PTSD – Should we Call it a “Disorder”?
Some time ago I was chatting with a colleague in the USA about therapeutic matters in general, but as he is of a similar background to me, i.e. ex-military, the conversation came to rest, as it so often does on Psychological Trauma, how we recognise it, treat it and so on. I like to catch up with colleagues like this, as America is far in advance of us with research and therapeutic intervention. It was, after all, research born out of the Vietnam War, that led to PTSD being formally recognised.
One thing struck me at the time of this conversation though. That was my colleagues absolute refusal to call it PTSD, favouring instead to simply call it Post Traumatic Stress (PTS). The term “Disorder” just wasn’t mentioned.
So why do we label it in this way. Ok, yes, if you were to look it up in the Diagnostic and Statistical Manual of Mental Disorders IV (DSM IV), it is there in black and white. Also true if you were to look it up in DSM V, currently doing the rounds among the psychiatric community for consultation prior to a 2012 publication date. It’s also called a disorder in the International Statistical Classification of Diseases and Related Health Problems (ICD) 9 and 10. Looking up the appropriate definition of the word “Disorder” I found the following:
“A disturbance in physical or mental health or functions; malady or dysfunction”.
That there is a disturbance or dysfunction in mental health functions of an individual succumbing to PTSD it certainly true, but is it right (or fair to the individual) to “label” them this way, simply in adherence to dictionary definition and obscure professional publication references?
So who am I to question these references put together by professionals of a far higher standing than mine in the international community? Certainly when I was staving off my own “demons” of this sort, I remember I felt acutely uncomfortable with the term “PTSD” when entertaining possible diagnosis for what I was experiencing. This also seems to be true when I have spoken with many clients in this area, regardless of whether they are civilian or from a military background. Including the word “Disorder” implies that there is something abnormal with the individual, that they are different in some way to the rest of us. This is where I have a problem. Yes I have continued to call it a disorder on my website, but only because that is how it has become recognised. Yes, an individual with this set of symptoms can be said to have a disorder in the strictest definition of the word. But I feel labelling them in this way is not only unhelpful, but disrespectful, both of them, their feelings and what they are going through.
Consider this. What the mind is doing in such cases is perfectly natural! It is all part of the mind’s natural protection processes. The fact that this often results in inappropriate thoughts and behaviours is, I feel, where the term “disorder” has crept in. Why on earth should we feel the need to label someone in this way when what their mind is doing is natural and normal?
Since that conversation, I have dropped the term disorder, if not on this site, when speaking to people with this diagnosis. I have found them able to relax a lot quicker, I am able to gain a deeper more meaningful rapport with them and ultimately able to assist them in a more timely manner. Isn’t that a lot more helpful than sticking one’s nose in the air and off-hand labelling them abnormal?