From the Editor


From the Editor

By Rich Simon

March/April 2010


Trauma, which literally means "wound," is a charged word, referring to a severe, even life-threatening physical injury—bones smashed, flesh torn, and body parts twisted—associated with brutality, violence, and sudden calamity. It's oddly fitting that the idea of emotional trauma—post-traumatic stress disorder (PTSD)—entered psychiatry not as the result of dispassionate scientific research into its diagnostic merits, but as the outcome of an intense, polarized, highly politicized struggle led by angry Vietnam vets and antiwar activists.

PTSD never did fit DSM very well. Virtually all the other diagnoses were assumed to be inside jobs so to speak—issues of personality dynamics, genetics, or character. PTSD, by contrast, didn't just require an external cause, it required a terrible external cause—an event threatening grave injury or death. In a sense, PTSD broke the rules, destroyed DSM's internal logic by dragging in not only the outside world, but, in many cases, the brute reality of human evil. It was a little like dumping a corpse at a tea party—the guests continue sipping, pinkies crooked, trying not to look at the bloody heap in the middle of the room.

PTSD forced acknowledgment that people's hearts and minds were often damaged by what other people did to them and, sometimes, what they did to other people. Add to this the inherent ambiguity of a disorder that includes within its name the signal word trauma—both a…

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