A First-Rate Madness (40 page)

118
“good outcomes in spite of serious threats”:
Ann Masten, “Ordinary Magic: Resilience Processes in Development,”
American Psychologist
56 (2001): 227–238.

118
a “steeling” effect:
Michael Rutter, “Implications of Resilience Concepts for Scientific Understanding,”
Annals of the New York Academy of Sciences
1094 (2006): 1–12.

120
Harry Stack Sullivan:
Helen Swick Perry,
Psychiatrist of America: The Life of Harry Stack Sullivan
(Cambridge, MA: Belknap Press, 1982). M. S. Allen, “Sullivan's Closet: A Reappraisal of Harry Stack Sullivan's Life and His Pioneering Role in American Psychiatry,”
Journal of Homosexuality
29 (1995): 1–18.

120
“low-grade morons,” “psychopaths”:
Ben Shephard,
A War of Nerves: Soldiers and Psychiatrists in the Twentieth Century
(Cambridge, MA: Harvard University Press, 2000), 199.

120
By 1943, 112,500 enlisted men had been discharged:
Ibid., 201.

120
“To the specialists”:
Ibid., 202.

121
This is the case with all hysteria:
Paul McHugh,
The Mind Has Mountains
(Baltimore: Johns Hopkins University Press, 2006).

121
In a classic example from medical history:
Edward Shorter,
From Paralysis to Fatigue: A History of Psychosomatic Illness in the Modern Era
(New York: Free Press, 1992).

122
most people who experience trauma do
not
develop PTSD:
Ronald C. Kessler, Amanda Sonnega, Evelyn Bromet, Michael Hughes, et al., “Posttraumatic Stress Disorder in the National Comorbidity Survey,”
Archives of General Psychiatry
52 (1995): 1048–1060.

The above study is the largest and most definitive U.S. community psychiatric diagnostic study. It documented a lifetime PTSD rate of 7.8 percent, twice as high in women (10 percent) as in men (5 percent). If one includes other traumas besides physical and sexual abuse (such as crime, war, major auto accidents), about half of the American population experienced a major traumatic event (60.7 percent of men and 51.2 percent of women). Thus only about 10 percent of individuals who experience a major trauma later develop PTSD.

These are averages. With more severe trauma, such as repeated and intense childhood sexual abuse, as opposed to one occurrence, the PTSD rates rise. In the aftermath of September 11, 2001, the general PTSD rate in New York City was 6–8 percent; but if persons had been physically injured during the attack, it was 26 percent. Among Vietnam veterans, chronic PTSD appears to be present in 9 percent; in those with the most combat exposure, it is 28 percent. Studies rarely find full PTSD present in more than one-third of any sample, even with the most severe trauma. Milder PTSD symptoms that may not meet the full definition (“subsyndromal” PTSD) occur, but still only in a minority. For instance, after September 11, 2001, with syndromal PTSD present in 6–8 percent of the population, subsyndromal PTSD symptoms were found in another 17 percent. (S. Galea et al., “Psychological Sequelae of the September 11 Terrorist Attacks in New York City,”
New England Journal of Medicine
346 [2002]: 982–987.) In sum, with typical traumas, even under the worst conditions, at least one-third of persons have no PTSD symptoms at all—ever. (G. A. Bonanno and A. D. Mancini, “The Human Capacity to Thrive in the Face of Potential Trauma,”
Pediatrics
121 [2008]: 369–375.)

The same holds in the absolute human trauma—death. Each of us must face the deaths of loved ones, and, eventually, ourselves. Grief after the death of a beloved person is a universal human experience. Chronic grief, however—a grief of such severity that it involves long-term depression and PTSD-like symptoms—only happens in about 10 percent of persons. (W. Middleton, P. Burnett, B. Raphael, and N. Martinek, “The Bereavement Response: A Cluster Analysis,”
British Journal of Psychiatry
169 [1996]: 167–171.) Even when a death is unexpected and especially painful, chronic PTSD-like grief does not occur in most persons.

