In 1917, as World War I was at its height, the gothic novelist Arthur Machen attempted to describe the growing sense of fear and unease that haunted the United Kingdom. He depicted a rootless and invisible emotion, a nameless terror, that moved silently across the land leaving a trail of destruction in its wake. Frightened horses, suicidal farmers, and paralyzed children mapped out the emotion's itinerary across the kingdom. Machen's tale of a transformative horror was rooted in a tradition of gothic literature that had been reinvigorated in the late nineteenth century. However, its central device of an epidemic of fear and its disease-like transmission across the population drew upon different sources: the scientific literature on the pathology of collective emotions that served as a precursor for psychiatric epidemiology in Victorian and Edwardian Britain. Even without its supernatural overtones, this tale seems curiously remote from contemporary psychiatric epidemiology. The distance between the epidemics of feeling described in those early writings and the organization of contemporary practice is striking. Although there was a large literature on the relationship between mental disease and poverty, there is little attempt to map the movements of affect or read transformations of emotion as an index of social or historical change. Instead such epidemics of feeling were read through the psychological concept of suggestion— as a form of primitive and unconscious communication—anchored in the evolutionary frameworks of crowd psychology and the herd instinct.

By the end of World War II this epidemiological understanding of fear had been transformed. Insecurity, terror, and anxiety were no longer seen as capricious forces but instead understood as environmental conditions that could be defeated through political interventions and social planning. Fear was tamed. It moved from being a fickle and fantastic force to become instead an object of political calculation. Indeed in the wake of the war, it would provide the grounds for a new program of social and material reconstruction. As this chapter will partly show, the architects of the welfare state in the 1940s and 1950s saw their task as the engineering of a society in which individuals would be freed from the pathological anxieties of financial insecurity, unemployment, and homelessness. Aneurin Bevan, widely seen as the architect of Britain's National Health Service, complained that modern lives were wrecked by anxiety.

Introduction: Stress and the Problem of Temporality

Implicit within every model of stress is a particular understanding of time. Stress disorders, in their myriad forms, are variously attributed to the fears and terrors of an anticipated future, the pressure of present circumstances, or traumas arising from events buried deep in the individual's past. They are also associated with temporal experience being connected to the increased velocity of life or its slowing down through long episodes of boredom or sensory deprivation. Psychosomatic medicine, in its various forms and iterations over the past two hundred years, has sustained these different temporalities through reference to a rich armamentarium of psychological and physiological objects—ranging from the practices of “expectant attention” described by nineteenth-century mental physiologists through to the hypothalamicpituitary-adrenal (HPA) axis that plays a central role in twenty-first-century understandings of the stress response.

The sheer number of concepts deployed in descriptions of the stress response and the broad variety of narratives that these make possible have attracted widespread critical comment from anthropologists, historians, cultural critics, and practicing stress researchers. Stress is derided as a sort of “conceptual glue” that can connect forms of physiological and psychological disturbance to any number of experiences and events. While these criticisms are rich and often provocative it is not my intention to rehearse them again here. Rather, I want to concentrate on how stress disorders have been connected to specific life events and ways in which those connections have been stabilized.