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Renaming a Disorder Might Help Veterans Seek Aid

Veterans Day - PTSD, PTS... A Rose By Any Name...

In early 2011 the Pentagon elected to change the name of Post Traumatic Stress Disorder (PTSD) to Post Traumatic Stress (PTS) in hope that by dropping the word “disorder” from it, it would lessen the stigma and thereby increase the willingness for veterans and soldiers suffering with it to reach out for help and treatment.

I don’t have the statistics on whether that change has increased the willingness of veterans and soldiers with PTS to seek treatment.  Years ago I was discussing PTSD (as it was called at the time) with my late mentor Dr. Edwin Shneidman after I had written Post-Traumatic Stress Disorder for Dummies (published in 2008).

Dr. Shneidman had a penchant for coming up with compelling words and phrases such as: suicidology, postvention, thanatology.  In our discussion he explained how he felt that the real underlying issue in Post-Traumatic Stress Disorder (which had previously been referred to as: “shell shock,” “combat fatique,”"war malaise,” “soldier’s heart” and was one time even referred to as “nostalgia”) was what he called Re-Traumatization Avoidance (RTA).

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In our discussion, Dr. Shneidman explained how in his experience what occurs in all the situations above is that a soldier is traumatized by a horrendous event that at some level they don’t understand how they made it through alive.  When that initial event occurs they focus on surviving and not on their underlying emotions or psychological processing.  Once the event passes, people with this malady feel a deep sense of vulnerability bordering on fragility and brittleness that seems to go to the very core of their being.  The net result is that although they got past the first trauma, there is a deep belief that they could never make it through a second retraumatization.  They don’t exactly know what would happen with a retraumatization (whether they would go crazy, fragment, die or some other horrid reaction), but nearly all their symptomatology is aimed at avoiding such an event.  That may explain why they avoid people, are hypervigilant, drink and use drugs to excess to numb it, have sleeping problems (because of their intrusive nightmares).

When I have spoken to veterans, soldiers and non-military who have PTS, they have told me that the above explanation of re-traumatization avoidance fits much better with their experience than something as abstract as PTS.  Even though I wrote a book with PTSD in the title, over time I also prefer RTA as a name for it.  The reason for that is that when others and I hear what is referred to as “experience near language” (i.e. words that you can experience as soon as you hear them, such a re-traumatization avoidance) it is easier to grasp, agree and accept it than “experience distant language” (i.e. words that you need to think about what it is, before you agree and accept it, such as post-traumatic stress).

Given the current challenge of having veterans and soldiers suffering from some war-induced malady — whatever we choose to call it — seek help, since there are now many more treatments to help it than were previously available, we might do well to follow’s Dr. Shneidman’s suggested name for it.  If a “rose by another name” gets people the help they need, why not try RTA?

Mark Goulston, M.D., is the author of the new bestselling book Just Listen: Discover the Secret to Getting Through to Absolutely Anyone.

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