122
Bonanno identifies four major types:
George A. Bonanno, “Loss, Trauma, and Human Resilience,”
American Psychologist
59 (2004): 20–28.

122
they recovered repressed memories:
This is what Freud's first patient famously called “the talking cure”—a staple of Freudian dogma. All sorts of unconscious emotions exist within us, some related to childhood trauma; our current neuroses, anxieties, and depressive symptoms flow from those repressed unconscious emotions. This view has not been without controversy: feminists later attacked Freud for repressing the theory of repression, fearing the consequences of revealing the sexual abuse of young girls in a male-dominated Victorian world; others see the whole concept of repression as a fabrication, mere suggestion by psychotherapists with their own ideologies (sometimes fantastically so, as in the theory of sexual abuse by aliens from outer space). The repressed memory debate has led to lawsuits and delirium, with some probable unjust accusations, and some legitimate cases dismissed as unprovable.

123
Similarly, in Gulf War veterans:
P. B. Sutker et al., “War Zone Stress, Personal Resources, and PTSD in Persian Gulf War Returnees,”
Journal of Abnormal Psychology
104 (1995): 444–452.

124
strong social supports:
Michael Rutter, “Resilience in the Face of Adversity: Protective Factors and Resistance to Psychiatric Disorder,”
British Journal of Psychiatry
147 (1985): 598–611.

124
Some psychologists call this “ordinary magic”:
Masten, “Ordinary Magic: Resilience Processes in Development.”

124
Similarly, in studies on World War II veterans:
K. A. Lee, G. E. Vaillant, W. C. Torrey, and G. H. Elder, “A 50-Year Prospective Study of the Psychological Sequelae of World War II Combat,”
American Journal of Psychiatry
152 (1995): 516–522.

124
In an uncommon project:
Stephan Collishaw et al., “Resilience to Adult Psychopathology Following Childhood Maltreatment,
Child Abuse and Neglect
31 (2007): 211–229.

124
psychologist Dean Keith Simonton found:
Dean Keith Simonton,
Greatness: Who Makes History and Why
(New York: Guilford, 1994).

125
are usually set by age three or so:
A. Caspi and P. A. Silva, “Temperamental Qualities at Age Three Predict Personality Traits in Young Adulthood,”
Child Development
66 (1995): 486–498.

125
Adults who have higher neuroticism scores experience more PTSD:
Lee et al., “A 50-Year Prospective Study.”

125
one study examined . . . terrorist attacks in Russia:
V. S. Yastrebov, “PTSD After-effects of Terrorist Attack Victims,” in
The Integration and Management of Traumatized People After Terrorist Attacks,
ed. S. Begec, 100–107 (Amsterdam: IOS Press, 2007).

126
study of forty-six college students:
Barbara L. Frederickson, Michael M. Tugade, Christian E. Waugh, and Gregory R. Larkin, “What Good Are Positive Emotions in Crisis? A Prospective Study of Resilience and Emotions Following the Terrorist Attacks on the United States on September 11th, 2001,”
Journal of Personality and Social Psychology
84 (2003): 365–376.

126
in young adults with childhood sexual abuse:
Bonanno, “Loss, Trauma, and Human Resilience.”

126
Genetic studies with identical versus fraternal twins:
Kenneth Kendler and Carol Prescott,
Genes, Environment and Psychopathology
(New York: Guilford, 2006).

126
George Vaillant . . . concluded:
George Vaillant,
Adaptation to Life
(Boston: Little, Brown, 1977).

127
followed children of the Great Depression:
Rutter, “Implications of Resilience Concepts for Scientific Understanding.”

127
a project . . . with which I was associated, at Massachusetts General Hospital:
Mark H. Pollack et al., “Persistent Posttraumatic Stress Disorder Following September 11 in Patients with Bipolar Disorder,”
Journal of Clinical Psychiatry
67 (2006): 394–399.

127
a study of well-being in two thousand adults:
M. D. Seery, E. A. Holman, and R. C. Silver, “Whatever Does Not Kill Us: Cumulative Lifetime Adversity, Vulnerability, and Resilience,”
Journal of Personality and Social Psychology
99 (2010): 1025–1041.

