Traumatic Stress Reactions (TSR)
I am among those who question the story of PTSD as a biologically rooted, chronic disorder to be managed through various drugs and approved talk therapies. There are many problems with this story, but I will outline two important ones here. First, despite billions of research dollars studying the brain from every conceivable perspective, there is no evidence of biological causation. Secondly, when construed as a biological disorder, the best that can be achieved is life-long management. This assertion ignores the reality that many people incorporate the lessons and fully resolve traumatic stress reactions and go on to lead perfectly normal, productive lives. Unfortunately, when military people and others are convinced to accept the idea of compromised brains to access disability remuneration and services, they are also set-up to accept and to live out permanent dysfunction. They and their families are left with few avenues to move on with their lives.
Arguably, medicalizing the experiences of Viet Nam veterans under the DSM (Diagnostic and Statistical Manual) in 1980 gave legitimacy to their struggles and spawned novel interventions that proved helpful to many people. It has also trapped many others in their past experiences. We are beginning to acknowledge the central importance and prevalence of moral injuries, the legacies of developmental abuse and neglect, intergenerational trauma, institutional betrayal, and military sexual trauma. All undermine medical ideas about PTSD as a biological susceptibility among some war heroes. As such, the concept of PTSD has outlived its usefulness as a concept and as an approach to distress.
A more helpful narrative is that chronic emotional avoidance, numbing, substance use, replaying specific memories, and vigilance among traumatized people are learned behaviours in the service of safety and predictability. While these behavioural habits are essential for distressed people who question everything around them, they usually create many other problems. These strategies can be unlearned and replaced with more adaptive habits. And the most helpful habit seems to come down to consistent engagement with other people in re-establishing a needed sense of safety. The solutions to traumatic stress reactions are in the unedited accounts of traumatized men and women. They are not to be found in some, as yet undiscovered corner of the intricate organ sitting on our shoulders.
As said eloquently by others in Canada, there can be no reconciliation without truth.
John J. Whelan
John J. Whelan, Ph.D., is the author of Going Crazy in the Green Machine, available now on FriesenPress.