight back remain on “Eden” alone, and the two others set back off for Earth with promises to send a rescue ship as soon as possible. Generations later, the people of Eden are still waiting. Still hanging out in exactly the same crash-landing spot. Still following the matriarchal rules structured by the mother of all. But their small area is becoming too crowded. They have to forage farther and farther for food.

John Redlantern is frustrated with “Family.” With their stubbornness at remaining in one spot when they could clearly spread out over the vast planet and have enough food for all. He’s tired of the extreme ritualistic nature of “Family.” The artifacts from planet Earth are passed around to be “ooohed” and “ahhhed” at, but they are meaningless to a people who have never experienced technology. John is tempted to disrupt the circle of the past, and create a new path for the “Family.” In doing so, he breaks down everything “Family” represents.

Let me start with an important point: although John Redlantern and his friends are teenagers, this is not a teen book. It’s “literary science fiction.” The beginning of the book, which builds the world, the people, and the tension, is really long and slow. It was a bit of a slog to get to the turning point. Once that happens they story finally begins to move a little faster – but even the post-turning-point action is slow.

The reason the narrative is so slow is because this is a story about Meaning with a capital M, and not about plot or action. Don’t get me wrong. There’s a plot. A plot with Meaning. There were several allegories to the story. The obvious one is the Biblical creation story. It’s all about how innocence is lost when people begin to get bored. But boredom is in our nature. Without boredom, we never learn new things. And new experiences don’t just change you, they change the world.

Dark Eden also explores a destructive nature of men – as opposed to a more structured, peaceful and confining nature of women. (This seems to be what the book implies, it’s not exactly what I think of the gender divide.)

Dark Eden demonstrates the irony that change is needed to survive, but change is destructive to survival. It’s not just a book about changing the world. It’s also about how the world changes the individual. The main characters in the book, especially John Redlantern and his lover Tina Spiketree, develop into strikingly different people as they adapt to the changing world. Innocence is replaced with deviousness. Ivory towers collapse, covering all bystanders with dust and grime. This is a story of identity.

In other ways, Dark Eden is a book about faith. How faith can lift you up and keep you strong during difficult times. But how it can be manipulated against you, as well. And how, as you realize everything you had faith in is mistaken, you are first paralyzed with numbness, but then are able to move on as a new person.

I want to give a good review for this book with so much Meaning. I mean, it should have been good. It had Meaning. But a great book has both Meaning and an ability to fascinate even if you don’t see the Meaning. Dark Eden did not. In Dark Eden, the story was lost in the darkness because you were blinded by the bright, shiny Meaning. It was too slow, the hero wasn’t even likable if you considered him an anti-hero, and it was thoroughly uncaptivating. I totally understand why it won the Arthur C Clark award and why it comes so highly recommended. Beckett’s world was unique – colorful and dark at the same time. The setting was unsettling and realistic within the boundaries of science fiction. The lingual drift was a nice, realistic touch. But most of all, the book was slow and Meaningful.

3.5 snowflakes for unique world building and Meaning

As an afterthought – I would like to post this Twitter conversation:

It is authors that are willing to interact with their readers, even when given a mediocre review, that are truly great. I had been on the fence about whether to read the second book in the series or not – because I am a little curious where his Meaning will go – this conversation put me over the edge to want to read it. Because when someone cares about his readers, I want to like his books more. 🙂

Severed, by Frances Larson

Severed: A History of Heads Lost and Heads Found, by Frances Larson, Narrated by Reay Kaplan

As soon as I heard about this book I just had to read it. I tried to convince my book club to read it for next month, but alas, the subject was too upsetting for them. So I chose to read it anyway. And I most certainly am glad that I did so.

Severed is about Western culture’s fascination with severed heads throughout history. The book begins with Larson’s own fascination with the shrunken heads in Pitt Rivers Museum at Oxford, where she worked. Apparently, they are quite an attractive exhibit there, drawing lots of fascinated people – adults and children alike.

The shrunken heads were made by Shuar and Achuar peoples from South America, ranging from Peru to Ecuador. The heads were considered to have the power of the souls of the former owners, and when the heads were shrunk, the Shuar and Achuar people were able to harvest that power. The shrunken heads were made by removing the brain and skull. The skin of the head was then put in hot water and filled with scalding sand. The sand treatment was repeated several times until the head shrunk down to the size of a fist.

