Most people don’t know that diagnoses vary and move along social currents. Because of the authority with which words like “clinical depression” or “bipolar” are used in modern conversation, they are given the impression that those words have a permanence and solidity they do not actually have.

For instance, what we now commonly call PTSD has only been recognized as a formal disorder since 1980. During the American Civil War, soldiers returning from battle with inexplicable symptoms were said to have “Soldier’s Heart.” In World War I it was referred to as “War Malaise” or “Shell Shock,” in World War II, “Combat Fatigue,” in Korea “Gross Stress Reaction” and after Vietnam, it was cleverly called “Post-Vietnam Syndrome.”

Does it matter what we call it?

Some think it matters a great deal because names often determine approach or treatment. It makes sense. If someone is called “Your Highness” we are sure to approach him or her quite differently than if he or she were called “dear.” Similarly, if we call a state of mind a chemical imbalance, than we are very likely to approach (or treat) that state with chemicals, often many. If, on the other hand, we call it a broken heart or loneliness or arrogance or self-pity, we take a rather different tack.

This comes up because of something a patient said to me the other day. She also recently moved east from New Mexico when her husband was made a corporate offer he couldn’t refuse. She came from an old family in Santa Fe with a history that went back almost 400 years to the Spanish Conquest. She had grown up with open vistas, nearly eternally clear skies, and a community in which everyone knew one another. To say hers was a shocking uprooting would be an understatement.

She came in complaining of inexplicable and free-floating anxiety, lethargy, a tendency to weepiness over trifles, an inability to sleep through the night because of dreams and restlessness. Her first question after she elaborated on her symptom picture was: “Do you think I’m depressed?” The as yet unspoken question underneath was: Did she need medication?

Instead of answering either of those questions, I asked her about her dreams, when these symptoms started, what she’d been doing since she moved here and how well (or poorly) she was getting acclimated to a new environment and culture.

As it turned out, her symptoms began about a month after arriving, shortly after the last box had been unpacked and recycled. Suddenly, there was nothing to do. Her husband was going to his new job. Her two young children were in school. She was at home, sans friends, sans work, sans family. In New Mexico, she had not only been working, she had an extended family that occupied a great deal of her time with social engagements and care-taking elderly members. People stopped into one another’s homes fairly regularly. She had a church she loved. Here, she was alone. Worse, she was lonely.

Could someone call that depression? I imagine they could find support for it in the diagnostics and standards manual. But I’d rather call it homesickness. Not only because it is more precise, but because it gives her a way out.

Of course she misses her home. Of course she feels lonely. Of course she’s bored and restless. Of course she longs for friends and relatives. Who wouldn’t in her situation? There’s no pathology in that.

What needed to be changed were not those feelings, but what she was doing all day with them. First prescription: Volunteer. Second prescription: Find a church with her husband. Third prescription: Join a club (in her case she agreed to a yoga class).

It took about a month for her symptoms to abate.  While she still missed friends and family (and bright, endless blue skies), she was no longer as lonely, bored or restless. She slept better because her energy was redirected and expended during the day. She began to make new friends and feel a part of something bigger than her own heartbeat in a large, empty house.

The more I think about her case, the more I am inclined to think of PTSD as Soldier’s Heart. I think it more clearly sums up what we are looking at: A wound of war that breaks a heart, not a chemistry problem.

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In My Lost City, Fitzgerald wrote, “I can only cry out that I have lost my splendid mirage.” He was referring to the life and the loves that he and so many others had enjoyed in New York when it truly roared in the 1920’s.

It was a giddy mirage, an imagined impression across the distance of a desert; a time of the swirling, singing nouveau, the sultry and seditious slipping off of Victorian repression, of skyscrapers and millionaires and railroads that seemed to be able to leap over mountains, of planes that hurled themselves through the air. It was the era that led to the consummate American hero in 1932 with the birth of Superman. It was an era of Romance that made people feel they could finally catch up to the horizon, and—better yet—go beyond it to a life never imagined before. The possibilities were limitless. They were limitless.

