Post-Traumatic Stress Disorder

PTSD: An Explanation for Violent Behavior?

PTSD symptoms are more about avoidance than lashing out

Posted Apr 18, 2014

Post Traumatic Stress Disorder (PTSD) has been invoked to help explain many aspects of human behavior, including violence. The April 2 shooting at Fort Hood in Texas that left three dead and sixteen injured is but a recent example. Although, according to reports, the alleged killer never was involved in direct combat, “PTSD” was immediately cited as a possible contributory factor to the assailant’s behavior.

According to the DSMV (the most recent edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders), the criteria for diagnosing the disorder include the following, none of which specifically mentions violent behavior:
*Exposure to actual or threatened death, serious injury, or sexual violence;
*Intrusive symptoms such as distressing dreams or memories, dissociative reactions (e.g., flashbacks);
*Intense or prolonged psychological distress at exposure to internal or external cues that resemble an aspect of the traumatic event;
*Negative alterations in cognitions and mood associated with the traumatic event;
*Duration of the disturbance is more than a month;
*The disturbance causes clinically significant distress or impairment in social occupational or other important areas of functioning.

There are innumerable sources of trauma and what may be one person’s trauma may be another person’s challenge.  An event that leaves one person angry and scarred for life may result in the inner strengthening of another individual who proves to be resilient and calm. When endeavoring to understand troubling behavior, especially criminal conduct, one may find a convenient explanation if the individual has endured trauma at some point in his life. We often read that a person commits child abuse because of the trauma he experienced by being abused when he was a child.  Yet most children who are abused do not abuse others. A person is thought to have become violent because he was a victim of violence.  Yet someone else experiencing similar trauma does not engage in violent behavior.

Most military personnel who experience horrendous traumatic events during combat do not come home and kill civilians. In fact, their more likely reaction is to withdraw, become anxious, and become fearful of their surroundings. They are far more likely to become avoidant than lash out at others.

A woman whom I know was traumatized when a robber stuck a gun to her head while she was working at a bank.  She suffered PTSD symptoms, including nightmares and flashbacks. Afraid to even leave her house, she became determined she would not assume the identity of a victim and remain incapacitated.  Resolving that she would work again, she forced herself to take small steps in order to recover, first walking a few blocks from her apartment, then riding a bus, then going shopping, finally becoming confident enough to take a job at a department store.  Violence was not a part of her personality either before or after she was subjected to a traumatic event.

Instead of focusing on PTSD as an all-encompassing, and far too facile an explanation of human behavior, it is essential to understand in detail the personality makeup of the person BEFORE the trauma occurred.  That is more likely to explain human behavior than simply assuming that a trauma transformed the victim into a person who is totally different from the way he was before he experienced the trauma. Such an analysis can facilitate more effective treatment of PTSD and other psychological problems.