Interestingly, after the heads were shrunk, they no longer had any power. Therefore when Westerners became interested in the heads as novelty items, the Shuar and Achuar people were happy to sell them. Even Westerners wanted a piece of the shrunken head profit: they would fake the heads using heads of monkeys.

Apparently, these shrunken heads are found quite fascinating by the Westerners even today. Many are in display in museums. I used to go to a museum when I was a child – it was called Woolaroc Ranch in Bartlesville, OK – and I was frightened and quite the opposite of fascinated by the shrunken heads. And even today, I searched “shrunken heads” in my stock photo source, and felt a little queasy at the results. Funny, I can read this book with fascination, but I can’t look at a picture of a fake shrunken head without feeling a little off. 🙂

Anyway, Larson’s story of severed heads did not stop there. She discussed trophy hunting during Pacific, Vietnam, and Korean Wars. It’s surprising what a soldier might do when he is in the foreign world of kill-or-be-killed. Again, the idea made me feel sad.

She discussed the sloppy ax beheadings of convicted criminals in the days before the guillotine. How an executioner would be praised by his ability to cut a head clean off, and would be shouted down, beaten, and possibly killed because of a sloppy execution. Because higher society became more “refined,” they decided that the rowdy crowds that executions attracted were disturbing – so they invented the guillotine. The crowds were disappointed by how quick and effortless the executions were, but the executions certainly became more humane.

Larson finally discussed phrenology, plastination, and dissection of heads by medical students (modern and in the old days of stolen corpses). Until she got to the plastination part, I was feeling rather fascinated but disgusted – actually a little high-and-mighty that I certainly did not find dead heads fascinating. (Yes, I recognize the internal contradiction in that sentence.) But then I realized she had a point. I was fascinated. I was fascinated by her book. And when the Bodyworlds exhibit came to the Science Museum of Minnesota, I sure did rush out there to see it. And I didn’t find it disgusting. Of course, there’s a difference between Bodyworlds versus collecting the heads of unwilling donors – the people of Bodyworlds all donated their bodies to this “art” project. In fact, I find mummy exhibits to be a little wrong.

Larson claims that our disgust at the collection of heads is rather a new concept – it isn’t inherent in humans. I find that a little hard to believe, but I recognize that some things that seem naturally right to me were not always “right.” For instance, homosexuality. Not more than a couple decades ago homosexuality was listed in the DSM as a psychological disorder. Now it’s mostly accepted as normal behavior for some people – and the idea that it was considered a mental illness is laughable (or insulting, depending on what personality type you have). So why can’t the same thing be said of my own uncomfortableness about severed human heads? But I’d like to point out my own argument against Larson’s point: if people of the past didn’t find the idea of severed human heads a bit off-putting, then why were they so fascinated by the idea?

Larson’s book was a fantastic read for the Halloween season. It was creepy, fascinating, and creative. The research seemed quite diverse and the narrative was engaging. I really think there’s a lot to learn from this book – at the very least it will make you rethink your own views on the subject of dead heads.

4.5 stars for creative subject, research, and engaging narrative.

Post Traumatic Stress Syndrome – the Basics

I think we all have some idea of what we think PTSD is, but it turns out PTSD isn’t as clear-cut as I thought.

Apparently, when PTSD was first introduced into the DSM, the diagnostic criteria required a traumatic event “outside the range of usual human experience” that would cause “significant symptoms of distress in almost anyone.” That fits pretty well with my own perception of PTSD. Rape, war, torture, violent experiences…these all fit into that description. PTSD is a normal response to an abnormal stressor.

However, in the DSM-IV, the nature of the “traumatic event” broadened drastically, and a requisite response was “intense fear, helplessness, or horror.” So in the DSM-IV, PTSD was a pathological response to a potentially less extreme stressor. Someone could be diagnosed with PTSD if they experienced “intense horror or helplessness” after watching a scary TV show or upon being diagnosed with a terminal illness.