Until, as all great romance must eventually, it crashed.

And all the wild speculation encouraged by big business at the time came tumbling down like a torn party dress around the ankles of the people who could afford it the least. Farmers, small businesses, dreamers, and desperate immigrants were swindled into sinking their lives’ savings into high-risk real estate investments, even though it was plainly evident that the need for space was almost nil, production schemes, even though growth was slowing, and consumer gimmicks even though they were as shady as an unregulated economy had ever been.

Sound familiar? Seems we have neither changed nor learned much since then.

It was heartless scheming. It was ruthless capitalism. It was cronyism at its worst. All true. Yes. But it was the Romantic Vision that allowed and perpetuated it. It was the insistence on the impossible and the belief in the limitless self that made people easy prey.

When I speak of romance in this sense, it is not just a reference to that flurry of the heart when we are falling in love. It is there then, as well. But it is more than that.

When Romance Is Good

In The Four Loves (1960, Harcourt Brace), C.S. Lewis talks about Romance as Eros and distinguishes it from lust by defining it as the rapture of the divine, the emotional foreplay of the gods within us.

When we are moved by this sort of romance or Eros to “fall in love,” what we are actually doing, he says, is seeing the divine in the other. When that happens we are inevitably guided by the impression that “Love conquers all” or that “In love all is possible.” It was the guiding principle of the late 1800’s and has been, in one form or another, one of the American four basic philosophical food groups since then.

He says, rightly, I believe, that this willing self-deception is both necessary and good for meeting and wooing the Beloved.

“By Eros I mean of course that state which we call "being in love"; or, if you prefer, that kind of love which lovers are "in"…. 

“Sexual desire, without Eros, wants it, the thing in itself; Eros wants the Beloved. The thing is a sensory pleasure; that is, an event occurring within one’s own body. We use a most unfortunate idiom when we say, of a lustful man prowling the streets, that he ‘wants a woman.’ Strictly speaking, a woman is just what he does not want. He wants a pleasure for which a woman happens to be the necessary piece of apparatus. How much he cares about the woman as such may be gauged by his attitude to her five minutes after fruition (one does not keep the carton after one has smoked the cigarettes). Now Eros makes a man really want, not a woman, but one particular woman. In some mysterious but quite indisputable fashion the lover desires the Beloved herself, not the pleasure she can give.”

This state of heightened awareness and ecstasy is precisely what allows us to become blissfully unaware of the Beloved’s imperfections and to begin a relationship which we might otherwise too quickly dismiss. For a relationship in which perfection is no longer necessary, we must move past Eros into Friendship.

To the extent that romance allows us to struggle through obstacles, hold out hope when it is truly needed and helpful, and imbue our lives with both promise and purpose, it is good. Meaning, when it serves us—when it helps us to build relationships, conceive of such miracles as airplanes, anesthesia, or cell phones, or push through malevolent military blockades to rescue the innocent—it is a blessing.

When it leads us to see ourselves as somehow beyond the laws of nature, as capable of controlling what is not controllable, as immune to the inevitable draw of gravity, it is a curse.

When Romance Is Not So Good

All things must ripen or fall off the tree too early and die. It is the way of things. Often it brings terrible sadness to us. Sometimes, shock. It is never easy to see the sun come up after the revelry and delight of dancing gods and goddesses; even harder to see what the brighter light reveals about who we’ve been dancing with.

But for us to have the lives and loves we long for—both individually and collectively as a culture—it is absolutely necessary for Eros to be replaced by a more sanguine and subtle understanding. If it doesn’t, we wind up like Fitzgerald, lost in a lost city, besotted by booze and benumbed by grief. And our society winds up in the same position we found ourselves in ’29 and in ’08, bereft of our fortunes, throwing ourselves out of windows in despair and shame.

Eros cannot tolerate bright light. It must either die or flee or be reformed by a new reality.

If it is reformed, we will be transformed.

We will stand ready to see clearly and know the Other. We will stand ready to be seen. Not for who we might be, who we represent (Venus or Mars), but for who we are.

