Endorsements
The following individuals and organizations support changing Post Traumatic Stress Disorder to Post Traumatic Stress Injury.
Service Women’s Action Network
Service Women’s Action Network fully supports the movement to change the name “Post Traumatic Stress Disorder”. The natural human reaction to a life-threatening incident should not be labeled a disorder. The stigma mental health conditions carry in the military community prevents veterans from seeking the critical treatment they need to recover from combat and other service-connected traumas, such as military sexual violence and domestic violence. As a community, we must do everything we can to reduce the stigma of post-traumatic stress and welcome our troops home with compassion and open arms.
Anu Bhagwati
Executive Director, Service Women’s Action Network
Former Marine Corps Captain
Mary Bosakowski
I commend your thoughtful, important, compassionate work and support your efforts to drop the “D.”
In the past year I’ve spoken with many traumatized veterans from past and current conflicts for a documentary I’m making, which explores the complex question of healing “after” a war. In these intimate conversations, we don’t use the word “disorder.” It’s not a rule, it’s more an unspoken understanding: the word diminishes the deep, invisible wounds of war and stigmatizes the soldier who carries them home.
Words matter. Words have repercussions. A “disorder” implies a weakness, a deficit. It is an unrealistic description of women and men who, in our names, have seen, experienced and sacrificed more than most of us can fathom. “Injury” is not only more realistic, it suggests the possibility of healing, which is the first of many, many things we owe these veterans.
Frank Ochberg, MD
I encourage everyone who believes that the stigma of PTSD will be reduced by changing the name to PTSI to express your belief here.
For close to a year, I have asked my patients, their loved ones, and those who advocate for their welfare about this name change, and they tell me, in overwhelming numbers, “Yes. Change the name to injury. That will help.”
I ask journalists and journalism students, because I have been working closely with journalists who cover trauma. They say, “Yes. Injury is less stigmatizing.” (Not all reporters, but most who speak with me).
I ask leaders of veterans’ organizations from the Vietnam generation and from the current wars. “Yes,” they tell me. Sometimes they add, “That would help our effort to get a Purple Heart for PTSD.” The veterans’ organization, Honor For All, agrees. The mentors who work with my local Veterans’ Court agree — unanimously!
When I point this out to friends on the DSM committee of the APA, they do not agree. Some ask that the issue be studied - “Where is the evidence?” Some say, “It wouldn’t make a difference.” Some disagree that PTSD is an injury. They believe it is a mental illness, with a genetic predisposition. As Jonathan Shay and I argue in our letter to APA President John Oldham, there is a strong case to be made for the injury model of PTSD — certainly equally strong if not stronger than the mental illness model of PTSD. And if injury is a defensible medical term for a condition, and if that term adds hope and honor and dignity to those who qualify for the diagnosis, why retain a label that has come, through time, to add salt to a wound?
This is not a trivial matter. One in four women are raped in a lifetime. Most women who are forcibly raped have PTSD. Half the Vietnam combat vets from “high war zone action” had the symptoms that we now know as PTSD. One quarter of the journalists who cover war have PTSD. And many victims of violence and war never come forward due to the stigma of being labeled. Untreated PTSD raises the risk of suicide. Untreated PTSD leaves veterans and survivors of cruelty and catastrophe outside the embrace of the healing human group.
Of course, some stigma will remain no matter what we do. Trauma causes a certain amount of self-negation. But changing the name from PTSD to PTSI is one step in the right direction and it will encourage other steps forward. More veterans and survivors of violence will come forward. We will take this condition into the main stream.
And instead of equating PTSD with rampage killers or with malingerers seeking benefits, we will honor the millions of Americans with this injury. We will welcome them. They will respect themselves.
Frank M Ochberg, MD
Clinical Professor of Psychiatry, Michigan State University
Former Associate Director, NIMH
Gloria Steinem
It’s easier to disqualify the evidence of cruelty than to end it, especially if that cruelty has been made to seem as inevitable as sexualized violence or war itself. A step toward revealing the cost of such cruelty — and our will to end it — is to stop stigmatizing the victim. The simple act of changing the diagnosis of Post Traumatic Stress Disorder to Post Traumatic Stress Injury would help to make clear that the injured party is not at fault. Naming reality is the first step toward making it visible — and changing it.
Gloria Steinem
Writer and activist
National Center for Victims of Crime
We support changing the name Posttraumatic Stress Disorder (PTSD) to Posttraumatic Stress Injury (PTSI) as requested by General (Ret) Peter Chiarelli.
The National Center for Victims of Crime is the nation’s leading resource and advocacy organization for crime victims and those who serve them. Since its inception in 1985, the National Center has worked with grassroots organizations and criminal justice agencies throughout the United States serving millions of crime victims. The mission of the National Center for Victims of Crime is to forge a national commitment to help victims of crime rebuild their lives. We are dedicated to serving individuals, families, and communities harmed by crime.