Although I don’t wish to undermine the intense stress that someone with pathological responses may feel, I think this definition undermines the intensely awful experience that someone with PTSD (in my mind) has encountered. The statistics agree with my assessment of these criteria: in a community survey, 89.6% of people reported that they had been exposed to a traumatic event and had responses that could potentially qualify them for a PTSD diagnosis.

Luckily, the DSM-5 tightened the traumatic event criteria again, and broadened the range of response to the traumatic event. Now, the traumatic event must occur directly to the subject, and they can exhibit other pathological responses besides “intense fear, helplessness, or horror.”

To be diagnosed with PTSD by DSM-5 standards, a person must be exposed to “actual or threatened death, serious injury, or sexual violence.” They must exhibit one of the following symptoms: intrusive distressing memories of the event, distressing dreams reliving the event, dissociative reactions, intense psychological distress at cues that remind the person of the event, or marked physiological reactions to cues that remind the person of the event. Additionally, the person must persistently avoid stimuli associated with the traumatic event, have negative alterations in cognitions and moods associated with the event (e.g. distorted cognitions about the cause or consequences of the event), and alterations in arousal and reactivity (e.g. hypervigilance or angry outbursts).

In general, people respond to trauma with decreasing pathological symptoms. In order to be diagnosed with PTSD, the patient must have experienced these negative responses for more than 1 month, otherwise they are experiencing “acute stress disorder.”

Despite the common association of PTSD with war veterans, PTSD is actually more common in women than in men – and the traumatic events are more often domestic violence or rape than war. However, a great deal of money and time has gone into research of PTSD in war veterans.

During WWI, symptoms of PTSD were called “shell shock,” and were thought to be caused by brain hemorrhages. However, this belief slowly subsided as doctors realized that the symptoms presented themselves regardless of injury. By WWII, traumatic reactions were known as “operational fatigue” and “war neuroses,” before the terminology finally settled on “combat fatigue” during the Korean and Vietnam wars. A rigorous longitudinal study of PTSD by Smith et. al. in 2008 found that 4.3% of military personnel deployed to Iraq or Afghanistan had PTSD. Of those, the rate was higher (7.8%) in those that had experienced combat compared to those who hadn’t (1.4%). An issue that is (rightfully!) getting much attention lately is the high rate of soldier suicide. Between 2005 and 2009, more than 1,100 soldiers took their own lives – generally with a gun.

There are several risk factors that increase the likelihood of PTSD – being female, lower social support, neuroticism, preexisting depression or anxiety, family history of depression, substance abuse, lower socioeconomic status, and race/ethnicity. (Apparently, compared to whites, African Americans and Hispanics who were evacuated from the World Trade Center in 2001 were more likely to get PTSD.) There is also a genetic factor that increases susceptibility to PTSD. Preliminary studies suggest that people with a particular form of the serotonin transporter gene may be more susceptible to PTSD than those with the “normal” form of this gene.

On the other hand, there is at least one factor that promotes resilience to traumatic events: intelligence. It’s possible that people with higher intelligence are better able to make “sense” of the event by viewing it as a larger whole. Or an intelligent person may be better able to recognize and buffer cognitive distortions such as “I deserved that,” “why should I have lived when they died?” and “If I had only done _______, this wouldn’t have happened.”

Researchers have come up with several ways to decrease likelihood of succumbing to PTSD after a traumatic event.

Stress-inoculation training has proved successful with members of the Armed Forces. Soldiers can be exposed, through virtual reality, to the types of stressors that might occur during deployment. Thus they are better able to deal with the trauma when exposed to the events in real life.

Debriefing after a traumatic event can also be helpful. This allows the victim to process the event in a safe environment, before the details become internalized.

Interestingly, one study showed that subjects who were exposed to a highly disturbing film were less likely to report flashbacks if they played Tetris for 10 minutes after the film than if they sat quietly for those 10 minutes. This team of researchers also showed that simply being distracted after the disturbing video was not enough to decrease flashbacks, and that doing a verbal task actually increased the number of flashbacks. So, apparently, visio-spacial tasks decrease the likelihood of intrusive flashbacks if performed immediately after the traumatic event. I’m not sure this information is particularly useful, but it’s interesting.

