Herman’s conditions reach practically everybody

The conditions set out above are ordinary ones. The mechanism Herman describes does not have a threshold. Foreclosure of response operates on whatever response a person had to make, and what it does to them depends on how many are foreclosed, how much rides on them, and how long it goes on. The ICD-11 criterion picks out the far end of that range. It does not mark where the mechanism begins.

What sits below Complex PTSD is not rare at all. Most people who have spent years in an organisation will recognise something from further down the range — a stretch when the work stopped being bearable and there was nothing in particular to point to. It gets put down to a demanding job, a difficult period, or a person’s own stage of life. Much of what gets explained that way has a root cause the explanations do not reach: HDM, running inside an employment relationship.

Most people working under these conditions will never develop a trauma disorder. Robert did.

Three conditions have to be present: a credible threat, no effective response to it, and no way out. How much of each a person gets varies, and it varies in two different ways.

The architecture of HDM supplies one of the conditions, by foreclosing an effective response. This is the element of powerlessness, and it is the same for everyone under it. What varies is how often a person ends up there. Nobody has to do anything with what a person perceives. Someone who sees nothing wrong with the decision never notices that this is how it works. Someone who perceives what is going to fail, and why, finds it out every time.

The other two conditions come from the employment relationship. A credible threat and no way out both vary in themselves. Carrying responsibility for outcomes is what having a job means; what varies is how often a person is held responsible for an outcome they have no control over, and what happens to them when it does not arrive. The way out has a price. It is low at the start of a career and rises with every year of pension, mortgage, reputation and professional identity built in one place.

None of the three is an episode. The reasoning behind a decision is not withheld once, the responsibility does not lapse between one outcome and the next, and the cost of leaving only rises. What the ICD-11 criterion requires is not a single event but prolonged or repeated exposure. All three conditions are standing arrangements, and a working life is long.

How much of each condition a person gets depends on the organisation as much as on the person. What sets it is how much architecture sits above them: how many layers, how far away the goals that determine their targets are set, how much of the reasoning survives that distance, how many separate chains of authority bind the same work, and how much of it is bound by protocols and procedures whose reasoning nobody now has.

Most of what sits below the clinical end is never counted as harm.

None of this says that every organisation is the same place to work. Employers differ, and the difference is large. In some places questions get asked and answered as a matter of course, and what people bring is wanted. Someone working in such a place is standing in less of this than someone who is not, and the difference is not imaginary.

What varies there is the practice, not the architecture. Where the reasoning behind such a choice does get given, and questions about it answered, it is because whoever is in post chooses to work that way, and it holds for as long as they are in post. Nothing requires it. It is written into nothing, so there is nothing to hand over. A successor inherits the position and not the practice.

Robert worked under two very different practices without changing employer. He joined a large telecommunications company in the 1980s and spent the first half of his career in what was a start-up inside it: dynamic, entrepreneurial, making it up as it went along. Much of the work was ground-breaking and started from a blank sheet of paper. He calls it the playground. He asked questions, took the initiative, said when something looked wrong and suggested how it might be done better. All of it was wanted. He thrived, personally and professionally.

Then his unit was reorganised into a much bigger division of the same company. More layers sat above him, the targets binding his work were set further away, and the body of procedure was heavier. The managers he now worked for were in the same bind. Their response was to demand certainty and volumes of information, in a process he calls sclerotic. What came with it was a culture he describes as command and control, running on fear. He calls this second half of his career the prison.

Robert was leading a team by then. In the playground he had worked from a blank sheet of paper; now he could not even order stationery without his manager’s signature. Requests for people or money came back refused, on the ground that his product area was not important enough. Where the means were withdrawn, what he was answerable for was not.

The culture Robert met there was not an accident of who happened to be running the place. It is what the same architecture produces when more of it sits above a person: more choices binding their work, arriving from further away, with nobody required to account for any of them. Same company, same architecture, same Robert. From the playground into the prison.

The people who make a place bearable are also the ones most likely to leave it. Anyone who gives directives, bar the person at the top, is also on the receiving end of them on the same terms. Some managers give their reasons and answer questions about them. Those are the ones who find it hardest to be handed choices that come with none. The cost of leaving is the same for them as for anyone. They pay it sooner. What goes with them is the practice.

Where a person currently sits on the range is therefore not a fact about them, and not a fact about their employer’s character. It is a function of how much of the architecture they are standing in, and that quantity is not fixed. It rises with tenure, with perceptiveness, and with the departure of whoever had been making up the difference.

The same account applies to everyone. The colleague who has gone quiet, the competent person turning cynical, the manager with a reputation for being unreasonable — each is standing in some amount of the same thing before any of it is a fact about who they are.

Very little of this announces itself. It arrives without an incident to date it, and the person carrying it is usually the last to have a word for it. Robert puts one of the reasons it got as bad as it did down to not understanding, at the time, what was going on. Where it gets recognised at all, somebody else usually sees it first. Knowing what to look for is what lets it be recognised — in yourself, and in whoever is at risk of going further along the range.