National Physicians Alliance

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On Vigilance and Violence

Posted by Simone Isadora Flynn, PhD, NPA Project Manager-Leveraging Social Media April 13, 2015 at 11:34 AM

Written by R. H. Sprinkle, M.D., Ph.D., School of Public Policy, University of Maryland

Here’s a quote we all remember: “Eternal vigilance is the price of liberty.” We can’t quite say who spoke it first because we don’t really know, but many people have repeated it, or something like it, on stumps and stages, at rallies and conventions, for two hundred years and more. I’ve heard it often, have never heard its message disputed, and would not dispute it now, though the all-against-all image the quote evokes is a bit too stark for me. I might say something less stirring but more realistically human: “Reliable cooperation is the guarantor of liberty.”

But that’s another matter. What concerns me today is the “vigilance” part. And its pathological exaggeration, “hypervigilance,” an unwarranted scanning for imagined threat. Hypervigilance is a clinically striking sign, but it’s nothing new. It’s long been noted in people surviving mortal danger, such as war or robbery or rape, and it’s a defining feature of post-traumatic stress disorder, PTSD. I suspect the hypervigilance cases we recognize — in part because they come with suggestive histories — are far fewer than the ones we miss, and that the ones we miss have many antecedents, mostly mundane and rather close to home. These cases often end badly, as seen recently in Chapel Hill, North Carolina, when three young adult students were shot to death in a parking-rage incident.

Vigilance, as personified by an armed police officer, frequently now must confront hypervigilance, but vigilance may itself become hypervigilance. This transformation we have largely overlooked until recently, when an unarmed man and a toy-armed boy were killed by police officers. We have long conceded the need for vigilance to be armed but have not much considered the likelihood that police officers themselves — without the reliable cooperation of the communities they patrol, the governments by which they are employed, and the fellow officers they know to be too few or too remote — would themselves grow hypervigilant, sensing threat everywhere, assuming every threat lethal, and having no dependable protection other than killing. An analogous dilemma, on a global scale, we once called “Mutually Assured Destruction.” Our present dilemma, on a neighborhood scale, is no less “MAD.”

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