The Harmony of Illusions: Inventing Post-Traumatic Stress Disorder

This book is an extraordinarily honest attempt to think outside the institutional box and look for a more complex set of truths. Allan Young was grappling with the experience of seeing the creation of a diagnosis through a political and economic process. He was looking at how that process actually marginalized the people so diagnosed, and limited the resources and attention they received, after being pigeon-holed as having "PTSD". Dr. Young was in no way trivializing the terrible experiences or the suffering experienced by the veterans; on the contrary, he was saying that this diagnosis and the way the diagnosis shaped their treatment was not necessarily either helpful or in their best interests. The negative reviewers of this book either didn't read it or got it exactly backwards. This book is/was a groundbreaking attempt to show that psychiatric diagnoses do not necessarily match the actual experiences of the sufferers, or respond to their real suffering in a helpful way.

This is a groundbreaking study of a "condition" whose popularity has grown way out of proportion to the limited evidence for its validity as a clinical entity. PTSD fits a profession's need for a "serious" mental disorder that requires psychotherapy as its primary mode of treatment, at a time when medications have come to be seen as the primary treatment from most Axis I psychiatric disorders. Just as importantly it meets the needs of patients who need a "reason" (or perhaps a "culprit") to account for their misery other than the mere fact of being ill. However, close study of the condition itself reveals that there is nothing intrinsic which distinguishes it from garden variety depression with prominent anxiety and intrusive rumination. It has been known since time immemorial that such conditions will arise independently of the issues which may occupy the minds of their sufferers. But now, as a consequence of the socio-historical milieu into which PTSD was born, it has become the favored diagnosis for those who see their emotional troubles as the responsibility of someone else. In this book the nature of that historical milieu is well described. Professor Young has broken a powerful taboo in opening this topic up for discussion, and his remarkable work of scholarship deserves the highest praise.

Young ideas' are not new. Many psychologists and psychiatrists working with persons in extreme situations have arrived to the same point: PTSD is an ethnocultural invention of Euro American Psychiatry. The so-called "PTSD-symptoms" are frequent. The syndrome is a construct. Allan Young collects evidence in passionate but scientific way. This book is a must for all students of mental health science that want to give to their profession a wider scope than just what one can get from a cookbook of euroamerican diagnosis that blinds more than helps as DSM-IV. Life is much more than DSM-IV and this book contributes to seeing that in an excellent manner.