Did you know that only half of the soldiers with trauma are willing to seek treatment?
Many are resistant because they do not want their symptoms to be labeled a “disorder”, as in Post Traumatic Stress Disorder.
Can a name alone really be that powerful?
According to Belleruth Naparstek, LISW, author of Invisible Heroes, there is a strong move away from using Post Traumatic Stress Disorder to describe the long-term results of severe trauma.
Many military personnel dealing with this condition feel stigmatized by being told they have a disorder. Even just the diagnosis of “PTSD” can be devastating to patients and families.
Watch below as Belleruth discusses the use of the term “PTSD” when treating trauma. It’s only 4 minutes long.
Actually, many people feel that Post Traumatic Stress is not a disorder at all – it is really a normal response to an abnormal situation.
We’ve talked to the leading practitioners and researchers in the trauma field and have used their insight to craft an expert training program for treating trauma.
To find out more, check this out.
In the meantime, what’s your opinion on whether to use PTSD or PTS – or something else entirely? Please leave a comment below.
When referring to the mental health condition that can occur after experiencing or witnessing a traumatic event, both “PTSD” (Post-Traumatic Stress Disorder) and “PTS” (Post-Traumatic Stress) are used. While they are often used interchangeably (brainworks.center), there are some important differences.
The term “PTS” is sometimes preferred over “PTSD” because it places less emphasis on the idea of the person having a disorder or pathology, and instead focuses on the normal response to trauma. It is thought that using “PTS” may help to reduce stigma and increase help-seeking behavior among those who may be experiencing symptoms.
However, it is important to note that both “PTSD” and “PTS” refer to the same condition and have the same diagnostic criteria. The term “PTSD” is the official diagnostic term used in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is the standard reference used by mental health professionals.
Ultimately, the choice of whether to use “PTSD” or “PTS” may depend on the individual’s preferences, cultural background, and the specific context of the treatment. Mental health professionals should be aware of both terms and be sensitive to the needs and preferences of their clients when discussing the trauma and related symptoms.
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The word “stress” belongs to the first part (post-traumatic) as in, how a person is after exposure to a traumatic stressor. It is not a “stress disorder,” it is not “being stressed” or any of that which most lay people (and apparently many clinicians) believe it is. And it SHOULD be a disorder, which means a problem that impacts functioning. A serious problem for which people need treatment. To nice it up by dropping the last word is to 1) fail to understand the language (as above) and thus the nature of the dysfunction and 2) to undermine its seriousness.
Additionally, just because it is “normal” does not preclude it from being a disorder (or injury, or dysfucntion, or any of those other nasty old words). Example – it would be normal for someone who gets shot in the leg to become disabled, but we don’t back away from that D word AND the fact that it results in problems is not minimized either.
The problem with changing terms to reduce stigma is, in most cases, the stigma just becomes attached to the new term. Remember when MR or LD was changed to “special?” Now the latter term has fallen out of favor.
“Many people feel that Post Traumatic Stress is not a disorder at all – it is really a normal response to an abnormal situation.” Then, what is one “labeled” who has experienced an abnormal situation and experienced no or only short-term post-traumatic stress? I think the elimination of the word “disorder” will have ramifications, such as how and how much medical/therapy treatment veterans will receive. In other words, as usual, this seemingly meaningful (to some) and seemingly minor (to some) word deletion seems to mostly be all about the dollar.
Yes, I think labeling just leads to identification of the experience and the more we can step back from pain, trauma and know that we are not that, the better. Stanlee
I was diagnosed with PTSD & yes the word disorder is a bit scary, but a word only has as much power as one gives it. Personally I don’t care if the word disorder is dropped, or not. All I care about is finding the best treatment for me.
I have a list in my office of normal responses to acute stress, my clients often read it and say “you mean I am not crazy??”
The term “disorder” implies something entirely different (as if the client is “defective” or “at fault” for their response to extreme stress.
I am neither a man nor a soldier so I cannot speak for them. As a woman who acquired PTSD by way of a beating, I found it very helpful to be labeled with a disorder. My community shunned me, the rape crisis center and the domestic violence people wouldn’t see me, and I almost lost the two people in my life who are still here. After a year, someone talked the Rape Crisis center into seeing me, and the counseling, description of my condition, and a fresh shoulder helped me to get my healing on track and I was able to smile again. After three years and a lot of EP, I am free of the condition. Having a disorder helped me a lot because my depression, anger, hypervigilance and difficulties with life had a reason other than my being unreasonable. Dropping the “D” is fine, but the seriousness of the condition should not be minimized.
