Not the Tragedy You Might Think
Have you ever had a reaction to a painful or terrifying event?
Not all things in our inner life and parts of reality are what we would want. We have an image or images of how things are supposed to be. If we are fortunate these images are not seriously violated. But sometimes they are.
Sometimes life is devastating and devastation can come suddenly in many forms or slowly and insidiously. A terrible storm, a horrifying accident may visit long term consequences on us.
Up front I need to say that this post is not simply about trauma and stress. The term usually noted with the short form of PTSD most often makes us think of returning veterans. But, of course, it isn’t confined to veterans. It is my perception as a psychologist that we need a wholesale revision of the meaning and even the use of the term.
Diagnostic Labels
Long ago we removed many difficult personal issues from the care of the church and said particular kinds of suffering people were not being tortured or possessed by demons. Instead we took them to doctors and defined them as suffering from mental illness and give them a diagnosis. Well and good up to a point. A compassionate response and management was better than exorcism.
But now we use the medical model for ever so many things and it is time to redefine our intervention and perception of cause. In this blog the focus is on battlefield trauma. But trauma is not confined to the battlefield and there can be many contributing factors.
Origins of PTSD
In wartime we send our people into zones where people are trying to kill them on a daily basis and they are supposed to kill on a daily basis.Then we send them home and tell them to have a nice day. We are asking a huge adjustment overnight. And recently I heard an officer speak about the nature of the experience and that it includes close personal support from fellow military people. Suddenly, when they leave service they have to give up this essential daily support even while they are to leave the killing fields. We are asking a lot and we tell them they have a disorder—a mental illness. There is typically stigma attached to mental illness and it places a barrier to getting help for what is fundamentally an adjustment.
A Personal Experience
Decades ago I was in a terrible auto accident which sent me into years of pain and recovery. And then more recently I was sitting at a stoplight when a man came around the corner too fast, spilled his coffee on himself and he ran full speed into my car which was totaled. I escaped with only a bruise. But within 48 hours I was anxious, having terrible dreams and a variety of other reactions. As a psychologist I knew I was thrown into PTS because it called up my prior accident. I called a psychologist friends and in four sessions we detailed the reaction and separated it from my current life. The bottom line here is that I had a reaction, not a mental illness and I went to someone to help me through my reaction.
The Real Tragedy of PTSD
Too often the outcome of trauma continues but it can typically be attenuated if the person seeks support and understanding which can be on a personal basis or a group setting. But it is important that they don’t feel stigmatized by being called “mentally ill”. The military is working to use PTS rather than PTSD which is important. It can be dealt with but not if we don’t respond correctly.
Mental Illness in General
We have work to do. Our lives are filled with stress and simple change. Over time we have multiple adjustments sequentially or at once. Guidance and clarification often is crucial and disturbing definitions and often unnecessary psychotropic medications may not be helpful.
Wisdom is needed to handle our world as it is and wisdom should lead us to a complete rethinking of the mental health field. It is complex. Yes, we have anxiety and some people constitutionally have more anxiety than others. It is manageable. Yes, we have depression and in my case my bouts with it were a function of an inherited vitamin D deficiency. I won’t even attempt to detail all the ins and outs of what has been thrown on the heap of “mental illness”. Basically it is clearly time for a complete restudy and reevaluaiton.
What is your catalogue of stress factors and adjustments needed in your life?