PTSD - BRIEF HISTORY
"Traumatised people are not suffering from a disease in the normal sense of the word, they have become stuck in an aroused state. It is difficult, if not impossible to function normally under these circumstances. While some people are able to recover from trauma on their own, many are not. The inability to rebound from such events could subject one to PTSD along with a myriad of physical and emotional symptoms."
Peter Levine (Author and Trauma/PTSD Expert)
There is a tsunami of psychological pain out there - anxiety, depression, PTSD, bullying, rage, deep despair, violence on the streets and in homes, addictions to substances and self-destructive behaviours.
Estimates put the number of Australians who live with PTSD as high as 3-4 million. This is a huge proportion of the population who are not living productive or enjoyable lives. This obviously comes at a huge economic and social cost to society. The leading cause of death in 14 to 44-year-olds in Australia is suicide.
The history of recognition of trauma is interesting as over time theories regarding the symptoms, causes and treatment resulting from trauma have greatly varied. The earliest references were found in 1900 BC where the term ‘hysteria’ was applied to woman and a constellation of symptoms that had no obvious physical explanation such as sudden loss of sight, loss of ability to walk or uncontrollable shaking.
Hysteria was then explained for the first time in a physiological way by Anton Mesmer in the nineteenth century. He was the first document that these hysterical symptoms could be present in both men and women and his approach for treatment, touching his patients with magnetic rods, is considered to be the predecessor to hypnotism due to the convincing manner of describing his techniques his patients and the strong suggestions of recovery.
In the 1850s with the advent of the railways in US there was a huge increase in accidents and deaths with passengers and bystanders and victims complaining of ‘PTSD like’ symptoms with no apparent physical cause. The term ‘railway spine’ was coined and it was recognised as a disorder with many associated symptoms. During World War I when men fighting on the frontline witnessed horrific events, many soldiers began demonstrating symptoms of ‘hysteria’. The medical profession was unprepared for the huge numbers of soldiers with these issues and it therefore drew much attention. It was not considered fitting to diagnose these men with a “woman’s illness” so a new label had to be created and it was often referred to as “The Red Badge of Courage”.
It wasn’t until World War 2 that the formal diagnostic category was developed. The term ‘gross stress reaction’ was published in the first diagnostic and statistical manual (DSM-1) in 1952. After the Vietnam war another wave of young men were traumatised in combat and there was no official diagnosis to give them and therefore, no coverage for treatment. The American veterans lobbied to construct a diagnosis and the American psychological Association came up with ‘Post Traumatic Stress Disorder’ as the operational diagnosis in the DSM.
PTSD is unique among other psychiatric diagnoses because of the great importance placed upon the causal agent or the traumatic stressor (Herman, 1992). Traumatisation is seen as being caused by an event, not because of some weakness or failing in the person. Along with the diagnostic criteria of being exposed to a traumatic event are symptoms including intrusive recollections, avoidance/numbing symptoms and hyperarousal symptoms. Once these symptoms have been present for a duration of one month it meets the criteria for the diagnosis of PTSD.