I am gratified to see the conversation threads about the impact of war and combat on our cultural psyche and history. For those who might be interested in exploring this further, here are some books I found to be insightful:
A Terrible Love of War; James Hillman
War and the Soul: Edward Tick
Odysseus in America; Johnathon Shay
Wonderful conversation!
Just to get all semantic again, the problem with ‘combat stress’ is that the traumatized responses are not always from direct exposure to combat – that’s why some Army folks call it ‘combat and occupational stress’, which is more accurate but a bit unwieldy.
Then last week, retired Gen. Peter Chiarelli suggested that PTSD should be changed to ‘Posttraumatic Stress Injury’, and was met with resistance from the DSM committee in charge of this category.
I agree that these terms are all connected to our very peculiar and often dysfunctional health insurance and disability rules and regs, which can bind up identity with being “disordered” – not good!!
And I also agree that we do indeed have cultural trauma, and we won’t see all of those unfortunate manifestations for years to come.
Thanks for the stimulating ideas and responses! Great way to start the day!
BR
I totally agree with the thought that the term PTSD is not right and PTS is much better!
As long as we are committed to a Western dualistic medical basis for understanding health and sickness, we will have more and more labels that pathologise people. Events which challenge the normal capacities of the human system will inevitably show up as symptoms whether physiological or emotional. Our labels work for the industrialization of the medical profession, the insurance industry and for Big Pharma .
DSM.V will only add to the plethora of circumstances that will be given labels which suggest abnormality.
For some of us this is reason enough to look at alternatives to the regular system and to avoid using our insurance which obliges the practitioner to use e pathologising diagnoses.
We all know the real problem with not having a diagnostic code is the reimbursement issue; let’s not mince words here. We (almost) all in the helping professions do what we do because we love our work. However, as with any professional who has worked hard to obtain the license to do what we love, we need and deserve to be compensated for what we do. I work with many people on a benevolent basis, but my time is limited. During my working hours, I need to get paid. If I worked with everyone without pay, it would require being independently wealthy. I’m not.
Yes, the symptoms these individuals experience are real, they are a consequence of abnormal circumstances; and not everyone under the same circumstances experiences the same reactions. There’s a recent study that indicates if the cycle of repressing the experience can be circumvented, the reaction can be diminished. It was very interesting. Perhaps the psychologists in the field with soldiers should be trained differently.
I don’t know the answers. I just know what I see when I work with any victim of childhood sexual abuse, domestic violence, or other trauma. What they experience is real. These people need to have their experience normalized and their symptoms reduced. Telling them they have nothing wrong with them (a complaint of soldiers now returning). Maybe there are some whose trauma wasn’t the same if they weren’t on the battlefield, but that doesn’t mean there aren’t problems. Denying the existence of the symptoms won’t help either.
I wonder if you have heard of (or are referring to) the study using beta-blockers?
I don’t have the original citation, but it is mentioned below
(from Wikipedia) “Post-traumatic stress disorder (PTSD) is theorized to be the result of neurological patterns caused by adrenaline and fear in the brain. By administering beta blockers immediately following a traumatic event, as well as over the next couple weeks, the formation of PTSD has been reduced in clinical studies.”
Exciting stuff. As is EMDR and EFT. And Mindfulness, and Art Therapy, and Guided Imagery.
I vote for PTS. Words are so powerful and what it means to the person. I now personally will try to introduce PTS into my practice and ‘possibly’ into training .
Thank you for the enlightenement.
Why not call it what it actually is: “Combat stress” and let it go at that.
Because what caused the stress is not where the solution lies. And the threshold for serious symptoms is met by many causes… childhood trauma is combat stress, too, in a way, as is growing up in a very violent neighborhood. Diagnoses are very specific, and helpful when you use them to clearly describe the intensity and frequency of certain symptoms. This helps the survivor, too, because it helps them see progress as they heal.
If I were a Teenage Mutant Ninja Turtle, now I’d say “Kounbwaga, dude!”
Yes, I think the word Disorder is not something any macho guys wouldn’t admit to especially if it effects their career.
