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Youtube BR Interview Sparks Questions on Posttraumatic Stress

11 Jan

Hello BR,
I had a chance this past week to twitter in and listen to/watch your interview with Ann Basset on the

.   As always, excellent and thought provoking.
You said something that has stuck with me and I wonder if you might elaborate?  You said that just recently professionals have ceased referring to ptsd and now use pts or ptss (syndrome) because pts is not a mental health disorder, but rather a neurophysiological condition.
Does that mean that pts is no longer considered an anxiety disorder? And will it no longer be part of the DSM?

Also, recently (because my own diagnosis is not a secret) folks have been approaching me about the subject.  When they begin to tell me that they have pts(d), I always ask how they know?  Have they been diagnosed by a professional?  More than one has admitted to no official dx (just their own conclusion) and they want to tell me stories of family dysfunction/childhood abuse as proof of their conclusions.  
In my own experience, the conditioned responses and dysfunctional behaviors I learned in my dysfunctional family of origin with lots of domestic violence are distinctly different from the childhood pts realities which came bursting through the layers of my consciousness at the age of 47 in the garb of flashbacks, et al.  I had buried those terrors so deep with full intention that they never see the light of day again and the flashbacks in particular are an experience I wish on no one.
The years in Al-Anon, ACA, and ACOA groups as well as much of my therapy were focused on the conditioned responses and learning new, healthy ways of building relationships.  No question that I had a lot of material to work on and talking/sorting/seeing/revisiting/building new habits were key pieces.  
The flashbacks, hypervigiliance, et al of the pts are, to me, something else entirely.  And not a diagnosis I would have chosen.  I'm taken aback a bit by folks' willingness to attach this label to themselves, kind of like it's the new designer diagnosis and cool.  When they begin telling me their stories, I ask that they not do so and suggest that they either find a good therapist and/or a good recovery group along with an excellent shrink (I say someone with a degree in biochemistry and excellent, demonstrated skills at psych/social interviews) who can give them an accurate diagnosis.  Am I being too much of a hard ass?   And am I seeing things clearly?
Thanks so much and Happy New Year?
Hi, Bonnie.
So glad you raised these points.  

No, it's still considered an anxiety disorder by the DSM and traditional therapists still call it PTSD; it will be interesting to see how the next iteration of the DSM casts it, but it will probably still be in the category of anxiety disorders.  

But as early as 2004 people were writing me to say, after reading Invisible Heroes, that they'd prefer calling it PTSS, because calling it a 'disorder' puts pathology on the so-called patient, as opposed to seeing this as a reasonable survival response to insane events. And there are some folks in the military and at the Pentagon who also call it just "PTS", very much on purpose.

On your second point, you are absolutely right that people are way too quick (and erroneous) to call themselves "traumatized".  (The word "depressed", actually, gets thrown around very carelessly, too, in this culture, and has become a synonym for just feeling lousy or sad...). 

I always try to correct people when they use “PTSD” to mean anything bad that happened to them - that's just unnecessary drama, and misleading, too - because, just as you say, the dysfunctional family patterns can be changed with regular therapy or good support groups - where the PTSD symptoms need these more specialized, targeted, mind-body treatments. So it's an important distinction to make, with serious treatment implications.

The signature cluster of symptoms for PTS is, just as you say - the "re-experiencing" that takes the form of spontaneous repetitive flashbacks, nightmares and/or intrusive thoughts.  These are not coming from the part of the brain where normal memories are stored, but are stuck in a more primitive, survival-based section of the brain, where they neither fade nor shift, but stay contemporaneous and current and terrifying.  And you can't talk your way out of them with the best counselor or therapist in the world.  Wrong chunk o' brain. You need imagery, hypnosis, acupoint release, energy work, etc etc. 

The other 2 symptom clusters of PTS - avoidance/numbness and alarm/ hypervigilance - can be symptoms of other conditions as well.  But this is not so with re-experiencing.  

Thanks for giving me an opportunity to try and clarify this.  Wishing you a great new year!!


Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award