Victims of crime have long met with prejudice and medical difficulties due to the wording of their damages implying a mental disorder as opposed to a medical injury. To change PTSD to PTSI would mean physicians believe that brain physiology has been injured by exposure to some external force. As noted in the letter from Drs. Ochberg and Shay to the president of the American Psychiatric Association, “The injury of PTSD is not necessarily permanent, but in chronic and complex cases, the injury remains for a long time and may be tolerated or may be seriously disabling. To those who live with the impact, PTSD is an injury–and a painful one at that.” This change in language to a justifiable injury model will help our constituents.
We agree that “The science supports an injury model, and the time has come to do what we can do to lessen the stigma and shame that inhibits our patients from receiving our help.”
Sincerely,
Mai Fernandez Mark Mandell
Executive Director Chair, Board of Directors
Honor for ALL
As Executive Director of Honor For ALL, a veterans’ organization dedicated to ending the stigma of invisible wounds, I am involved daily with the social inadequacies resultant from the stigma of PTSD. On behalf of Honor for ALL, I strongly endorse the campaign to change the name Post-traumatic Stress Disorder to Post-traumatic Stress Injury.
Until we as a society accept, identify, and honor the condition as a wound we cannot expect the victim to.
Until the victim is able to solidly presume our understanding that this is a wound, not a weakness, we cannot expect him or her to comfortably and proudly step forward to admit suffering the effects.
Until the victim can comfortably and proudly admit to suffering the effects, we cannot expect the healing to begin.
The word “disorder” in the very name of the condition is a primary and singular source of stigma that by simply changing we can redirect all succeeding efforts to alter the way we perceive invisible wounds and mental health in general.
Identifying the condition as an injury can and will help the effort to revise the criteria for the Purple Heart, an honor now unjustly, and disarmingly, denied the recipients of this battle borne wound.
Not until we honor this condition as a wound, can we expect to begin to subjugate the feelings of shame and guilt now associated with it.
Not until we end the stigma can we expect to attenuate the current rate of veteran suicide and restore dignity to the families of those already fallen.
I applaud the efforts of Drs. Frank Ochberg and Jonathan Shay and sincerely hope the American Psychiatric Association will seriously consider their recommendation to change the identifying character of the condition from a disorder to an injury.
Respectfully,
Thomas Mahany
President, Honor for ALL
Christal Presley
For years I shunned my own father because I thought something was inherently wrong with him. I knew he had Post Traumatic Stress Disorder from Vietnam, and I was more afraid of his condition (and of him) because the word “disorder ” frightened me so. “Disorder” dehumanized my father’s experience and made him sound more like a man who wasn’t tough enough or mentally stable enough to fight a war and seamlessly integrate himself back into society. He viewed himself as weak-largely, I believe, because of the stigma behind his diagnosis-and is still unable to see himself as a man who was injured by external forces, rather than a man who was deeply affected by the things he experienced because he wasn’t strong enough within. I fully support the change of Post Traumatic Stress Disorder to Post Traumatic Stress Injury-for my father, and for all young men and women everywhere who have served and are living with the stigma of a diagnosis with a connotation steeped in injustice.
Christal Presley, Ph.D, author of Thirty Days with My Father: Finding Peace from Wartime PTSD and founder of United Children of Veterans
www.unitedchildrenofveterans.com
Marla Handy, PhD
I strongly encourage changing the name of this condition from Post Traumatic Stress Disorder to Post Traumatic Stress Injury. Not only do I believe it more accurately describes the condition as one that is acquired as the result of forces external to the person (much like closed-head injuries), but it provides for new definitions of, and therefore opportunities for, healing. If the condition is defined as a disorder, then healing is defined as getting oneself back in order, returning to one’s pre-traumatic event state. That may be possible for those with acute symptoms following a single traumatic event, much like a bruised forehead will heal after a fall. But for those of us who have had symptoms lasting long enough to be considered chronic, that is not possible. Yes, we may have had the bruise, but we also have a lasting internal injury (from stress responses) that requires a different approach to healing, one of symptom management and accommodation.
It may be frustrating to live with an injury, but there is no need to apologize for it. There is no stigma attached to losing an eye. There is no social or personal expectation that, with enough effort or will, one could get oneself “back in order” and grow a new eye.
Accepting that I have an injury has been key to my ability to make peace with living with PTSD. Based on responses to my book No Comfort Zone: Notes on Living with Post Traumatic Stress Disorder, this concept has also brought peace, reduced shame and assisted in treatment for others.
Marla Handy, PhD
Author, No Comfort Zone: Notes on Living with Post Traumatic Stress Disorder
Steven M. Gorelick, PhD
Over two decades ago, I developed and began to teach an undergraduate course at Hunter College examining the impact of language on our collective understanding of illness, natural disasters, violence, and many other painful challenges to social and personal well-being.
As I think back on all the changes in our collective attitudes, language, and behavior during this time, one trend seems to be constant: Again and again, we have chosen to eventually jettison labels and names that we realized were vestiges of eras in which – unable to fully understand the complexity of a problem — we resorted to blaming victims rather than struggling to understand.
