"A clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress (i.e., a painful symptom) or disability (i.e., an impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom. The syndrome or pattern must not be merely an expect able and culturally sanctioned response to a particular event. It must currently be considered a manifestation of a behavioral, psychological, or biological dysfunction in the individual. No definition adequately specifies precise boundaries for the concept of mental disorder. Also known as mental health, mental impairment, mental illness, brain illness, and serious brain disorder," (DSM-IV, 1994; p. xxi).
Lets break this down a bit. By definition stated above, being hit by an IED, mortar round, grenade, or even simply watching a friend do the same can fall under these qualifications as a disorder. However, the response to these events are not a dysfunction in the individual but merely a natural reaction. The word disorder has got to go. Being diagnosed with PTSD can leave a veteran to almost reason with his/her service as being crazy and not have a way to sort the feelings out. The word disorder gives reason to not hope, no way out, leaving a veteran feeling more helpless. Maybe saying a natural reaction to the duration and exposure to combat should be an obvious symptom of Post Traumatic Stress. IF the re-occurring thoughts and feelings keep manifesting and the person has problems with reintegration or what have you than it needs to be treated in a clinical setting. I feel like the mental health professionals at the VA or any other place that serve veterans have the verbiage wrong in this matter. These are natural reactions to horrific events that can cause damage but labeling a veteran with a disorder just compounds the problem.
When I went in for my mental health evaluation after I had been blasted a few times I was asked a series of 4-5 questions. I answered to the best of my ability and truthfully. What I came out with was a mental health diagnosis of Post Traumatic Stress Disorder. Guess what? It drove me to not want to get help from the professionals who just hooked me up. I lived up to that diagnosis and basically convinced myself that I was borderline crazy and it was never going to go a way. Once I started studying psychology in college my thoughts changed. Everyone, in some capacity has a threshold to endure pain, suffering, and trauma. The bodies natural reaction is to shut down the conscious mind and pick up certain events through the unconscious, this is the brains defense mechanism. The purpose is to help shield the traumatic memory. That mechanism is a natural reaction. The re-occurring dreams, sounds, and smells, are not dysfunctions. They are the natural response to the traumatic event. I'm not saying that guys should not be diagnosed, I am saying the verbiage needs to go. The stigma of having a disorder while still in a Ranger Battalion, Special Operations Warfare Team, or simply still being a line dog in the Infantry can ruin your psyche. Having things in your medical file like, "mental impairment," "serious brain disorder," "or mental illness" can ruin a man's position within a team. It can also send signals to others, to stay away from that person, he's crazy. etc. This goes so far as to affecting veterans, and employment. The stigma of being in combat is nothing more than feeling like the rest of world is labeling you as a crazy, those labels drive isolation. Isolation leads to suicidal thoughts, and you get the complexity of the situation.
Karl adds: The VA's accepted treatment for PTS is immersion therapy. In my opinion, immersion therapy is criminal negligence on the part of a mental health professional. In immersion therapy you relive the trauma over and over and over and over... by telling it to a parade of different (and usually non-veteran) shrinks. They believe if you go through it so much you become hardened to the experience, better able to deal with it. Makes sense, you know if you continually rip the scab off an open wound it heals, right? NOT. Doesn't make sense at all, it ignores basic understanding of the brain's ability to capture and store memories. We are working with Dr. Carrie Elk on an innovative treatment program that is working for Special Operations veterans (and active duty too) without drugs, without immersion, and we are seeing success in a couple of one hour sessions. We seek to bring her to communities all over the country to train the trainer and get this therapy wide-spread exposure. More to follow on this.