As of yet, there isn’t a highly successful way to “cure” people with PTSD. Cognitive behavioral therapy, which helps the victims recognize cognitive distortions (e.g. “I deserved that,” “why should I have lived when they died?” and “If I had only done _______, this wouldn’t have happened.”), can be helpful in reducing anxiety. Antidepressant medications can alleviate some of the depression and anxiety experienced by victims.

One up-and-coming treatment has shown promising results. Someone with PTSD can undergo prolonged exposure to the traumatic events. They can do this through repeatedly reliving the events out loud, or even by re-experiencing them through virtual reality. Unfortunately, many PTSD vitimcs drop out of such treatments because reliving the events is too difficult. However, this treatment method has proven very helpful to people who complete the process, and I hope that work in this area continues.

This is a series of posts summarizing what I’m learning in my Abnormal Psychology course. Much of the information provided comes from reading my James N. Butcher’s textbook Abnormal Psychology. To read the other posts, follow these links:

The Definition of Abnormal
A History of Abnormal Psychology
Abnormal Psychology in Contemporary Society
Contemporary Viewpoints on Treating Mental Illness – Biology
Contemporary Viewpoints on Treating Mental Illness – Psychology
Frontline: New Asylums
Brave New Films: This is Crazy
Clinical Mental Health Diagnosis: Biological Assessment
Clinical Mental Health Diagnosis: Psychological Assessment
Does the DSM Encourage Overmedication?
Post Traumatic Stress Syndrome – The Basics
Panic Disorder
Obsessive Compulsive Disorder
Hoarding and Body Dysmorphic Disorders
Depression – an Overview
Personality Disorders – Clusters and Dimensions
Personality Disorders – Cluster A
Personality Disorders – Cluster B
Personality Disorders – Cluster C
Biological Effects of Stress on Your Body
Somatic Symptom and Related Disorders
Dissociative Disorders
Borderline Personality Disorder
Dialectical Behavioral Therapy
Paraphilic Disorders
Gender Dysphoria – Homosexuality and Transgender
Anxiety Disorders
Bipolar Disorder – The Basics
Suicide – An Overview

References:

Butcher, James N. Hooley, Jill M. Mineka, Susan. (2014) Chapter 5: Stress and Physical and Mental Health. Abnormal Psychology, sixteenth edition (pp. 129-161). Pearson Education Inc.

A Draw of Kings, by Patrick W. Carr

A Draw of Kings, by Patrick W. Carr

Genre: Teen / Christian Fiction / Fantasy

Reason for Reading: This was a galley copy provided by the publisher through Netgalley in exchange for an honest review. This is the third book in a trilogy that I have been enjoying.

Synopsis (May contain slight spoilers for previous books in the trilogy): In this third, and final, book of the Staff and Sword trilogy, the war for Illustra begins. In order to maintain order within the Judica, Errol must retrieve The Book that was left behind in Merakh. Meanwhile, Adora and Liam must journey to the Shadowlands to make a pact with these newly discovered allies. A feeling of dread descends upon everyone, as the people of Illustra realize they are surrounded by vast armies of enemies and demon spawn. They must discover who their king and savior is – or else the barrier will never be restored and the demons will destroy Illustra.

My Thoughts: This book was every bit as good as the previous two – and it tied off most of the loose ends quite well. For fantasy fans, this book was packed with battles, intrigue, foreign lands, and ranging demon-spawn. I was also quite impressed with Carr’s ability to write religious allegory. He deftly got his message across by showing it within the story instead of writing lectures into the dialog as many authors do. In fact, I bumped this book up an extra half a star (something I rarely do) because I admire how much finesse it takes to write a good allegory without sermonizing.

One of the allegorical issues presented is the fallibility of humans (as well as the organizations that we create). The church, in Carr’s world, was composed of many good men (as well as a few villains) who often made mistakes and were suffering under misunderstandings of God which had accumulated after the loss of their religious book. This is the message that I originally interpreted as criticisms of the Catholic Church in my review of Hero’s Lot, though after reading this book the criticism feels more forgiving. The message is: no one is perfect, we are all human, and we’re going to make mistakes. We can’t judge everyone in a group based upon the mistakes of some of its leaders. I’m not sure if this is the message that Carr intended, but it is how I felt when I read A Draw of Kings.