127
in seventy-eight women who had experienced a serious life event:
Allison S. Troy, Frank H. Wilhelm, Amanda J. Shallcross, and Iris B. Mauss, “Seeing the Silver Lining: Cognitive Reappraisal Ability Moderates the Relationship Between Stress and Depressive Symptoms,”
Emotion
10 (2010): 783–795.

128
Resilience grows out of exposure to . . . risk:
Rutter, “Implications of Resilience Concepts.”

130
“Get down, you fool!”:
Alexander Woollcott, “Get Down, You Fool,”
Atlantic Monthly
161 (1938): 169–173.

131
“blow your trumpet” and “give the order to charge”:
G. Edward White,
Justice Oliver Wendell Holmes: Law and the Inner Self
(New York: Oxford University Press, 1995), 470.

131
“A second-class intellect, but a first-rate temperament”:
The aide thought Holmes was referring to FDR, and this is the standard view; but some historians now claim the statement referred to Theodore Roosevelt. Paul Boller,
Not So! Popular Myths About Americans from Columbus to Clinton
(New York: Oxford University Press, 1996), 102–103. This phrase has been repeated in various combinations: “second-rate mind,” “second-class mind,” “first-class temperament.” The most commonly cited original usage appears to be what is in the text, and the original source was the aide, Thomas Corcoran, who reported it verbally afterward.

131
FDR's first-rate temperament . . . was hyperthymic:
In what follows I describe symptom evidence for hyperthymia, but I did not come across in my research evidence for full manic episodes or for clinical depressive episodes. The closest evidence for a possible clinical depression comes toward the end of FDR's life, when he had suffered from severe hypertension for years and was about to die of a massive stroke. Alen Salerian, an FBI psychiatric consultant, has suggested that Roosevelt might have been clinically depressed during the Yalta conference in 1945. David Owen, reviewing medical records of the time, could not confirm this impression. In any case, depression at that time would most likely be attributable to Roosevelt's cerebrovascular disease, especially since there is no evidence of a prior pattern of depressive episodes throughout his life. David Owen,
In Sickness and in Power: Illnesses in Heads of Government During the Last 100 Years
(Westport, CT: Praeger, 2008), 47.

131
“Obviously that man has never had indigestion”:
John Gunther,
Roosevelt in Retrospect
(New York: Harper and Brothers, 1950), 23.

131
the State Department asked him to brief the president:
Ibid., 24–28.

132
“FDR's extreme loquaciousness”:
Ibid., 55.

132
“My own method”:
Ibid.

132
“The simplest way to get at the President”:
Ibid.

132
“asking somebody who had never been in Latin America”:
Ibid., 56.

132
after Pearl Harbor:
Ibid., 31.

132
“His vitality was . . . practically unlimited”:
Ibid., 63.

132
he made 399 trips by rail:
Ibid., 139.

132
“The Roosevelt family is completely superhuman”:
Marion Elizabeth Rodgers,
Mencken: The American Iconoclast
(New York: Oxford University Press, 2005), 434.

133
TR needed only six hours' sleep:
Gunther,
Roosevelt in Retrospect,
8.

133
he had only two sleepless nights:
Ibid., 32.

133
“He was often restless”:
Ibid., 33.

133
He spent about a quarter of the working day on the telephone:
Ibid., 125.

133
“You know, a man will do a lot of right things”:
Ibid., 130.

133
“incurably sociable”:
Frances Perkins,
The Roosevelt I Knew
(New York: Viking Press, 1946).

134
“It was here that Roosevelt was irresistible”:
Robert H. Jackson,
That Man: An Insider's Portrait of Franklin D. Roosevelt
(New York: Oxford University Press, 2003), 135.

134
“[Wilson] refused to see most of them”:
Ibid., 135–136.

134
“There was always considerable conflict”:
Ibid., 111.

135
“Roosevelt certainly was not accomplished as an administrator”:
Ibid., 111.