Susan Sontag’s seminal 1978 essay – Illness as Metaphor – provided an especially eloquent explanation of how and why we have been so shamefully prone to loathing those in pain. Terrified at our impotence in the face of the scourges of tuberculosis, cancer, and HIV/AIDS, we adopted cruel and stigmatizing language and narratives tracing illness to human weakness and destructive human behavior. It was them, not us. What a relief.
It is almost impossible to believe some of the bizarre and cruel folk-theories we came up with, chastising cancer patients for emotional repression or suggesting that HIV/AIDS was some sort of divine retribution for sinful behavior. Eventually, and often only after fierce resistance by those unfairly stigmatized, we moved from the hurtful to the humane.
And now it’s time to do the same with PTSD.
The pioneers who developed this diagnosis intended a clear departure from the language of battle fatigue, shell shock, and “war neurosis,” rejecting the idea that it was the neurosis rather than the trauma that destroyed lives. Over time, though, the term “disorder” has led far too many people to see such trauma as outside the boundaries of normal human behavior; as a pathological rather than understandable reaction to prolonged trauma.
And that’s why it has to go.
If we learned anything from the most lethal century in human history, it’s that trauma exacts a painful and lasting price from many of those who face it in war, catastrophe, and other less extreme settings. To continue to use the term “disorder,” widely and popularly understood to suggest some peculiar pathology, is to willfully ignore our collective responsibility for the pain and suffering that is anything but peculiar when we repeatedly ask people to use violence and force to clean up our political messes.
The injured are not peculiar. They are injured. And only a change to “Post-Traumatic Stress Injury” will make it absolutely clear that we are rejecting victim-blaming and unflinchingly facing the collective social failures that made pervasive injury inevitable.
Steven M. Gorelick, PhD
Professor of Media Studies, Hunter College
Drs. Charles & Kathleen Figley
We must insist on the D2i Movement to transform the use of PTSD (a mental illness) to PTSI (a treatable injury). It is rather simple:
_______________________________________
Disorder vs. Injury
Crazy vs. Injured
Needs Meds vs. Needs Rehab
Needs Therapy vs. ”
Lifelong vs. ”
It is time to recognize that PTSD does not adequately capture the full spectrum of trauma reactions and service requirements; that it is a blunt instrument for classifying the traumatized as having or not having PTSD. The traumatized require and deserve a far more nuanced and sophisticated category of recovery than PTSD.
The recent discoveries in the neurobiology of memory is close to guiding us in a far more effective way of helping the traumatized manage their memory not unlike physical brain damage requires speech therapy. The focus on injury is rehabilitation toward functionality. The same should be true for traumatic stress injuries.
With hindsight we can all see that it was a mistake approving a syndrome like PTSD that would be compensable. In the case of veterans, they are being paid because of their illness not their dysfunction that can be fixed with a program of rehabilitation.
Today we must change the current situation and insist on all who assess, diagnosis, treat, and study the traumatized to begin to focus on their injuries not the systems associated with a particular disorder. We must shift the compensation for an illness to an injury which an effective treatment plan.
We must stop vets from being paid for being sick, for example, and enable these men and women from all wars to live full and productive lives by providing all their needs for rehabilitation and acquiring meaningful work. Vets don’t want a hand out, just a helping hand from the community, not just the government.
We who study, care for, and know traumatized people believe that they deserve the respect and to be treated in a way that is consistent with their injuries with methods that work and do not cause other problems. This is especially true for war veterans and their families who turn to us for help.
We must reject the current approach to classification of the traumatized as either meeting the existing PTSD symptom criteria, being sub clinical, or not meeting the criteria and not discussing individual behaviors or symptoms as if it represents the potential for meeting criteria.
See Dr. Mark Russell’s blog, “Underestimating the True Prevalence of War Stress Injury in the Military”
The time is now. D2I, D2I, D2I, D2I.
Drs. Charles & Kathleen Figley
Figley Institute
http://figleyinstitute.
Susan Herman
I strongly endorse the campaign to change the name PTSD to PTSI because words and labels can have profound consequences. As others have already stated quite eloquently, we know two things about this issue.We know that the term injury accurately reflects the nature of the condition. We also know that changing the name of this condition would undoubtedly benefit millions of people who suffer from it.If either one of these statements were not true, I would understand the resistance to change–but they are both true. We have so very much to gain from this new term and absolutely nothing to lose.
Susan Herman
Associate Professor, Pace University
Author, Parallel Justice for Victims of Crime
Laurie Barkin RN, MS
As a psychiatric nurse and writer who has worked with many survivors of traumatic injuries, I enthusiastically support changing PTSD to PTSI. Being “injured” implies hope of healing and a process of recovery. Being “disordered” implies a static state of derangement, and we all know about the stigma associated with that. The very least we can do for those who have sacrificed so much is to acknowledge the power of words and to demonstrate sensitivity in choosing them.
