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Experts discuss possible name change for PTSD

January 18, 2012
by Nick Zubko, Associate Editor
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What is PTSD? Is it a true mental illness, the result of trauma or battlefield-related injuries, or is it something else entirely? That’s the question being posed to many experts recently as officials from the U.S Army are requesting the American Psychiatric Association (APA) to reevaluate what the condition is called.

In December, PBS Newshour covered the emerging debate, which focuses on the exclusion of the word “disorder” from the diagnosis, potentially alleviating some of the stigma preventing some veterans from seeking treatment. APA president John Oldham, MD, told the Newshour in an interview that he was “open to the suggestion” of changing the name.

The idea was first introduced by Gen. Peter Chiarelli, the Army's vice chief of staff, in a letter to Oldham. Chiarelli told the Houston Chronicle in a Jan. 16 story that the word disorder is “misused,” asserting instead that what soldiers experience is “an injury to the brain and how the brain works.”

According to the Chronicle’s story, Oldham is evaluating possible updates to the association's diagnostic manual with a new subcategory for PTSD, using “combat post-traumatic stress injury” as an example. He said the change would more clearly link the condition to “the impact and the injury of the combat situation and the deployment experience.”

These stories raise an interesting point. The stigma associated with many mental health conditions does seem to prevent many from seeking help. But what has been your experience with cases of PTSD? Do a large number of patients resist treatment due to the implications of having a "disorder?" And could a simple name change make that much of a difference?

Let us know your thoughts.

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Comments

Call it what it is: Trauma-related disorder.

My work with a former military judge has taught that the military will go to any length to avoid long term treatment or disability payments. By calling this disorder an injury will make treatment finite and once again cheat those who have served us so valiantly.

Patricia K. Sullivan
Billieve in You llc

You said it, the STIGMA is the problem here. People including VETS seek treatment for many physical illnesses with stranger names than PTSD. I think everyone needs more education and open discussion so they can feel comfortable and habituated with the terms.It's not crazy to have a Post Traumatic Stress Disorder.

Actually, the entire DSM-IV (as well as the forthcoming DSM-V) including all the categories, should be thrown out. It is a document which encourages fear and loathing, as well as being on shaky scientific grounds. Probably half or more of the categories found in it can be traced to the results of trauma. While great work has been done on trauma, even when it doesn't rise to the level of PTSD (see Healing Trauma by Peter Levine), little of it has made its way through the maze of marketing propaganda from the drug companies which support. But as the DSM-IV states " Inclusion of a disorder in the Classification 9as in medicine generally)does not require that there be knowledge about its etiology." (pg. xxiii) It promotes ignorance (and of course drug pushing). Nothing else.

I am a person who has sat in both chairs, so to speak: as a therapist and as a patient. I have experienced various traumas throughout my life, beginning with a six-week premature birth in the late 1950s.

Peter A. Levine, in his seminal book *In An Unspoken Voice*, has come to understand the core of trauma (over nearly forty years of focus on the subject) as immobilization/helplessness + terror -- a genuine threat to existence. Trauma is a dire injury to the whole person; it is not simply a 'mental health issue' (What a vague, belittling term!).

The term 'complex post-traumatic stress disorder' was considered as a diagnostic category during the early and mid-2000s for situations of multiple / long-term trauma (as contrasted with the impacts of a single devastating experience) ... The term makes sense to me for such injuries. All told, though, the term 'shell shock' still speaks volumes when one considers it deeply. A grave shock affects every system and function in the body; the aftermaths can last for years. People so injured often describe their post-traumatic self as a 'shell' of who they used to be.

'Post-traumatic stress' sometimes strikes me as an oxymoron -- Stress itself is a neutral state, a fairly constant experience for most human beings. Eustress is seen as 'positive stress' and distress is seen as 'negative stress' -- and trauma is the extreme of distress. True trauma marks one for life. The term itself has been erroneously used in many contexts -- I recall reading an article that claimed children were 'traumatized' by the ending of a popular book series.

Trauma *is* the injury; what happens afterward is a series of aftermaths.

What logic dictates that removing the word disorder from one group of people (drawing attention to the term) is going to eliminate stigma? That's illogical. Also, changing the names of diagnosis every five years only builds an illusion that the APA are actually doing something constructive. Stop renaming things and redefining them and looking for new ways to advertise them. Start actually looking for a real way to treat the illness.

Nick Zubko

Associate Editor

Nick Zubko

@BH_Zubko

www.behavioral.net

Nick Zubko is associate editor of Behavioral Healthcare.