That people suffer the after effects of traumatic events is
indisputable and very unfortunate for those experiencing the emotional and
mental upheaval – whether or not they have had it diagnosed as Post Traumatic
Stress Disorder (PTSD). Yet this condition – PTSD - was “created” by the
American Psychiatric Association’s Diagnostic and Statistical Manual of Mental
Disorders (DSM) only in their1980 third revision – DSM III. Prior to this date
– while people certainly suffered – it was not categorized as Post Traumatic
Stress Disorder.
Traumatic and highly stressful experiences rob us of our
belief that we can keep ourselves safe in the world and we wait anxiously for
the next traumatic event and react nervously to every unexpected sound
–compounding our fearful expectations. Whatever our traumatic experience it is
important to remember that such events, though terrible, evoke responses that
are ordinary human responses to extraordinary circumstances. Everyone going through such an “out of
normal” and fearful experience needs comfort and support, just as we all need
comfort and support when, for instance, we are injured, lose a close friend or someone we
love. But to categorize our ordinary reactions to this fear or grief as a
“mental disorder” both diminishes and demeans our experience. We have had this
experience, which is outside our normal expectations, and we react by trying to
master our memory of the event and the emotions that are evoked. The
mind will often attempt to ‘retreat’ from unpleasant life circumstances. It
will do so in the only way it can, by going to a place of refuge and shutting
off the ‘hurt’. This can manifest in many ways – as ‘depression’, as apparently
delusional thoughts or neurotic behaviour. Such reactions far from being an “illness” are but a desperate attempt
to preserve our concept of self, our identity, which is in danger of being
overwhelmed.
Since humans first evolved millions of people would have
experienced highly stressful or traumatic events. People in antiquity, as far
as I understand history, would have suffered the after effects of the trauma
experienced in battles and ever present likelihood of being captured and taken
into slavery. Similarly in their daily experiences with the natural world of
their times – wild animal, floods, earthquakes, droughts, starvation and such
like would have tested the resilience of the strongest characters.
With the
winding down of the military activities in Afghanistan many military personnel
are arriving home with emotional and psychological scars which need to be
healed. Assistance is available for those who wish to take advantage of what is
offered.
What happens,
however, to those Iraqis, Afghans or Sri Lankans who were caught in the middle
– between government military and the Taliban, supporters of Al-Qaeda or
militants fighting for their cause? Those people who lost their livelihood,
family members or were themselves severely injured by Improvised Explosive
Devices (IEDs) or who suffered revenge attacks because they happen to support
the “wrong” side – what support do they get? Do they cry? Do they dull the pain
with opium? Do they get drunk?
As in most
wars it is women and children who bear the brunt of trauma; in all countries it
is women and children who endure the effects of violence and abuse of any kind.
What support do they get from anyone – anyone at all? What is of great concern about
any traumatic event is the long term health effects, even generational health
effects it may have on people – possibly even those not yet born.
Drugs, except
in the very short term, generally don’t help and are not a “cure” for PTSD. In
any event the side effects of antidepressants and antipsychotics are quite
severe. Furthermore to suggest chemicals can address the distressing flash-backs,
the recurring memories and recollections, the guilt, the “what if …” or the “if
only…” is plain wrong. All chemicals do is to help dull the pain and put a
brake on the expression of any emotional response – they have the effect of “dumbing
down” the sufferer. This may be good – in the very short term – to give a
person time to gain strength but let it be known that there is no known test for
a “chemical imbalance” in the brain. Let it be known, also, that no one knows how
to measure the “chemical balance” for any person’s brain or to
determine what such a “balance” should be.
What is
needed is counselling and as much love and emotional support that the PTSD
sufferer can get – and time, and sleep, that “knits the ravelled sleeve of care”
(Shakespeare – Macbeth).