Laurie Barkin RN, MS
Author, The Comfort Garden: Tales from the Trauma Unit
Victor Herbert
The Academy for Critical Incident Analysis at John Jay College strongly endorses the change in language from disorder to injury. While some may miss the significance of the change, ACIA believes it will enable victims to find their place in society and seek the help they need to recover fully.
Victor Herbert
The Academy for Critical Incident Analysis
Bridget C. Cantrell, PH.D.
Yes I agree the word “disorder” must be dropped. A warrior is intrinsically reliant and if the words we use as clinicians and loved ones portray someone who is broken disordered we have reinforced a very negative self concept. This further perpetuates the stigmas that prevent and hinder our warriors from coming forward to first off admit they could use some help. I might even goes as far to say …”wound” a wounding occurs in their mind, body and Spirit by a traumatic situation. This is not a disorder, it is part of the fabric of a warrior who has seen so much. We must reframe this on behalf of humanity Post Traumatic Stress must be embraced so one can learn about every aspect in order to manage the symptoms , learn about how to recognize their new skill set and this done by normalizing and the disorder gets in the way.
Bridget C. Cantrell, PH.D.
Dr. Raymond Scurfield
In addition to the many excellent points made in the various endorsements, I want to emphasize that, from my 40+ years (from serving Vietnam in 1968-69 onward, to include a 25 year career with the VA leading several PTSD programs), there is a remarkable angst created by having a veterans’ benefits system that in effect, financially rewards veterans for having psychiatric disorders and that punishes them financially if they improve significantly. The current system requires that veterans be awarded a psychiatric diagnosis to be eligible to receive financial and priority medical services. This extremely powerful dynamic inflates the numbers of veterans who are given and who maintain PTSD diagnoses (Scurfield, 2006).
Furthermore, there are serious problems with the validity and usages of a PTSD diagnosis in being able to differentiate between a “normal” or “expectable” response to trauma versus a “disordered” response; too often, a PTSD diagnosis is used to incorrectly label many veterans as “psychiatrically disordered” — when they are actually experiencing what could be considered normal and expectable reactions to combat. In turn, veterans contribute to this dynamic; they want and feel that they deserve a disability rating — but such can only be awarded if they are labeled with a psychiatric disorder. Ironically, the military recognizes this dynamic much more than the VA does. Military mental health refers to “combat stress reactions” and not the psychiatric disorder of “PTSD” for the vast majority of psychiatric casualties in a war. To remove “disorder” from PTSD would be a major step to help rectify this tragic conundrum.
Dr. Raymond Scurfield, Professor Emeritus of Social Work, University of Southern Mississippi
Author of A Vietnam Trilogy and co-editor with COL Kathy Platoni of War Trauma & Its Wake.
Expanding The Circe of Healing (in press, 2012) and Healing War Trauma. A Hanbook of Creative Approaches (in press, 2013.)
Military Family Network™
The Military Family Network™ mission is the success and well being of the military community. Since our inception, we have communicated with hundreds of thousands of service members, Veterans and their families who have shared their experiences, thoughts and feelings with us about the aspects of military life including deployment, separation, stress, depression, combat, trauma and loss.
The effects of trauma and the subsequent post traumatic stress it may induce is not borne by the individual alone; more and more research is discovering that families -especially spouses and children - and even friends, neighbors, employers, colleagues and others may be affected. It can be a cascading effect that ripples through the fabric of our communities.
This is why Military Family Network™ supports initiatives that seek to improve the lives of our service members, Veterans and their families and communities. We especially support those efforts that improve opportunity and access to quality care, treatment and early intervention without judgment or fear of consequence.
Therefore, we laud the efforts of General (Ret) Peter Chiarelli , Dr. Frank Ochberg, Jonathan Shay, MD, PhD, the organization Gift From Within and others for their efforts to change the term “Post Traumatic Stress Disorder” to “Post Traumatic Stress Injury” in advance of the next edition of the Diagnostic and Statistical Manual in May, 2013.
This initiative is very important work. With so many combat-experienced service members returning to our communities, any undertaking to assist their transition and ease their reunification with their families and communities will be instrumental to their success and ours.
Megan Turak
Founder and Executive Vice President
Military Family Network™
www.militaryfamilynetwork.com
Georgian Society of Psychotrauma
We, Georgian professionals working in trauma care strongly agree with the proposed shift of paradigm in the field of psychotraumatology. Shifting from “disorder” to “injury” will support traumatized people to overcome marginalization and win their struggle with trauma. That will assist professionals, helpers, states - to be more efficient in providing assistance.
The words do have power – they frame reality, create discourse, shape policies; they also make difference. And that’s what we need in the field of trauma care – a Change, making the system of responses client-centered and resilience-based.