I know insurer like to have “synptoms neatly laid out for stats and charges So maybe an addition would b in order…….
How about: Internalized Constant Alert Signals or Internalized Alert Status … Use anything to get rid of the word “Disorder”
I think the 6 month rule was/is a good if arbitrary delineation for military or combat based PTSD to distinguish between those who can destress from combat fatigue and those who can’t.Thus regular monthly evaluations should be the rule during the first 6 months of redeployment .The problem of stigma has to be handled through soldier preparation and training in how chain of command handles the individual soldier in the battalion to increase acceptance and decrease shame.
The impossible doublebind combat soldiers experience in admitting extreme stress while maintaining the warrior persona is the problem no mattter what you call it:PTS or PTSD.Since many combat soldiers will tell you returning to the USA is like coming to another planet after a year in the desert how do they achieve the mindfulness and self reflection demanded to spot their own distress early? And the stress that overwhelms is sometimes waiting inthe family when the soldiers return.Familiies need preparation and support from boot camp on….and especially around redeployment.
Probably a continuum on a scale from battle fatigue to long term reaction to combat would help;one that includes incidents of exposure to explosions, mindful attention to what has been experienced through the senses,emerging triggers and results of standard fMRIs and psych testing..all prior to diagnostic labelling…there is little doubt there will be increasing evidence of a neurological overlap with behavioral symptoms. Will there be a time when a brain scan could be part of the standard redeployment physical so soldiers with signs of shearing are not given multiple combat deployments? Could early detection and care minimise long -term issues?
I think we trivialize PTSD to normalise it. It is not normal. Ot is prolonged and debilitating. The Freeze,flight,fight response is only nomal at the original incident.
I love the idea of standardizing baseline data for each person starting in bootcamp. It would really be something to include that education from the beginning… how to recognize signs of stress and manage them as needed. All these ideas reveal a much deeper challenge embedded in MILITARY CULTURE, which undervalues health/wellness when it conflicts with goals of “unit cohesion.”
In other words, service men and women will never have access to this kind of psychoeducation for building resilience during the time they need it most –in the beginning of military careers, as they are entraining new habits– because the MILITARY UTILIZES THIS INFORMATION AGAINST new recruits in order to “break them down.”
Actually, the military does have an extensive resilience training program that has solid content including mindfulness training. In my observation, however, it hasn’t yet done a lot to reduce the stigma of seeking treatment.
As an overcomer of sexual child abuse, the suggestion that I had PTSD was quite disconcerting to me because I didn’t want to believe that what I was experiencing was a disorder. Though I knew that my order was definitely “dis”, I still felt like I was being forced into a theory that made me feel less “me” and more “the disorder.” I didn’t feel OK, I felt broken. Yes, I guess saying that I had a “disorder” made me not feel OK. All I wanted was to feel OK. That OK feeling is what finally helped me overcome. PTS or something else entirely would by my opinion.
Very interesting conversation here. For any who experience the trauma of combat, it seems that the process of coming into balance will likely not be completed until the culture that makes combat “normal” gets addressed. Perhaps the vets who live on the street, in the woods, or who die from suicide are serving the rest of us more than they did in uniform by refusing to participate in treatment intended to normalize something that should never be seen as normal. Perhaps the disorder lies in those of us who send young men and women into combat. Until we journey this path, it may be unlikely many would want to join the ranks of “normal”. Combat trauma does not stay within the skin of those on the front lines, no matter how we would like that to be the case. Addressing both the cultural trauma and the personal trauma simultaneously might give many of us more incentive to participate.
Wow……….Amazing discussion here. I love this last perspective on addressing the cultural trauma. I get a glimpse of that being the antidote for the shame that further inflames this condition. Regardless of how we “label” it. A consciousness where we heal together seems to be called for.
Thank you everyone for your input!
Call a spade,a spade. PTSD IS a disorder, however it Amy be created by different events. Perhaps those events can be specified using the word combat related vs car crash, rape etc.
Yes, I so agree that it’s been insulting to my intelligence and self-esteem to call the outcome of being catapulted on my head at birth a *traumatic disorder* instead of a devastating brain and skull injury.
I notice that trauma shows up in so many ways.
It would be much more helpful to approach trauma from a mindful perspective with the understanding that the trauma can be treated and the brain chemistry can be redirected to alleviate the symptoms.
