Emasculated by Trauma: A Social History of Post-Traumatic Stress Disorder, Stigma, and Masculinity

Winner of the William M. JonesBest Graduate Student Paper Award at the 2012 American Culture Association ConferenceThe suppression of fear and other strong emotions is not demanded only of men in the trenches. It is constantly expected in ordinary society. -Elliott Smith and T. H. Pear, 191 71The history of medicine is a social one. Although medical knowledge and its history are often understood as objective fact, divorced from cultural and social context, historians of medicine have recendy begun to undermine these assumptions. Social histories of medicine have put forth a thesis about the social nature of knowledge, specifically related to health, disease and medicine. Namely, the way a disease is understood, treated and talked about is shaped not only by medical knowledge, but also by broader cultural, social and political climates and ideologies. This social construction of disease is evident across the history of medicine but is perhaps most prominent in the history of mind-body medicine. The history of post-traumatic stress disorder (PTSD) and other war-related traumatic disorders is a study in evolving American sensibilities, social mores, and gendered cultural expectations. Since its first appearance on the battlefield, PTSD and its predecessors were used by Americans to symbolize the manifestation of societal concerns surrounding unfulfilled gender roles, tightly bound to concepts of heteronormativity. Trauma-related nervous disorders became the mark of someone who had failed to live up to culturally constructed notions of the ideal male citizen soldier. Thus, victims were blamed for their unmanly behaviour by way of stigmatizing medical diagnoses.Cultural mores surrounding gendered social roles have long shaped both the medical understanding of PTSD (and related predecessors) and the way its victims are treated and regarded within the societal framework. According to Harvard historian Ann Harrington, a cultural inability to understand the non-physical properties that lead to disease and ill health has caused society to explain these health problems through a variety of narratives. Harrington grounds western culture's inability to comprehend mind-body medicine in modern medicine's foundational assumption of the physicality of illness. Namely, modern western medicine believes that physical illness must have a physical cause. This assumption is what makes mind-body medicine so complicated. Due to the ambiguity and lack of understanding surrounding the connections between mind-body, physicalist cultures must turn to narratives as a way of explaining what does not fit into the physicalist medical paradigm. These narratives are useful in understanding the experiences of bodies and minds and how they have been understood within specific cultural contexts throughout history.Harrington explores six narratives in her book: power of suggestion, body that speaks, the power of positive thinking, broken by modern life, healing ties and eastward journeys.2 While quite expansive in scope, these narratives do not represent an exhaustive list and fail to adequately address the stories surrounding battlefield trauma. In light of this, another narrative of mind-body medicine is needed. Within this narrative, entitled "emasculated by trauma," the male body speaks of the trauma it has experienced on the modern battlefield, marrying the two narratives of "the body that speaks" and "broken by modern life. " However, this story is also one of soldiers as failed citizen subjects. Soldiers suffering the effects of trauma show an inability to exhibit the virtues of the ideal male, by failing to meet expected gender norms and fulfil male gender roles. Soldiers are still and have historically been expected to be strong and fearless, but trauma-related nervous disorders such as PTSD serve to expose the vulnerabilities and frailty of these men. Therefore, this narrative explains both a soldier's failure to fulfil the cultural expectations of men, as well as cultural and institutional notions of the good soldier. …