The South Caucasus, due to the wave of armed conflicts which it went through since nineties of the last Century, is one of the regions heavily suffering of PTS(D). That is especially true for Georgia, where people forced to leave their homeland (IDPs –Internally Displaced Persons) make up approx. 8% of the country population. The recent war with Russia (August, 2008) significantly enlarged the population of traumatized individuals. Following it there was a case of IDP lady who has burned herself publicly and thus articulated her SOS. And the main thought in response, provoked by this incident in the mind of general public, authorities, journalists – was about her mental disorder, while for us, professionals working with the traumatized people, that was not about disorder; that was trauma and social exclusion, which led her (and us) to the tragedy.
In April of 2011, while in Tbilisi, Dr. Frank Ochberg, at his master class delivered for Georgian professionals working in the field of trauma care shared idea of shifting the paradigm which was a huge insight to us: the new, client-friendly “injury” frame enhances potential for professional help and social inclusion. That is especially important taking into consideration that in most of the cases trauma is about social isolation. Therefore, Georgian Society of Psychotrauma strongly votes for the proposed change.
Nino Makhashvili, MD Jana Javakhishvili
President, Georgian Society of Psychotrauma, Founding Board Member,
Director, Global Initiative on Psychiatry - Tbilisi Georgian Society of Psychotrauma,
CP of Dart Centre in South Caucasus
Dr. (COL) Kathy Platoni
I applaud and celebrate the courageous stand taken by this group to at long last, remove the” sting” of the disorder label from the upcoming DSM V. The stigma and the shame associated with this terminology, indeed sends so many suffering souls running far and fast from the treatment room, slamming that door shut to assure that all hopes of betterment and being able to come all the way home are laid to waste. We can ill afford to perpetuate the illness model for the thousands who continue to function at home and on the battlefield with Post-Traumatic Stress Injury for the very reason that they have had the courage to face these demons, to adapt, and to overcome. “Disorder” connotes otherwise. We can ill afford to forget that trauma is haunting and unforgettable, yet reactions to the catastrophic are unquestionably not disordered, but normal responses to that which lies far beyond the realm of the normal range of human experience. Drop the term and throw open the bomb bay doors to promote the desperately needed treatment of wounds that do not bleed.
Kathy Platoni, Psy.D.
Clinical Psychologist
COL/US Army Reserve
Army Reserve Psychology Consultant
Co-Editor, with Raymond M. Scurfield, DSW of War Trauma In Its Wake ~Expanding the Circle of Healing (in press, 2012) and Healing War Trauma~A Handbook of Creative Approaches (in press, 2013)
My husband, Dr. Richard Sword and I were part of a psychological team lead by Dr. Philip Zimbardo that presented a new therapeutic approach (Time Perspective Therapy) for PTSD at the 2012 Western Psychological Association Annual Conference in San Francisco. As part of our presentation, we suggested the name change from PTSD to PTSI, as we have for the past few years. The mental health professionals as well as the psych students in attendance were enthusiastic about this powerful one word change.
In order to bring awareness greater awareness to our greater community, I began a petition via wwww.change.org calling for this change; http://www.change.org/petitions/ama-american-psychiatric-and-psychological-associations-change-the-dsm-iv-tr-309-81-ptsd-to-post-traumatic-stress-injury-ptsi?share_id=ufKoAwszFQpe=pce. Although my husband and I are private practice, the majority of our patients are veterans suffering from PTSD(I). We are well aware of the enduring consequences of PTSD(I), especially the stigma of mental disorder under which they live.
Post-traumatic Stress is a normal response to trauma and therefore we consider it to be a “normal” military experience. Ideally, the first step in treating PTSD(I) would be dealt with through greater communication between sergeants and peers in the field. While the word “Disorder” is considered a “more neutral term” than “mental illness”, Post-traumatic Stress Disorder has attained an unintended negative connotation by society, especially in regards to our active military personnel and veterans. Post-traumatic Stress is not a mental illness, which may be caused by genetics, disease of the mind, deterioration, etc. Rather it is a mental/psychological Injury and should be considered and treated as such. Post-traumatic Stress may be likened to experiencing a physical wound – it happens to normal people who have suffered a life-threatening or potentially injurious trauma to self or others, leaving one with a psychological wound – one that cannot be seen but is certainly felt.
By the simple act of changing the word “Disorder” to “Injury”, the stigma surrounding this diagnosis will be lifted and society may better understand that some sufferers do not to seek the help they need due to the negative societal perception.
Rosemary KM Sword, co-author (with Philip G Zimbardo and Richard M. Sword)
The Time Cure: Overcoming PTSD with the New Psychology of Time Perspective Therapy. Jossey Bass/Wiley Publishers. October 2012.
I have struggled for decades with the intellectual and emotional aftermath of rape complicated by other traumatic events. I was raped before PTSD was identified in the DSM. Although I sought and found psychological help, my therapist and I were both completely unaware that I had PTSD.
It took me years to understand that something was wrong, and years more to identify it. I think that’s typical of many people suffering from PTSD. We often have a very difficult time recognizing we’ve suffered an injury and seeking treatment.
We are not cowards, we can’t just tough it out. Violence does not dissipate; the effects of trauma do not simply vanish with time or effort, no matter how strong we are. That’s not easy to absorb and face.
