Wiston Papers

What's in a name?

The U.S. Army wants to change the name of Post Traumatic Stress Disorder (PTSD) and this week the American Psychiatric Association (APA) is considering it.

At the heart of the discussion is the term “disorder.”  Advocates of the word change claim that the term carries a stigma, which makes some sufferers reluctant to seek much needed care.  “Injury” is the term proponents seek.

Opponents argue that “injury” implies that the malady can be either cured or repaired like cancer or a broken bone.  That often is not the case they note.  Some victims require years of intensive therapy and medication to regain some semblance of normalcy.

Years ago I asked a psychiatrist who worked with veterans suffering from PTSD why some persons returned from war with it and others seemed virtually unscathed?  

There are many factors he explained.  But the principal one was how strong the individual was when he or she went off to war.  Those who returned healthy came from strong families, generally were well educated, enjoyed high good self-esteem, and had a strong religious faith or philosophical belief.  PTSD patients, he noted, often lacked one or more of these traits when they entered the military and were thus more vulnerable to stress and its consequences.

I doubt that a name change alone will motivate men and women who are struggling with psychological trauma to seek the help they need.  Too many will self-medicate with either alcohol or drugs to help cope with a civilian world they can no longer navigate. And too many will refuse to recognize or admit that they have a problem no matter what the label.  

There would be less stigma if the military did a better job of counseling our men and women at all stages of service from enlistment, tours, to discharge.  Our soldiers, marines, sailors and air force personnel should receive thorough screening and evaluation every six months while in service.  Those displaying symptoms of “stress” or “injury” should be rotated home for intensive treatment and reassignment or--in extreme cases--discharge with mandatory treatment as part of their release.

Too many Americans return from war with physical and mental trauma.  The military should be the first source of the necessary treatment and support.  In the case of mental “stress” or “injury,”  the military not the patient should take initiate diagnosis and treatment.  Unfortunately, too many veterans are expected to make the transition from war to peace on their own with little or no preparation for the inevitable “reverse culture shock” every person experiences after protracted time abroad.  Many can’t do it and the military is to blame.

Until  our government takes the necessary steps to protect our men and women--mentally and physically--all steps of their tour, we will continue to see a stream of veterans virtually abandoned by the very nation they vowed to protect.  

Call it Post Traumatic Stress Disorder or Injury.  Changing the name isn’t the answer.  Better treatment by the military is.

Steve Coon

May 08, 2012