Trauma

“The concept of Post-Traumatic Stress Disorder created a standardized model of how victims respond to trauma, a ‘single syndrome that appears to be the final, common pathway in response to severe stress.’ . . . Military psychiatry, instead of languishing in an obscure medical ghetto, became part of a burgeoning sociomedical movement that aimed to bring into the open society’s ‘collective secret’ and finally to reverse decades of willful ignorance of traumatic acts and denial of post-traumatic suffering. In 1985, the International Society for Traumatic Stress Studies was formed; soon afterwards The Journal of Traumatic Stress began to appear (Shephard, 385). . . [re PTSD] The fundamental objection, however, is that these hypotheses do not explain why some people are affected by traumatic events and other are not. There is still no ‘Grand Unified Theory that can explain in a single sentence or equation’ the cause of PTSD (389). . . . over the last decade, much of the theoretical underpinning of Post-Traumatic Stress Disorder has also been unraveling. . . . [PTSD researchers] overlooked the central fact that not everyone does suffer in the wake of trauma. It has taken psychiatry two decades painstakingly to rediscover this basic truth; in 1995 two high-regarded PTSD researchers announced, with great earnestness, that ‘PTSD is not an inevitable consequence of trauma.’ Any front-line medical officer on the Western Front, never mind William Brown in 1919 or T. A. Ross in 1941, could have told them that. . . . Thus PTSD, if there is such a thing, is not an extreme form of the normal reaction to stress but something qualitatively quite different. In the face of this evidence, the simple uniform model of ‘trauma’ adumbrated in 1980 has been fragmenting into different categories – acute and chronic PTSD, simple and complex PTSD, even male and female PTSD. At the same time, the old issue of ‘predisposition’ or ‘vulnerability,’ anathema in the 1970s, has resurfaced (390-91).