In my opinion, eliminating the term PTSD entirely would be even more problematic. As mentioned by others, the “D” for Disorder IS, in many cases, the ALERT which generates attention and often results in services. We really do need some way to distinguish between a well-integrated increased sensitivity to stress (as one finds after utilizing one or more healing modalities that worked), and situations of crisis that call for more immediate intervention. If we use the same term to describe the entire range of experience, we are missing the opportunity to use words to discern one from another in ways that help us as clinicians to identify individual needs in a timely manner, AND to help our clients understand where they are on that healing continuum. I believe the real problem as described in the video, is not the USE of the term disorder, but the definition of it. The stigma seems to be based in the fear of being labeled as “forever damaged.” We can continue to reduce the stigma, and educate the public to think of “disorder” in it’s most basic definition: (Oxford American) “1. a lack of order; confusion. 2. a riot; a commotion. 3. (Medicine) a usually minor ailment or disease.” I think this is key. For those who need assistance, something IS out of order… perhaps even causing a riot in the mind and body. Those ARE the people we want to seek help immediately! For those of us who have HAD PTSD, however, and used some sort of healing modality that created order, allowed integration, and left us with an understanding and ability to moderate future stress, we can use the suggested PTS term to distinguish our experience from those who are still suffering. The bottom line is that many people mistakenly think of “disorder” as something that cannot find a cure, which is not true. Many disorders of the body and mind either find cure, remission, or end up being well controlled with medication (as in blood pressure or diabetes).
I see that supposed *mental illnesses* are physical and/or chemical chaos and the more they are spoken of openly(i.e. not in secret) the sooner the stigma(the not-like-me misconception) will evaporate.
Wow, thank you for letting us hear this intro from a military to the guided imagery of Belleruth Naparstek. I have been playing a play on Traumatic Stress for soldiers and I really love to hear this special kind of resiliancy and humour I have met so often form the military audience. This is a great bridge form one world to another ! Good luck, love form Ilja.
In my opinion, there is a much larger problem than the semantics of what we call the symptoms from which combat veterans are suffering. Under the current “rules” of the VA system, military veterans need to have a PTSD diagnosis in their military medical record in order to benefit from many of the services which they need after they separate from the military. In my experience, I definitely agree that many soldiers perceive a PTSD diagnosis as being detrimental to their active duty careers and will under-report symptoms or choose not to seek help for symptoms. The stigma of the diagnosis is still very much present for them within the military. Unfortunately, without the PTSD diagnosis in their record they may be ineligible for appropriate behavioral health services in the VA system. Another aspect of the issue seems to be the perception of some active duty miltary members that the military medical system will not diagnose them as having PTSD even though their symptoms fit the criteria. In their perception, this occurs to keep them in the military and in repeated combat assignments even though their symptoms are significantly impacting their ability to function effectively as a soldier and/or as a family member. Another perception is that the PTSD diagnosis is not given in order to limit the impact the number of veterans needing behavioral health for combat trauma has on the VA treatment system and budget. We have thousands of homeless veterans in this country who are not receiving the care they need. Many end up in the prison system or as chronically homeless. In my opinion, what we theoretically label their symptoms pales in comparison with the urgency of the need to create better systems of care for those who served to protect the rest of us.
This is the absurdity of the system. You need to be labled as “disordered” and “sick” in order to get help.
I agree! The system is definitely broken.
I am offering the suggestion that instead of another label of “disorder”, “undesirable” and all sorts of that name for the post-trauma natural response, we would address it as actually a healthy and natural way of the body-mind organizm to react toward a trauma. The NATURAL nechanism of the body-mind reacts that way in a natural chain of responses all for helping the preservasion of life. It resembles inflammations, fevers and all these HEALTHY natural reactions of the body to ward off a disease. This is why allopathic medicine that fights the symptoms misses the whole point – the therapist needs to address the underlying problem (trauma or chronic problem of any sort) that caused the symptoms, becuase when one addresses the underlying problems – the symptoms will go away anyway.
So, i believe that instead of talking to the client in terms of disorder and all that, we could make him/her realise that THIS IS A HEALTHY RESPONSE. Then much of the stress and the stigma problems attached to the process could be avoided. The person will be able to forgive and accept themselves more easily, there will be no blaming and the whole healing process will be quicker more efficient and less painful.
