In a recent article published on the Public Broadcasting System’s (PBS) NewsHour, military and phsychiatric professionals debated the merits of changing “PTSD” to a less stigmatizing and potentially more accurate term.
Former Army Vice Chief of Staff General Peter Chiarelli made his case for the change last October and was recently seconded by two top psychiatrists, including Dr Jonathan Shay, whose published works include Achilles in Vietnam: Combat Trauma and the Undoing of Character and the excellent Odysseus in America: Combat Trauma and the Trials of Homecoming - which I read on my flight to Iraq in 2006. I am in full agreement with General Chiarelli’s and Doctor Shay’s recommendation to relabel PTSD as Post Traumatic Stress Injury or something equivalent in order to help destigmatize it and accurately reflect its true nature as an invisible physical wound suffered from contact with the enemy.
In a previous blog titled A Legion of Shadows I made the case from personal experience and anecdotal evidence to define combat-induced Post Traumatic Stress Disorder as a physiological wound of war. I am pleased that certain influential senior military officers and world-renowned psychiatrists are largely in agreement with my rationale.
Marines with 2nd Platoon, Kilo 3/2 take cover from a 500 lbs Joint Direct Attack Munition (JDAM) dropped on an insurgent machine gun position in Karabilah, Iraq during Operation Spear. June 17, 2005
The crux of the stigma associated with the psychological definition of PTSD is that it infers that the “disorder” comes from a subject’s mental predisposition to be negatively affected by a traumatic event. In the military – and in other social circles – such an inference is often sneered at as weakness. Yet, in my personal experience from two combat tours in Iraq during the worst years of 2005-2007 and my association with scores of combat veterans, no one escapes unscathed from significant and prolonged contact with the enemy. Regardless of “predisposition”, every combat veteran is changed by his experience, and the effects of that change might rightly be classified as an injury.
In the interest of furthering public discourse on this important subject, I ask the reader to share recommendations for or against reclassifying PTSD as an injury rather than a disorder.
The reader may be interested in sharing such recommendations at Dr. Shay’s website advocating for the American Psychiatric Association to change the name of PTSD to Post Traumatic Stress Injury.
A much-needed re-classification which is overdue. PTSD results from external stimulus and trauma, not from internal causes primarily. Thanks for posting on this topic. I will check out Shay’s books.
You are absolutely correct! Injury would be the more accurate in my opinion as well.
Much like the long struggle that it took for tbi’s to be recognized as worthy of the Purple Heart (and for which in my opinion the USMC still has the most idiotic guidelines), I fear this will not be a quick fix.
Trauma Induced Brain Injury, perhaps?
So true, Chris. There is a lot of research going on with traumatic brain injury…football players, boxers, combat trauma. Even those that appear to recover fully apparently have increased risk of Parkinson’s later on in life.
And I’m not joking when I say you may very well write a best seller at some point. You have a story to tell, and could tell it so well in order to help educate the public on what PTSD really is, and how difficult the road of recovery from the trauma is. Your post on Lt. Smith’s post “What’s it Like?” is gut wrenching….seriously gut wrenching. It skillfully brings to reality the raw emotions that a person experiences in a moment of horror and the trauma that is endured from that moment on. Most kids the age you were when you were in Iraq think about which college party or function they are going to attend the next day. You guys worried about who or what was going to be behind the next door you breeched, or where your next step would fall. The day to day stress of that is unimaginable, not to mention the trauma of seeing one of your brother’s fall.
The letters “PTSD” seem so benign to most Americans I think. We see it in news articles and on TV when the topic comes up. Sometimes it is used to describe the emotional distress of someone whose home was destroyed by a tornado or someone who experienced a crime. But seven month stretches (multiple deployments in some cases) of intense stress and sometimes moments of horrific distress? ……unimaginable to most.
A simple name change from PTSD to PTSI is not enough in my opinion. These stories need to be told by people like you and LT. Smith so that ALL Americans will know “What It’s Like”.
sniperdad –
PTSI is an improvement, but as you say, not enough.
As you may or may not be aware, the services only a few months ago changed their guidelines to allow concussions to be classified as purple-heart worthy. The inevitable debate over “cheapening” the award is, in my opinion, ridiculous; the medal should be awarded in direct proportion to advances in medical science and understanding.
The Army, Navy, and Air Force, as I understand it, have decided that any in-country diagnosis of “any concussion…resulting from hostile action” qualifies the servicemember for consideration for a PH.
The Marine Corps dictum from September 2011, however, states that the Marine may only recieve the award if the above ‘qualifications’ are met AND the individual was removed from duty for 48 hours – which only happens in a combat zone if the Marine recieved a black-out or “grade three” concussion which automatically qualifies him/her for a PH anyway. So nothing changed.
I think that it is safe to say that the above example will hold true for PTSI as well as TBI.
Cosmetic and PR changes may be made but it will probably be years before real changes are made.
PTSD treatment for Veterans found ineffective.
Eli Lilly made $65 billion on the Zyprexa franchise.Lilly was fined $1.4 billion for Zyprexa fraud!
The atypical antipsychotics (Zyprexa,Risperdal,Seroquel) are like a ‘synthetic’ Thorazine,only they cost ten times more than the old fashioned typical antipsychotics.
These newer generation drugs still pack their list of side effects like diabetes for the user.All these drugs work as so called ‘major tranquilizers’.This can be a contradiction with PTSD suffers as we are hyper vigilant and feel uncomfortable with a drug that puts you to sleep and makes you sluggish.
That’s why drugs like Zyprexa don’t work for PTSD survivors like myself.
-Daniel Haszard FMI http://www.zyprexa-victims.com
Disorder is not associated with alcoholism, drug addiction or other conditions with far reaching social and morale implications, and are not disorders, but disabilities. Because we have a name for “it” does not give the mainstream medical community the right to classify something as a disorder versus an injury. Civilians working in traumatic life and death decision jobs, are given counseling and treated for the undue load placed on the mind-but not dumped into a category of “disorders” because of too many months in the Neonatology ICU at a large medical center.