1 Boring Old Man

My title is borrowed from a book by Robert Graves written in 1929. Graves is one of a group known as the British War Poets from World War I who set out to educate the English populace about the reality of war, and where they had sent their children. It’s pretty amazing how long it took him to write this autobiographical account of his experiences Good·Bye To All That, over a decade after the war was over. There were only a few other similar books – All Quiet on the Western Front by Erich Maria Remarque, a semi autobiographical account of his experiences as a German Soldier [1927]; Virginia Woolf’s masterpiece, Mrs. Dalloway , an account of her character’s encounter with a  disturbed veteran [1927]; and the works of J.R.R. Tolkein, The Lord of the Rings, a thinly disguised allegory about his experiences in the trenches. Graves’ title was ironic though he gave it his best shot, leaving England and living on the Isle of Majorca for the rest of his life where he was a prolific writer. But like Tolkein, his books were filled with themes of war, politics, and forgotten soldiers. He couldn’t say "Good·Bye To All That." It was too much a part of his being. Nobody can without losing something that’s essential.

In that war, there was an epidemic of battlefield mental illness – "Shell Shock" the soldiers called it, and the name stuck. Some thought it was from brain damage, some thought the soldiers were faking to get out of the trenches, and some of the soldiers were shot as cowards. It fell to a British Physician, Captain Harold Wiltshire, to make a simple observation that changed the story into something rational. He noted that on the medical/surgical wards where the soldiers were badly wounded – there was no "Shell Shock." On the psychiatric wards where there were a number of seriously disturbed soldiers, none of them were wounded, at least not seriously. That doesn’t fit actual "Shell Shock" as a cause.

During and after the "Great War," Sigmund Freud in Austria, W.H.R. Rivers in England, and Abram Kardiner in the U.S. began to understand Wiltshire’s observation from a new perspective. These soldiers were wounded in a different way, wounded in their minds. In fact, a visible wound protects from these psychic wounds. It’s a "wound that shows." Everyone can see the reality of what happened. War Neurosis comes from a "wound that doesn’t show" – and the mind of the afflicted is tortured by attempts to push it out of awareness yet hold onto it because it’s the most important thing that ever happened – an integral part of the personal narrative – a vital piece of one’s self. It returns as symptoms, in dreams, and in the way one sees the world.

And it doesn’t take something cataclysmic to produce this state of affairs. In fact, it’s often the subtle things that can do the most damage, because they’re so "unseen." And it doesn’t have to be something that fits the term – traumatic.  It can be something like what happened to Allen Jones – being put in a situation of being asked to do an investigation and when you find something big, being told to "unfind" it. If you do "unfind" it, you’re haunted with a shameful secret. If you don’t, you get fired by the very people that sent you on the quest in the first place. It’s an impossible situation. In either case, you can never really say, Good·Bye To All That.

In psychotherapy, the treatment always starts in the same place – with a testimony. A wound that doesn’t show needs to become a wound that talks and is heard. In the case in Texas, Allen Jones had his dramatic "day in court" Thursday week when he summarized his story for us from the stand in a Texas Courtroom. It didn’t take him very long, but the result was an obvious palpable relaxation of some of the tension from a decade. The cross examination was contentious – something about things he said ten years ago, something about why he sued in Texas instead of going directly to the Attorney General. Whatever the content of the cross, it got the Janssen lawyer little other than a reprimand from the Judge for brow-beating the witness.

I don’t yet know if I have a wound that needs to talk about the testimony last week, but I do feel a pressing urge to talk about something from those 4½ days in the courtroom. I haven’t totally figured out why, but it’s clearly the videotaped depositions from the Janssen employees that stays in my mind – playing in my mind in the quiet spaces on the plane and since I returned. With all the other more dramatically laden moments in that trial, I’m surprised that the testimony of the sales reps is the thing that still runs in the background. My thesis, poorly formed, is that there’s a personal reason for that. I know I have a wound and that this blog is a way of dealing with it, a testimony of sorts. You wouldn’t have to read it very long to figure out where that wound is located – leaving or being extruded from academic psychiatry in the mid-1980s with the coming of the psychopharmacologist psychiatrists to Emory University where I was on the faculty. I thought I said Good·Bye To All That and moved on, but was apparently no more successful than anyone else in that endeavor, because when Doctor Nemeroff was exposed for unreported conflicts of interest [and other things], everything about those days returned in living color as if I’d never left them. I guess I never did.