5 gold stars for this response.
I agree most profoundly. I think the Label alone would make anyone behave in detremental ways think the worst scenario of themselves their health and their future even perhaps refuse help.
There are so many other useful avenues and descriptive use in the english language that can be used more appropriately to describe the mind body disassociation. .
Who are we helping when we put people in little boxes?
“I was seeing that the concept of mental illness was a destructive concept because it implied that something was wrong with people that needed fixing. That very concept gets in the way of people’s development and evolution.”
Marshal Rosenberg (founder of “nonviolent communication” shared by trainers and facilitators throughout the world for purposes of healing, liberation and conflict mediation
Great comments all. From a mindfulness perspective, I’d suggest that this label —- as with so many others —- intrudes between therapist and patient, interfering with being fully present to them and their work, thus disrupting the alliance. I suggest this is so for vets as well as other trauma survivors. Whatever the source of the trauma, we all benefit from the universality and disconfirmation of group work, as well as re-building of relationship(s) both in individual and group therapy. As with everyone else the utility of the DSM labels for dx and Rx too often interferes with all of the above.
Doesn’t the government reimburse veterans who are diagnosed with PTSD?
If it is not considered/called a “disorder” than how will they get reimbursed?
My normal response to an abnormal situation is to help others survive the loss of their child, especially if it was from violent death or homicide. I haven’t experienced a worse event in my life as losing my only child, my 21 year old daughter, to homicide. I have the knowledge that I’ve already experienced the worst thing that could ever have happened to me, so I fear nothing now. Not death, my time will come when it does. Not cruelty or horror, I’ve experienced enough of that too (outside of my daughter’s murder) – to be labeled with PTSD. Now that I’ve had therapeutic help (which I was extremely reluctant to seek), I can re-engage with my life and others around me. For those of us who have experienced traumatic situations, it is extremely normal to respond the ways we do. How long did I wait till I sought help? I existed for seven long miserable years. Now I am able to function well in my home life, social life, and career again by getting the help I needed…and I love living again. Please help all of us by dropping the “disorder” label and lobby to increase the amount of “approved insurance coverage for mental therapy” given to help us regain our life productivity. An aerospace engineer and student pursuing a post graduate degree in psychology specializing in research for traumatized people. Pat
I prefer PTSR. The “R” is for “response”. I reject the “Disorder” handle; especially malapropos in these instances of a completely normal (not disordered) response to an insult(s) — including ones of the psychological kind — to an organism that’s wired to handle trauma by dissociating and/or repressing. Pretty soon those DSM-V jocks will be labeling grief as a “Disorder”.
I was so happy to find a diagnosis after so many many years – other than “well lady – you’re just hopelessly crazy!” that it never occurred to me that ‘”disorder” was a demeaning label. And I agree that the painful state of PTSD is a “normal response to an abnormal situation.”
But one’s thinking and response in “normal” situations IS “disordered” – what can I say – whatever works…that’s my “rule of thumb”!
Yes, I can do without the “D” for Disorder. PTS works just fine. However, I can also do without the “normal”, in “normal response to an abnormal situation”. The word “normal” comes with too much semantic baggage of its own, implying to most folk, things like… expected, inevitable and permanent (“If it’s really normal, I guess I’m just stuck with it”) Not a good choice of words. A physician doesn’t emphasize how “normal” it is to have a seizure after a concusion. I find no reason to emphasize how “normal” it is to have PTS symptoms after psychotrauma. “Understandable” or “common” would communicate much more accurately.
Doing away with the term PTSD is a good idea. Also, I like PCT (post combat trauma) even better than PTS. The word “combat” is more realistic.
If you change it to post combat, then you are forgetting all the people who have PTSD as a result of events other than combat…..and that is an awful lot of people.
I really enjeyod your blog, especially your guiding principle. I served in the Army as an Infantry Officer during the 1980s and wish there would have been an internet with this kind of information available then. I agree that although we are no longer serving in our nation’s military, we are never discharged from the service of our Lord. Thanks for making a difference with our vets. I just started an online christian bookstore at veteransforjesusbooksandmusic.us. Check it out if you get a chance.