I’m fairly certain that my injury is permanent. I can treat it, I can adjust to it, I can live with it, but it’s not going to go away. PTSD is known to be difficult to treat, and it’s notoriously dangerous. Far too many suffers either live or end their lives in isolation and despair.
I have long suspected that PTSD is a brain injury, whether complicated by physical trauma or not. I think future research into the connection between the symptoms of PTSD and changes in the structure and function of the brain will confirm that PTSD is indeed PTSI.
Changing the classification from Disorder to Injury hews closer to the truth. We are normal people who have gone through very abnormal events, events that have left us injured, not disordered.
Thank you.
Carla Bolte
New York, NY
I support changing the word to injury. Thank you for making the effort on behalf of survivors. Words do matter and this might help lessen the stigma survivors sometimes feel. I think injury is more accepting and less stigmatizing than the word, disorder.
“There’s something wrong with you.”
There’s not. I’ve been injured. The way that my brain functions has been altered by horrible things that I have lived through and things that I have witnessed. We (survivors of traumatic events) have been injured and we have to work really hard every single day to try to recover from that injury.
I support the change from the word disorder to injury. I think it will make a world of difference in a time that we are in need of a lot more support and understanding from everyone.
The time has come to change the name of Post Traumatic Stress Disorder (PTSD) to Post Traumatic Stress Injury (PTSI). By doing so, we will align the true etiology of trauma-which begins with an outside influence, an overwhelming traumatic event involving horror, terror, and potential loss of life-with the right name. Changing the name to PTSI tells it like it is: that there are experiences so traumatizing they have the potential to hard wire the brains and memories of the sufferers.
Calling the wound an “injury” reflects the true reality of the trauma-PTSI is an injury for which one is not responsible for having caused. The injuries most often result from man-made violence: torture, wartime combat and exposure, domestic violence, sexual assault, rape, child abuse, and prolonged exposure to the violence and suffering that law enforcement officers, emergency responders, and journalists are exposed to. Changing the name would thus reduce the negative stigma associated with it and give those who suffer with it better odds of coping and managing its complex array of symptoms involving random intrusive images of the traumatic events; the eventual numbing and constriction of the body and spirit; and the anxiety and hyper-vigilance that comes with losing one’s sense of safety and trust in the world.
I’m so encouraged by this campaign and want to thank you for leading this important cause. Having worked with law enforcement officers and managed law enforcement critical incident stress programs, I can speak first hand to the fact there is a tremendous negative stigma associated with the “disorder” aspect of PTSD, and it prevents people from seeking the help they so rightfully deserve and need. I’m confident in Dr. Ochberg’s leadership-he helped write the original definition; and who better to understand the potential of this name change to bring our understanding of trauma into this next generation.
“I for one, support dropping the word “disorder” from the acronym PTSD….”disorder” sounds more to me, like an an “abnormality.” Injury means that one has been harmed and is in need of care….”
Elise McGhee
Thirty Years of Silence
I am a Combat Veteran of VietNam having served with the 101st Airborne Division. I was diagnosed with PTSD by the VA in 1992.It took me many years to come to grips with the fact that my combat experience was affecting my Family and my Work life.I have been involved with a PTSD counseling group for the last 12 yrs. at my local VA Clinic. Knowing that I have a support system of other PTSD veterans helps to get through the day. I don’t think changing the name to PTSI is going to help us at this point. But if it helps people to cope with their diagnosis and if it helps to lessen the stigma associated with having PTSD then I am all for a name change.
I am a medical doctor who has become a journalism professor in Tbilisi, Georgia. On behalf of the Caucasus School of Journalism and Media Management of the Georgian Institute of Public Affairs, I write to support the initiative on shifting the name PTSD from disorder to injury.
Since 2005, CSJMM has worked with the Dart Center for Journalism and Trauma, and the trauma therapists at the Georgia Institute for Psychotraumatology. These are much-valued relationships. Trauma reporting has been taught at CSJMM since 2007. We find that the word, disorder, is discouraging, but the word, injury, is not.
I believe this initiative will support hundreds of Georgian men who have served in Iraq or Afghanistan and those who have participated in the wars with Russia over Abkhazia and South Ossetia, many of whom are finding difficult to adjust to life back home and whose voices are rarely heard in the Georgian mainstream media. This is due to lack of understanding of the problem by local journalists and also because of the existing taboo and stigma: Veterans are not able to identify the symptoms, journalists are not able to cover the problem and society is not informed. It is a vicious cycle that prevents progress by all involved parties.
I believe that proper wording matters and it will have an impact on journalists and their reports, on veterans, their family members and friends, and society overall.
Tiko Tsomaia
Assistant Professor and Program Coordinator
Georgian Institute of Public Affairs
I would like to point out that law enforcement personnel, and other first responders, feel equally stigmatized by the term “Disorder.” I fully support a change to “Injury.” The words we use DO make a difference. As we identify words and phrases that work better in trauma situations, it is the responsibility of trauma professionals to change the vernacular.
