Post-Traumatic Stress Disorder
Post-Traumatic Stress Disorder (PTSD) is a disorder that has existed for many years but is just now beginning to be accepted by mainstream society and government bodies. In this brief paper, I will discuss the history of PTSD as a recognized disorder as well as the symptoms exhibited by someone suffering from the disorder. To conclude the paper, I will discuss some of the techniques that have proven useful in treating PTSD. History
The history of PTSD is three-prong. With the advent of the railroads and increased travel by rail, doctors began to see train wreck victims who presented with symptoms even though there was no physical cause. So common was this phenomenon that medical doctors began diagnosing it as “railway spine.” Psychologists were more derisive however, labeling it “compensation neurosis,” believing that the victims were malingering in order to receive insurance benefits.
Across the ocean, Sigmund Freud was working with young women when he began noticing symptoms of denial, repression, avoidance. He believed these were due to childhood sexual abuse and labeled it “hysterical neurosis.” His findings of widespread childhood sexual abuse were not well-received by polite Victorian society and he was forced to disavow his findings.
However, it has been exposure to combat that has generated the greatest number of incidents. As early as the American Civil War, symptoms labeled “neurasthenia,” “soldier’s heart,” and “nostalgia” were reported. In World Wars I and II, the increase in aerial bombardment and artillery gave rise to the terms “shell shock” and “combat fatigue.” Although doctors did not know how to treat it, PTSD (or the symptoms rather) were recognized as a psychological disturbance by the end of World War II and the Korean War years.
It was the war in Vietnam and the sheer volume of affected returning soldiers that truly thrust PTSD in the spotlight. Although it was previously denied by policymakers, a coalition of grass-roots support groups forced politicians and health sciences officials to acknowledge the reality of the issue. Research into rape and child and spousal abuse victims found that many of the symptoms being reported were the same as those afflicting soldiers. With the publication of the DSM-III, Vietnam Veterans syndrome, rape trauma syndrome, battered woman syndrome, and abused child syndrome were combined under the rubric Post-Traumatic Stress Disorder. Diagnosis
Diagnosing PTSD is challenging. Frequently, the symptoms presented could be indicative of several different diagnoses and many times other diagnoses are comorbid such as alcohol abuse or depression. According to the DSM-IV-TR, in order to be diagnosed with PTSD, the client must have been exposed to an event that involved actual or perceived death or serious injury or threatened the physical well-being of themselves or others. They must also persistently re-experience the event in at least one of the following ways: recurrent and intrusive recollections of the event, recurrent nightmares, flashbacks that cause the person to dissociate and act or feel as if the event were recurring, intense distress upon exposure to cues that resemble the event, or physiologic reactions upon exposure to cues that resemble the event. The client must persistently avoid the stimuli in at least three ways: attempts to avoid thoughts, feelings, or dialogues associated with the event; avoids activities, people, or situations that arouse recollection of the event; unable to recall important aspects of the event; exhibits markedly diminished interest in significant activities; detached emotionally and socially from other people; numbed feelings resulting in restricted emotional affect; and general sense of foreshortened future. Finally, persistent symptoms of increased nervous system arousal that was not present before the event must manifest, as...