I certainly agree with your comments. Who wants to be labeled as anything which seems like you are broken, or less than? During my years as a psychotherapist, I used diagnostic labels for the paperwork, but avoided giving my client a label. Part of my reluctance, is that when a dx is given, it can become a script for the patient to follow. So I don’t “teach” clients how they need to be in order to have the dx. As Lankton & Lankton state in their book, “The Answer Within”, “The explanation, theory, or metaphor used to relate facts about a person is not the person.”
Here in the Netherlands the military only call it PTSD, when after a while, the stressresponses do not stabilize, the amygdala does not shrink back to normal. Thus a veteran/soldier only suffers from PTSD, when hypervigilance, insomnia, backflashes etc. keep showing up. They found that isolating returning soldiers first on Crete, Greece, for a period of time, before having them return to their families, did shrink the amygdala back to normal size, stabilizing traumatic responses, enabling soldiers to return to ‘normal’ family life. Also not all soldiers react to a traumatic event with PTSD symptoms and possibly our society is too much inclined to think it is so. Possibly also is that a soldier gets traumatized, coming home into a ‘normal’ familysituation, where noone gets, what he has been through, making him feel totally alienated, isolated and alone. Where the wives expect their husbands to return to the situation as it was prior to the mission, which is impossible. None can be without their ‘history’ included. It is almost impossible to be in relationships where the others simply, not out of their own fault, do not get you.
So possibly therapists should hold of for a while, before giving the sticker/stigma of PTSD, letting it be known, stresssymptoms are normal, but also most likely temporarily for most.
Gertrude van Voorden: Now I am hearing a better definition and description of status. it is both a brain chemistry and a situational problem. In my situation, I was pulled out of college into a war no one liked and then sent home to people who threw tomatoes and rocks at us calling us baby killer etc. Since we were disliked by the mainstream public, it was hard to fit-in with these civilians and hold a job well. This status by itself continued the trauma leading to a more permanent condition.
I think it is more the STIGMA that is attached to the label than the label itself that is causing problems. The stigma is related to what men have been taught about how they are supposed to be in society and in the military. The same problem has existed for years about depression. Maybe the term syndrome is better than disorder, none the less, a person does become dis-ordered, when exposed to traumatic events. Yes, it is a normal response to an abnormal event and we get stuck there, until some technique helps us get out of there. We literally get stuck in fight, flight, freeze mode, and PTSD has always been considered a psychiatric disorder, which also added to the stigma. Get rid of the stigma and the label really doesn’t mean anything except a set of symptoms that describes what is happening with a person.
Robert Scaer made the point that “screeners” using the DSM IV-R diagnosis of PTSD, which everybody I have read recently says is faulty because it leaves out trauma caused by long exposure to fear and what Peter Levine calls “tonic immobility” and most of the rest of us are calling the “freeze response.” As a result, according to Scaer, thousands of returning military vets are being told their only problem is a personality disorder, which in the medical model, is untreatable by definition, and so they are not qualified to receive treatment–this, even if they do overcome cultural biases and seek treatment in the first place. Having received several invitations from insurance companies to apply to be qualified as a screener of military vets (and refused to apply to avoid supporting the travesty) I expect that this abuse will not only continue, but expand — especially if those of us who are lobbying for a DSM V revision of the PTSD definition are unsuccessful, as Scaer and Bessel van der Koch predict. Radio announced yesterday a government investigation. One hopes.
I totally agree with you. The medical model is based on medications and not of physiology and reactive changes. you can not cure everything with a pill. Allopathic control of healthcare needs to stop. There is a place for all practitioners in healthcare. We are failing to see the total picture when we allow one body of physicians to direct care based on their interests and mode of care. it takes a multidisciplinary team to help.
PTSD, PTS or other is not as much a problem as to understanding the need for one soldier to communicate with another (camaraderie between them). It is the connection that has been drilled into our heads that gives the trust to unlock defenses. You can not take a soldier that has had his training rammed down his throat from basic training on and expect him/her to listen to a civilian. It is the special connection that is made from basic training on that is the door to help. Without that “confidence” being built, no progress is actually made with the soldier. I have used many techniques to help vets in the past and today. One I have found very helpful is the use of games on the internet to make the connection. Using a term like Isolated Post-Stress Status may sound less intimidating.
