The Long Shadow of Trauma


Childhood Abuse May Be Our Number One Public Health Issue

March/April 2010


Back in the late 1970s, a motley crew of Vietnam War vets, sympathetic psychiatrists, antiwar activists, and church groups undertook a crusade to have a hastily-assembled new diagnosis almost completely innocent of scientific research included in the DSM-III. Driven by a sense of mission and responsibility to the huge population of Vietnam vets and buoyed by the accumulating everyday clinical evidence that their war experience had profoundly disrupted the lives of thousands and thousands of young men, this unlikely coalition prevailed. Once established as a distinct disorder in the official manual of psychiatric diagnoses, the otherwise unaccountable behavior of badass vets—their hair-trigger tempers, violence toward wives and girlfriends, drinking and drugging, difficulty getting and keeping jobs, social alienation—suddenly made sense. There was a reason for it and the reason had a name and that name was post-traumatic stress disorder (PTSD). By giving words—a verbal shape, a definition—to an amorphous constellation of symptoms, what had before been invisible became a part of standard professional discourse.

As a diagnosis, PTSD is quite straightforward. A person is exposed to a traumatic event or events "that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others," causing "intense fear, helplessness, or horror," and followed, down the line, by variations on intrusive reexperiencing of the event…

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