Denial in the professional community.
I had to stop writing yesterday because I was so mad, and since then I have had comments from vets and spouses about professionals not believing in PTSD, saying PTSD can be easily cured, and encouraging women to leave their PTSD vets because they are just a-holes and PTSD doesn't exist.
Makes me very angry. I hate trendy shit, and this is simply another trend in the struggle to understand and treat PTSD.
In 1968, the trend was suddenly combat fatigue and gross stress reaction (PTSD) didn't exist. In 1980, PTSD was put into the DSM III but most psychiatrists thought it was made up for Vietnam vets, despite the fact that Holocaust survivors, WWII vets and POW's, flood, fire, tsunami, hurricane and other natural disaster survivors, battered women and children, rape and incest survivors and survivors of industrial accidents and fires all had it. People see what they want to see.
In the 90's it was all "lets fix it with drugs" which did not work. It still doesn't work. Drugs can help but they do not cure.
Then psychologists started getting smart, so if they developed a treatment, they did follow-up studies and some of the new treatments do actually lower PTSD symptoms. Is it a cure? Does it last forever? In 50 years we'll know.
Most of these studies are on sexual abuse (rape) survivors but a few have been done on combat vets. The "evidence based" therapies do work for some. So do a lot of other therapies as long as someone who cares is listening.
Many, many therapists, social workers, psychiatrists, and other mental health people work hard and long to help our vets in the VA system. If you get someone you can talk to, hang on to them.
Then there are the smugly self-righteous. They know the new ways are the best ways. They are going to change the world and human nature.
They have no idea how lethal they can be, especially when they tell you you don't have PTSD, or that you can't be helped, or they can cure you quite quickly.
I call this a profound and pervasive narcissistic sense of entitlement, a phrase I read in a paper about Vietnam vets with PTSD, which really pissed me off. Society makes a deal with soldiers. You go do our dirty work, and it is dirty work in every sense of the word, and we will respect you, and honor you, and take care of you. So vets who felt they were owed something were narcissists. NOT.
But someone with a PhD or MD who thinks they know everything and can fix everyone if they just listen to MEEE. Yep. Narcissistic sense of entitlement.
PTSD has been around since the beginning of writing, if not before. When Saul (who had killed his thousands) was troubled by an evil spirit of the lord (PTSD), they sent for the harpist, David, to soothe him. Saul tried to spear him to the wall twice. I was at a National Conference Of Viet Nam Veteran Ministers (NCVNVM.org) retreat when I first heard this. I laughed. It sounded just like Bob. Most women can identify.
The PTSD psalm, the 137th, starts out with the captors saying forgeddaboutit, just like everyone says to vets.
Be happy. Sing! Yeah, right!
The vets feel they will betray their friends (If I forget thee, oh Jerusalem) if they forget so they don't (and can't).
The last bit isn't usually read in church: happy are they who take the children of the enemy and dash their heads against the rocks. People with PTSD are angry. We all have an innate sense of justice. We know that what happened to us was not right, whether it is people trying to kill us or surviving rape or losing everything in a fire. That is why "irritability and outbursts of anger" are part of the diagnostic criteria.
In the Iliad we read about PTSD (read Jonathan Shay's Achilles in Vietnam) and homecoming in the Odyssey. Shakespeare mentions every symptom of PTSD in Lady Percy's description of her husband in Henry IV, Part I. There are lots of other examples if you look for them. I always do. Always glad to hear about them too.
The final thing I want to say today is the difference between a startle reaction (when a vet wakes up swinging or hits someone who has surprised him) and battering. Batterers go through a cycle: hit, sorry, honeymoon, slowly growing anger, and hit again. A startle reaction is completely different, and any therapist who doesn't know the difference should learn it. Most vets are not batterers and if they are, it is not from the war. It is learned at home and despite the conventional wisdom about battering, there is help for batterers and their wives: Compassionpower.com.