Easier said than done.

We are surrounded by forces—economic and cultural—that will do anything to keep us from making that transformation.

If you look carefully at what happened in the twenties, you may notice a profound connection between the rise in advertising as a broad medium of communication and the rise in a sort of cultural far-sightedness, in which we could only see that which was far away and nearly out of reach. (“You, too, can have this X, Y or Z when you just send us…”) We became in many ways the nation we are now—consumers and climbers, always waiting on line for the next version or the newest sensation that will somehow make our lives what they “should” be.

This is the romanticism that is sold on Madison Avenue, not the Romance of the gods.

And, I believe, it is the one that has shaped us as a country and kept us from that which we long for most: love, joy, gratitude, companionship, a sense of belonging, purpose. So long as we exist for the revelry of Eros, dance only in the dark, and shield ourselves from the morning’s truth by turning our faces inside out so we can only see our own ideas, we are trapped in a lie. We may become mortals without morals, but we cannot become humans without limits.

The irony is that we are so much more.

"It is a serious thing," says Lewis, "to live in a society of possible gods and goddesses, to remember that the dullest and most uninteresting person you talk to may one day be a creature which, if you saw it now, you would be strongly tempted to worship, or else a horror and a corruption such as you now meet, if at all, only in a nightmare. All day long we are, in some degree, helping each other to one or other of these destinations. It is in the light of these overwhelming possibilities, it is with the awe and the circumspection proper to them, that we should conduct all our dealings with one another, all friendships, all loves, all play, all politics. There are no 'ordinary' people. You have never talked to a mere mortal.”

–C. S. Lewis, From The Weight of Glory.

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It was a long time ago. I was young. I was writing for Madison Avenue, hobnobbing with celebrities, going to parties. It was as far from a meaningful life as I've ever been, but it was the 1980's, Reagan was president, we were selling and everyone was buying. Life was "good."

Then one day I got an ad order for one of the firm's big clients. They were pushing a new diet pill that would expand in the stomach and fool the person into feeling full so they wouldn't eat. I read the marketing stats carefully. Their targeted audience was young, female and anorexic.

I don't know what made me suddenly so sensitive or intolerant of such an obviously necessary strategy — who else would you sell a diet product to? — but I got angry. And in a pique of rebellion I hurled my typewriter against what I felt to be a nasty injustice and sealed my fate when I submitted an ad with a picture of the little expanding pill and a headline that read: Fat Chance.

Needless to say, they never ran the ad…

To see the whole article, go to Huffington Post.

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Everyone knows that sex sells.  The Romans knew it, the Greeks knew it, snake-oil salesmen on the American frontier knew it and we thought we knew it. It’s been the American way since America’s had a way. Sex was the king of Madison Avenue, the number one guarantee at the cash box, the Great Motivator.

Until now.

Because the American best-seller is no longer sex. It’s fear.

It's the holiday season and what better time to be bombarded with rapid fire ads designed to make us worry and buy. And what do these purveyors want us to worry about? Everything – what we eat, when we eat, what we wear, when we wear it, who we touch and what we can catch.

And with a sagging economy and sales way down, the sooner we worry the better.

The "self-improvement" ads that ordinarily start making us hate our bodies after January 1^st now start around Thanksgiving. What better spirit to celebrate Christmas and New Year’s than the spirit of Panic Present?

The message is the same everywhere. Be afraid. Be very afraid. By the end of the day we've been slipped about a hundred different fear mickeys and we are almost entirely unconscious about it.

The Christmas season has a special sort of viral fear that gets added to the mix of the usual doomsday, global warming, code red, “It Could Happen Tomorrow” programming. At this special time of redemption and renewal we get to fear the flu, unsightly blemishes and weight gain, loneliness, collagen loss, not being invited to the big parties, alcoholism and early onset Alzheimer’s, not to mention fallen meringues, sagging breasts and cervical cancer if we don’t get the vaccine now. Anxious about how anxious you are? Great. They’re selling a pill for that, too.