I would like to suggest that this is true of every “disorder” listed in DSM IV. When a client comes into see me and says “Oh, I am bipolar” or “I have cancer” it appears to me that it is much more challenging to encourage them to work at changing their behaviors that contribute to their label. What I have begun to say to my clients is, “”OK, you have a diagnosis, but I ask that for the time you are seeing me that you consider that you are NOT your diagnosis.” And then I explain that we always have choices in how we live our lives and if they had their druthers, how would they like to do that? Now, let me say I am new as a MFT, but have been seeing clients as a craniosacral practitioner for 11+ years and the clients with recent diagnoses can more easily let go having it own them. The ones who were diagnosed for a long time have generally “become” their diagnosis. When a client identifies as their diagnosis it requires a great deal more work to help them heal. But the truth is that with some help each client can see their self as a healthy person with a condition that can respond to better self care and awareness of what needs to change. Isn’t it always true that if you keep doing what you’ve always done, you’ll always get the same results?
I was actually diagnosed by a psychologist (in training to do PTSD) as bipolar! I would have laughed but she was serious about her diagnosis and it would have damaged her eagerness to learn. Her training lead her to want to tie my status to a past childhood status. It became obvious that she did not understand what soldiers go through in training and active duty. Therefore, I still state it takes another soldier with a therapist to break this barrier. The therapist may be a past or current military person as well.
Thank you for this eye-opening video on the topic of whether to use PTSD or PTS. I really like how they highlight that Post Traumatic Stress is not a disorder at all – that it is really ‘a normal response to an abnormal situation’. I agree that language is very important (ex. person-first terminology) and that we need to use the most respectful terminology that we possibly can. If changing the name is going to allow more individuals the courage to come forward and get help (which it sounds like it would), then I’m a huge proponent of moving towards the diagnosis of PTS.
Angie: It is a disorder but not as in a physical sense. I think we have placed trauma patients in a box as if they fit a physical disorder (i.e. fracture or amputation). It is different for each soldier and as debilitating as a gunshot wound or amputation. Because it is not a discoloration or visible dis-figuration, the governing body (usually military) disregard the injured or label them as cowards. The soldier does not want to think of themselves as a coward so the response is to go within themselves. Here the problem of naming or treating is not focused.
The whole labeling bussiness that the western psychology is so busy doing is alltogether harmful. I had clients who were disabled for life just because some “professional” labled them as “borderline personality” – beautiful vibrant people who due to a stupid lable struggles unecessarily. I am also what you could call a “PTSD” surviver and I remember the day when a profssional told me that I might get better but I had to prepare myself to be “disabled for life”. I knew there and then and I told her so – that this was crap, and I am not prepared to accept it. I eventually proved myself to be right (NOT with the help of professionals, I can tell you, but by a combination of spirituality and Integrative Medicine) and I am downright furious when I see people crippled by those lables. How does this labeling help anyone to gain health and happiness – that I never understood.
Yaelah, Chinese Medicine , Israel : I agree as a PTSD soldier from the Vietnam War. First, I had no contact and for 40 years I dealt with being drafted out of college and forced into a military situation I was not prepared for. It is a situational thing rather than a disease. This causes the brain to find a way of coping with the trauma. Some have a brain chemistry that allows them to recover fast, some slow and some not. Knowing who is who will help in directing the treatment on an individual basis. Every one is different and can not be placed in the same sardine can.
Dr. Clark, Just to clarify, of course the symptoms of distress known as “PTSD” (which as you say are individual for each one) should be recognized and dealt with asap so as to avoid years of unecessary suffering. What I am against is all those labelings. If the person had a trauma, we need to deal with the trauma which is the underlying problem of all those symptoms without the need to call it names – there is really no need for that. Labeling it as this or that only adds to the confusion and low self-esteem of the person and it does not contribute one iota to his/her health.
The point about “disorder” is so true – as if it is the normal state not to be affected by traumatic events! Treatment can fall into the same category: I prefer to teach my clients ways to change the impact of previous events. After all, it is not I that make the change (though I teach the “how to”).
Margareta
Labels , labels everywhere for all kinds of dis-ease; everything has to be labelled and so many people demand a diagnosis and then live up to the symptoms of that diagnosis and sadly the label becomes their identity and forms their behaviour. Maybe as Warren Berland says, it is time for getting out of the box in a way that supports the trauma sufferer, to take steps to regain their freedom and uncover the authentic self beneath all the trauma.
Completely agree