I am writing on behalf of GEVHA (Group for the Study of Violence Towards Humans and Animals), the Iberoamerican Link Coalition, the Health Commission Against Family and Gender Violence of the University Hospital Mútua Terrassa. We support the change of the word “disorder” to “injury.” Victims can be re-harmed and re-victimised in so many ways, and wording is one of them.
Thank you very much for this beautiful initiative,
Dr. Nuria Querol Viñas, MD, BSc, MSc
Researcher and Professor
Clinician
Group for the Study of Violence Towards Humans and Animals
I suffer from PTSI from childhood trauma and a long abusive marriage. I discovered my injury through searching my symptoms online and finding a resource for women with PTSI (Gift From Within). Although it was incredibly affirming to discover I had a legitimate injury and that it had a name I have always felt embarrassed to tell someone I suffered from a “disorder.” It was difficult enough to try to explain my symptoms. Having to state it was a “disorder” further stigmatized me. I always felt it was unfair because a disorder seems more of something a person is born with. I was not born with PTSI and it is not my fault I suffer from it. It resulted from how significant caretakers interacted with me when I was too young to take up for myself, and when I was mistreated by someone who was supposed to cherish me. I did not ask for this to happen to me. I hate how I struggle with my symptoms every day of my life. Changing the name from PTSD to PTSI would go a long way towards affirming those of us who suffer from this injury.
I support this change. I have learned recently just how much “languaging” can affect views of the health care system and society. While PTSD is not known to go away, it is caused by circumstances, not by a biochemical imbalance. The difference should be made clear in this diagnosis, so that anyone seeking help or understanding can receive the validation they need.
When I first learned that I had a diagnosis, I was stunned. How could I have a disorder? I just thought what everyone else thought in my life - I’m just crazy. After going through therapy, I discovered that I wasn’t crazy at all - the term Post Traumatic Stress Disorder just made me feel that way. Post Traumatic Stress Injury says it all. I was molested as a child from about the age of three until about twelve years old. My parents were highly dysfunctional people and recently admitted that they simply just tossed me to the side of their lives and loved my brother more - do I have a disorder or do I have an injury?
Changing the language of PTSD to PTSI, begins with a single step from each of us. Still many who suffer with this injury…suffer in silence, so as NOT to be labeled “damaged” by a disorder. Defining PTSD as an injury and not a disorder clearly demonstrates how it should be focused. I whole heartedly support the change to PTSI, placing a more positive effort on healing rather than finality.
As a clinician, a healer, and former student of Dr. Figley, I fully support the change from PTSD to Post Traumatic Stress Injury. For years, I have stood by the position, in my personal practice, that many people who experience crisis events, although they did not fit the “criteria” for PTSD, were still suffering from maladaptive behaviors related to the event, sometimes years later. I think we are still reaching for a point of understanding of the myriad of ways the crisis experience affects people, including the affect on the energetic system, which is utilized in the system of acupuncture and other healing modalities. To me, as a trained traumatologist and pranic healer, it just makes sense to continue to explore this field with an open mind.
Jessica D. McMorris, LCSW/ Pranic Healing Practitioner
This is an important aspect of how to heal our language in order to heal people. Another: How we describe people whose jobs or homes have been taken away. We usually call them the “unemployed” or “homeless.” Try “disemployed” and “dehoused” and refuse to say they have “lost” their homes or jobs, as if they had lost a phone — stupid and shameful to “lose” something that way. Exactly how the official culture wants us to think — stupid and ashamed of being “Losers,” instead of angry at being disemployed or dehoused.
theshalomcenter.org
It’s hard to imagine a country like ours allowing our young fighters to
come home after facing death and injury day and night and not making
certain that they get all the help they need to try to put their lives and
bodies back together. I have been working for several years to help make
brain and traumatic stress injury understood for what it is…A wound,
not a weakness.
Gwen Weiner
This will help send people to the correct treatment.
To reduce trauma and PTSD related stigma via changing the name is one way. But I have also a belief that in time we will need to change new term. “Injury has less stigma”, what about PTS Reaction?
Yerevan State Medical University
I wholeheartedly support removing the stigma of “disorder” from Post Traumatic Stress. If only the national political and medical community would honor the “Injury” with comprehensive treatment of the whole person. That way combat veterans, survivors of sexual, religious, physical and ritual abuse and those suffering from secondary post traumatic stress, who have been witnesses, not just victims, to incest, violence, and war. Please name the diagnosis to Post traumatic Stress Injury, and remove the stigma of pathology and give people a more empowering reframe.
Mikele Rauch
Author, Healing the Soul after Religious Abuse: the Dark Heaven of Recovery
MaleSurvivor.org
As a faculty member in the MSW Program at California University of PA, I help my students recognized how important it is to avoid labels whenever possible, particularly those labels that promote stigma, prejudice and discrimination (e.g., a label like “post traumatic stress disorder”). As a licensed social work provider, I use a strengths-based, resiliency model that focuses on what individuals can do as opposed to focusing on what they are not yet ready to do. The term “post traumatic stress injury” fits well with this approach, an approach that works miracles… Most people want to be healthy and high functioning. The word “injury” allows a person to internalize a health and wellness approach to recovery. Use of the word “disorder” leads to a more negative self-perception on the part of the individual affected by the trauma and on the part of those who use the “disorder” label.