Viral fear pops up on your home page, too. Look at the ads on the internet. Really look. Instead of glossing over them or clicking at the latest new-and-shiny, look at what they’re really selling.

The Study of Fear and the "C" Word

In her study on fear in advertising, Lynn Kennedy profiled a billboard of Sammy Davis Jr. that looked like a tombstone. Next to a withered, sunken likeness of him was his date of birth and date of death. The headline read: The tobacco industry made him history.

Nothing strikes fear in the hearts of Americans as much as cancer. Many can’t even say the word itself and instead call it “the big C.” Pharmaceutical companies, “natural” food suppliers, vitamin manufacturers and home improvement specialists (air purification systems, for instance) work that fear carefully so that we buy what they sell.

The virus can mutate: It's not just a fear that we'll get "the Big C" or that we won't be attractive. It's the fear the "something might happen."

The entire insurance industry is based on profiting from the terror of the unknown. Prudential has based its whole campaign on that simple idea. They batter us with a slide show of the gloomiest, most gut-wrenching imagery then whisper to us so paternalistically: "Don't wait till it's too late."

And it works. People buy things they don’t really need and walk around worried about all the things they can’t do anything about.

After 60 years of Viral Fear media, what are Americans afraid of today?

They’re afraid of terrorists, of course. They’re afraid of attack just like we were in 1954.  We’re also afraid of germs, of erectile dysfunction, of not being successful, of robbers, of child abduction, of Alzheimer’s, of not having enough, of not being enough, of too much intimacy, of too little, of AIDS, of failure, of sunspots and solar radiation, of global warming, of dishwasher spots on our glasses and e-coli on our spinach. And we’re always worried about sex. (It's not number one anymore, but it still works.)

The greatest danger as I see it is that even when we use sex and scandal to sell, we’re still using fear to close the deals. The American limbic system has been mutated so that now fear, violence and sex have been fused. (Anyone who has done any research in forensics knows the fusion of aggression and sexuality is actually what happens in serial sexual sadist killers.)

Viral fear has capitalized on our culture’s weakest point – our urgent need for the quick fix. Viral fear encourages irrational thinking, greed, conformity, while it undermines self-worth, independence, connectedness with others and, worst of all, faith in God and a higher meaning in life.

So what are we to do?

The Power of Awareness

This is what Edward A. Merlis said way back in 1975 when he worked with the U.S. Senate Commerce Committee and devoted much of his time to advertising legislation. “He [the American] is bombarded at every flip of the magazine page, at every turn of the TV dial. Can he be proud that we now export our form of mental gang rape to the people of other countries? Advertising is a science, designed to attack people's weak spots in order to sell a product. Wolfbane may have been the antidote for vampires and wolfmen, but it appears that only knowledge and awareness are the antidotes for our 20th-century monster, advertising.”

He was right, of course. Knowledge is power and awareness can be life-changing not only in terms of what you’re willing to buy, but what you’re willing to swallow. Many years ago in another life I worked in advertising. I started as an assistant, worked my way up to copywriter. It was fun so long as I was playing the game and didn’t confront the ethical anomalies. One day the account executive sat down the creative team to discuss a new account. We would be developing an advertising and promotional campaign for a diet aid. It was designed to expand in the stomach and give the illusion of fullness as well as provide some stimulant action. (Meaning they would have gas, abdominal distension and the trots as well as increased heart rate, racing thoughts and agitation. But at least they wouldn’t eat.) The target audience for our advertising was young women from 14 to 35. As the account executive expanded the market profile, it became clear to me that they were targeting anorectic girls and women with body dysmorphic disorders, meaning women with delusional images of themselves. I mentioned this to my creative director who told me to go to my office and stay away from the account team. So I wrote an ad that would eventually become one of my last. On the top of the page was a close-up of the diet pill and the headline was FAT CHANCE.

Needless to say, they didn’t like the ad. But I did. And I’ve never regretted it. Not once. Knowledge may not be absolute power but it sure as hell packs a punch.

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