The other allegorical message that I felt was done tremendously well related to faith and doubt. There was a moment when Adora as climbing a cliff and Liam was behind her, and even though she knew Liam was there to catch her if she fell, she suddenly doubted that he was there at all – that he had ever been there. And then he carried her. I’m sorry if that is a spoiler, but I couldn’t help but point out the beauty of that moment. Because it’s so true, isn’t it? It’s so easy to lose faith – even though this loss of faith is irrational when viewed from the outside-the-moment.

My interpretation of this story has evolved so much while reading this third book, that I feel I ought to go back and revise some of the criticisms I made about the second book. Of course, I always have to include criticisms, but…. Which brings me around to my criticisms of A Draw of Kings. My first complaint is how violent it was. I felt that the good guys (Adora especially) were sometimes more violent than they ought to have been. Of course, this could simply be another way in which we are only human – and therefore fallible. So this is only a small criticism. The other criticism is that I felt threads were dropped in relation to the countries other than Merakh. There needed to be a little more tie-up after that much build-up. But that, too, is only a minor issue since the major threads were tied up wonderfully.

Overall I was greatly pleased with this book, and I will recommend it to all of my friends who read books of this genre. In fact, I’m hoping it wins some awards – it’s well-deserving of the Christy Award for Young Adult literature.

The Garden of the Evening Mists, by Tan Twan Eng

2012 Book 159: The Garden of the Evening Mists, by Tan Twan Eng

Reason for Reading: Short-listed for the 2012 Booker Prize

Review

Having suffered through a Japanese slave-camp during WWII, Yun Ling Teoh, a young Chinese-descent lawyer in Malaysia, carries around a lot of anger against the Japanese. However, she’d made a promise to her deceased sister that she would build a Japanese garden, so she reluctantly visits Aritomo – the only Japanese gardener in Malaysia. Aritomo refuses to design a garden for Yun Ling, but he offers to take her on as his apprentice so that she may design one herself. Yun Ling learns to let go of her anger as her friendship with Aritomo grows. But Aritomo has his own secrets.

How can I express what an amazing book this was? Sure, it had a couple of slowish spots (it WAS, after all, a book about gardening) but the story is magical. The historical and cultural backdrop is intriguing (I learned a lot while reading, but didn’t feel like I was being “taught”). Because the book takes place in two different times (current day and shortly after WWII), the story unfolds gracefully – allowing the reader to learn the story of Aritomo and Yun Ling at just the right rate…but yet somehow the time also blends together giving an impression of continuity that is particular to Eastern philosophy. On top of that, the more I learned about the story, the more fascinated I was by the two characters. This book is definitely worth your time.

Interpretive note with possible spoilers

One thing that struck me while I was reading this book is that I noticed an inconsistency in what the narrator (Yun Ling) was saying. At first, I wasn’t sure whether the author had made a mistake or if he had purposely introduced inconsistencies to show that Yun Ling had either an unreliable memory or was hiding something. I finally came to the later conclusion (though the unreliable memory was possible too). I think it’s fascinating that such inconsistencies added to the overall effect rather than subtracting from it. I applaud Tan Twan Eng for his careful writing of this book. 🙂

Surrender the Dawn, by MaryLu Tyndall

2012 Book 75: Surrender the Dawn, by MaryLu Tyndall (5/12/2012)

Reason for Reading: ACFW bookclub choice for May

My Review 4/5stars
Because all the men in her family have left to fight in the War of 1812, Cassandra Channing must financially support her family. She desperately decides to invest the rest of the family’s money in a privateering ship captained by the town rake Luke Heaton. Because she is forced to trust someone outwardly untrustworthy, she is forced to come to grips with the fact that not everything is as it seems…and sometimes she should have more faith. This is the third book in the Surrender to Destiny trilogy, but I read it as a stand-alone book. (It works fine that way.) However, I liked it so much, I’m planning on reading the first two in the series, as well…just so I can get a complete picture of all the characters. This book is a sweet romance with an interesting historical backdrop. It definitely has a religious message, but it is never preachy. I think it was just what I needed at the moment.