The Harmony of Illusions

by Allan Young

As far back as we know, there have been individuals incapacitated by memories that have filled them with sadness and remorse, fright and horror, or a sense of irreparable loss. Only recently, however, have people tormented with such recollections been diagnosed as suffering from "post-traumatic stress disorder." Here Allan Young traces this malady, particularly as it is suffered by Vietnam veterans, to its beginnings in the emergence of ideas about the unconscious mind and to earlier manifestations of traumatic memory like shell shock or traumatic hysteria. In Young's view, PTSD is not a timeless or universal phenomenon newly discovered. Rather, it is a "harmony of illusions," a cultural product gradually put together by the practices, technologies, and narratives with which it is diagnosed, studied, and treated and by the various interests, institutions, and moral arguments mobilizing these efforts.


This book is part history and part ethnography, and it includes a detailed account of everyday life in the treatment of Vietnam veterans with PTSD. To illustrate his points, Young presents a number of fascinating transcripts of the group therapy and diagnostic sessions that he observed firsthand over a period of two years. Through his comments and the transcripts themselves, the reader becomes familiar with the individual hospital personnel and clients and their struggle to make sense of life after a tragic war. One observes that everyone on the unit is heavily invested in the PTSD boundaries between therapist and patient are as unclear as were the distinctions between victim and victimizer in the jungles of Southeast Asia.

Genres: Psychology, Anthropology, Nonfiction, History

328 pages, Hardcover

First published December 22, 1995

Reviews

[Stephanie McGarrah · Rating 4 out of 5]

I'm always on the hunt for books that are critical of psychology as a science and stuck Harmony Of Illusions on my "to-read" shelf awhile ago. About a month ago I was diagnosed with PTSD. This was not my first diagnosis, I had already been told I had severe depression, generalized anxiety disorder, some type of bi-polar and borderline personality disorder. Needless to say, I thought it was a good time to pick this one up. I wanted to learn more about the origins of PTSD.

The Harmony of Illusions traces the birth of the idea of traumatic memory, and its eventual evolution into a psychiatric disorder cataloged in the DSM. I didn't realize how much post-traumatic stress and its entrance into the DSM was tied to Vietnam war veterans. Tell someone that a mental illness was invented, and they will look at you like you are all kinds of stupid. Allan Young addresses these skeptics at the beginning of the text: "The suffering is real; PTSD is real. But can one also say that the facts now attached to PTSD are true (timeless) as well as real? Can questions about truth be divorced from the social, cognitive and technological conditions through which researches and clinicians come to know their facts and the meaning of facticity? My answer is no."

It is an academic book, but don't let that intimidate you if, like me, you have no prior knowledge of psychology or psychoanalytic concepts. There were some sections that went over my head, but overall Allan Young does an excellent job of defining jargon and explaining theories. There are also some interesting and scary case studies explored in the book to further illustrate how PTSD was diagnosed and treated. I'm not sure how things have changed since Harmony Of Illusions was written, but it does seem to me from academia's embrace of "trigger warnings," and "safe space" language, that more and more people are either being told they have post-traumatic stress like myself, or believe they suffer from it. I recommend this book to anyone interested in the production of mental illness, and anybody who has been diagnosed with PTSD.

[Kali · Rating 4 out of 5]

Young's discussions of Ribot, Charcot, Janet, Rivers, and Freud's emerging and contrasting ideas of trauma are very interesting, as is the historical background on which Young's argument is based. Similarly, the discussion of political history the institutionalization of PTSD in DSM is fascinating. I am less convinced by his argument that contemporary trauma diagnoses are committed to making "time flow in the right direction" from "the etiological event to the post-traumatic symptoms." My sense, in fact, is that he's trying to make time flow in the right direction for his own argument about the etiology of the PTSD diagnosis. But what lifts this book to above average status for me are really the transcripts from the VA PTSD treatment center, and his analysis, which completely demolishes the pretense to either science or rationalism in that unit. I read the transcripts somewhat differently than Young does, but his reading is also compelling.

[Steve Woods · Rating 5 out of 5]

I found this book fascinating. It outlines the ways in which the diagnosis of ptsd has been shaped by history ond pasychaitric practice. It points out that much of what we now define as ptsd has been defined and delineated by the very profession intending to treat it, and this has been so since the major appearance it put in after WW1. the book discusses in depth the role ov Vietnam and the politics surrounding that conflict in establishing the parameters for the present day. Particularly helpful was the discussion of the evolution of the definition in the DSM.

There is also a treatment of a specialist centre set up in the US to treat Vietnam veteran's; an outline of its philosophy and the application of treatment within those parameters. It seems that the centre was successful in many respects and typically was defunded because of cost considerations.

A lot of the centers approach made sense to me and the framework through which clinicians viewed the dysfuntion and treated it. What became clear was that there has to be an approach that maintains a philosophy from which treatment arises. This requires the evolution of understandings about the dynamics of ptsd, the language used to describe them and the symptoms they generate, and the treatment applied.. All of that seems to be lacking at least in facilities in Australia.

I undertsood a great deal more about why clinicians do what they do and much about why most of their efforts fail us. Should be required reading for all clinicians working in the field.