Railway Spine and the Origins of PTSD

In an interesting Harper's essay, Will Self explores the origins of Post Traumatic Stress Disorder. He connects it to the stresses of our modern, mechanized age, and says one of the first prominent forms was the mid-nineteenth-century phenomenon of "railway spine". After train crashes, many passengers who were not physically injured nonetheless suffered debilitating illnesses:

The very notion of the “accident”—not an unlucky coincidence, such as being struck by a hurricane, but rather a wholesale collapse of a functioning system—also owes its inception to the technologies of the era. These were technical apparatuses capable of self-destruction, and it would seem that the human apparatus was similarly affected: many victims who appeared to have suffered minor injuries—or none at all—succumbed nonetheless to psychic and physical symptoms that proved highly debilitating, if not fatal.

The hedging of personal and corporate liability by means of insurance—what Arthur Schopenhauer described as “a public sacrifice made on the altar of anxiety”—is also a product of the second industrial revolution. In order for some claimants to be compensated, they needed an etiology that allowed for physical causes to produce only psychic effects. Just as traumatized Vietnam veterans and activists would campaign to have their psychological symptoms recognized to qualify for compensation, victims of railway accidents made a similar case to insurance companies. Both groups faced the same problem: Without evidence of organic damage, how could they prove a particular event had so grievously affected them? The initial explanation of the psychic injury suffered by some railway-accident victims was indeed physiological: “railway spine” consisted of supposed microscopic deterioration of the spinal cord caused by the accident’s impact, a physical trauma that had psychic effects.

These were the sort of effects that Charles Dickens suffered when he survived a railway accident in June 1865; seemingly unhurt, he hurried to help those who’d been injured. However, when he was recounting the incident in a letter a few days later, symptoms arose: “But in writing these scanty words of recollection I feel the shake and I am obliged to stop.” Which he did, abruptly, with the appropriate valediction: “Ever faithfully, Charles Dickens.”

The question of why we moderns suffer so much from past traumas, or at least attribute so much of our suffering to past trauma, is fascinating and difficult. Could it be that people in the past actually did suffer lingering effects of trauma, but did not talk about it in those terms? Could it be that their psychic coping mechanisms (e.g. religion) worked better than ours? Or could it be, as Self argues, that something about the charging machines, and battlefield explosions of our age makes for worse psychic damage than hand-to-hand combat or acts of god like earthquakes?