Our traumatic neurosis and its brain.

Abstract

During the nineteenth century, physicians either discovered or invented a variety of clinical autobiography called "traumatic memory." Freud produced two versions of this memory, the final version in the 1920s. A revolutionary nosology (DSM-III), adopted in 1980, promised to extirpate Freud and the concept of neurosis from American psychiatry. However, it made a tacit exception for Freud's concept of traumatic neurosis, renaming it "postraumatic stress disorder." The following decades have been a period of intense clinical and scientific interest in this disorder. An influential research program has investigated traumatic neurosis and its brain through variations in cortisol excretion. I describe the history of this program, and examine its distinctive knowledge product. its running narrative of its achievements. The narrative's structure is analyzed and found to resemble a crossword puzzle constructed from heterogenous kinds of inference, recalling The Interpretation of Dreams. My conclusion is that, far from extirpating Freud's neurosis, biological research has secured a place for it in today's post-Freudian psychiatry.