Peg Christopher, Ph.D., MPH, LSW, ACSW
DEERWOOD SOCIAL WORK AND COUNSELING SERVICES
I fully endorse and support this proposed change. Language matters, and inaccurate labels stick. I agree that the term PTSD carries the stigma of mental illness, whereas PTSI implies a treatable injury that carries the hope of healing.
Marty Tousely, CNS-BC,FT,DCC
Grief Healing
In my experience as a Marine infantry officer with two combat tours in Iraq from 2005-2007 and now as the Executive Director for a national nonprofit organization that helps veterans and transitioning service members gain employment, I have had occasion to interact with hundreds of combat veterans. What is currently labeled PTSD is so widespread amongst the ranks of combat veterans that I question the validity of labeling it a “disorder.”
The cause and effect between prolonged exposure to a combat environment and resulting psychological, physiological, and behavioral changes is so pronounced that experientially it is the “norm”. I am no medical expert, nor do I pretend to be. But when prolonged exposure to enemy contact almost always results in similar patterns of behavior and psychological/physical responses in combat veterans, it would seem that we are dealing with an injury, or a normal response to abnormal circumstances - neither of which is a “disorder.”
Reclassifying PTSD as PTSI would acknowledge that an injury does not have to be visible to be real, and would help destigmitize a wound suffered by many tens of thousands of combat veterans. The true cost of war has always been underestimated; properly labeling and identifying PTSI goes a long way towards recognizing, treating and honoring the silent sufferers of invisible wounds.
Nathan Smith
The Soldier’s Load
I would like to argue that words are just words and it should not make a difference. But there is a stigma attached to terms like “disorder” or “illness.” Using a generic and user friendly word like “injury” would be less stigmatizing and feel more like a healing process will take place rather than feeling permanently disfigured.
This one change could make a difference in not only society’s views but our own as well. I am not defective and having a “disorder” makes me “feel” defective. As if I will never heal and recover.
Connie Kirkpatrick
A Spiritual Paradigm
I support these efforts because changing the name of PTSD to PTSI is a great first step for removing stigma, shame and self-blame for victims of an invisible but very real injury. As a clinician, I have witnessed firsthand the devastating effects of torture, war, domestic abuse and other traumatic events on the victim. PTSI would more accurately reflect what happens to the victim of those events and may even promote more research for better treatment of the injury.
As a clinician who has worked extensively with victims/survivors of many kinds of trauma, I can say without reservation that language matters. Labeling a human being’s natural reaction to an unnatural experience a “disorder” implies that the problem lies within the receiver rather than with the perpetrator of that violence. It makes no more sense to consider an emotional reaction to trauma a “disorder” than it does to apply such a label to a violence-induced bruise or bullet wound. Who would think of considering the swelling, discoloration, and pain associated with physical manifestations of violence evidence of a disorder of the body? Simply because the injuries to the brain and spirit caused by trauma are not as readily amenable to measurement in our “seeing is believing” culture, we have relegated PTSI survivors to the fringes of humanity - those of questionable strength and character for not “getting over it” or “toughing it out.”
Personally, I would like to see the term “injury” or “reaction” applied to many of the human experiences that are currently considered disorders, such as borderline personality disorder, for example. There is substantial research implicating prolonged verbal and emotional abuse as causative factors. Words can cause lasting wounds - by being the primary source of wounding in emotional abuse, or secondarily by requiring the receiver of the abuse to carry the responsibility and stigma for having been injured.
It’s time that society takes responsibility for the damage caused to our shared humanity by our endless wars and our denial of sexual, emotional, and physical abuse, particularly of children. Using that quintessentially human trait - our words - to begin to acknowledge this responsibility by replacing “disorder” with “injury” is a step toward that end.
In the past 30 years the the negative stigma surrounding mental issues has decreased but only very little.
In my volunteer work with members of the military and their family members, the overwhelming consensus is the use of the word disorder implies a condition exists from which you cannot improve. Changing the fourth word in Post Traumatic Stress from Disorder to Injury is one way to let both the patient and the general public know that this is in fact an injury, one from which you can heal.
As the mother of a second lieutenant in the U.S. Army, I read daily of the struggles of fellow Army families trying to support their soldiers. Many of the soldiers do not want to go to a mental health professional because of potential negative repercussion on their career. Changing the name from Post Traumatic Stress Disorder to Injury is a step in the direction that could have significant impact on the well being of our military veterans and their families.
A veteran at a conference I attended once said when asked his opinion of changing the name from PTSD or PTSI. “I can heal from an injury, a disorder is something I cannot heal from.”
Dorie L. Griggs, M. Div.
http://doriegriggs.wordpress.com/