As a Trauma-Sensitive Yoga Facilitator, there are a number of questions that I frequently receive. One of the most common questions is regarding the difference between PTSD, PTS, Complex Trauma, and all of the other terms being thrown around these days.
PTSD, or Post-Traumatic Stress Disorder, is currently the only medical diagnosis related to trauma currently recognized by the American Psychiatric Association’s DSM handbook. Mental healthcare professionals indeed are using additional terms which have become somewhat mainstream, but this currently is the only medical diagnosis recognized.
Why does the distinction of what medical diagnoses are recognized matter? It matters for a few reasons. Access to care for those who have suffered trauma can have an impact on their recovery. (That is not recorded in any research I have personally read, but it is an observation from personal experience. Shout-out to all the researchers out there: there’s a thing for you to go measure.) Health Insurance and various benefits require a medical diagnosis.
Possibly the most important reason that diagnosis terminology matters is to the person that is diagnosed. We humans use language to describe and identify ourselves. Words that others use to describe us, especially at an early age, become part of our identity. For many survivors, distinction in terminology between various outcomes of traumatic experiences helps us to better understand ourselves—and others.
For the majority of people, PTSD is a relatively new term given that it was first listed as a DSM diagnosis in 1980. Only in recent years has it become a household name. Even now, nearly 40 years after DSM III was published, many people still only associate it with military service. This is likely because the majority of funding for research (as well as health care) is provided by the government for soldiers returning from active duty. Unfortunately the leading causes are actually rape and various forms of abuse (childhood, adult, sexual, verbal, physical, etc.).
Complex Trauma, C-PTSD, and Other Words
Beyond PTSD—which is a diagnosis for a one-time occurrence of trauma—mental health professionals are seeing far more cases of people who have survived multiple traumatic experiences than those who have only been exposed to trauma once. They have termed the effects of multiple traumatic experiences C-PTSD, Complex Trauma, as well as devised other terms that are more specific to the various types of trauma. Psychologists and mental health care professionals are realizing that the likelihood of a person with PTSD never having experienced any other trauma prior to the one-time incident that led to their current diagnosis is minimal.
I mean, come on. Can you think of a single person you know that has never once had a traumatic experience? Birth is a traumatic experience (at the very least in terms of physical trauma). Death is traumatic. And even if you haven’t experienced any of the atrocities of rape, abuse, neglect, or war between the two, “trauma” is completely subjective. As much as researchers can (and will undoubtedly) try, you can’t make a list and check it twice when it comes to an individual’s human experience and interpretation of an event or social interaction.
Even if rape is a one-time occurrence, the experience of not being believed is traumatic. Even when a soldier comes home only to experience the division between their family, friends, neighbors, community, country, and world can be traumatic. Even when a child is provided a safe home with foster parents away from their abusers, the acknowledgement (whenever it may come) that their own parents were the ones that did them harm is traumatic.
We all have our own story. We all have our own pain. We have all lost someone, to death or other circumstances. Those of us who remember 9/11 experienced trauma that day regardless of where we were. Even those who do not remember it have been brought into a culture that is now largely defined by that trauma. The number of terms that are now being used to attempt to describe the effect of traumatic events on the human soul show how complex “trauma” is, and how feeble the American medical community’s attempt is at not only appropriately treating it but preventing it.
Is There Any Hope?
Another question I am often asked is whether someone with PTSD (etc) can ever completely recover. YES. A study was completed with Vietnam veterans that showed that some fully recovered from PTSD after a period of time. Some, however, did not. What was the difference between those who did and did not recover? Personal experience. Not just during the war, but both before and after. Childhood abuse is often a precursor for PTSD development later in life. Environment and societal culture are keys to recovery after PTSD has been diagnosed. Based on my own observations, those in poverty with PTSD (including but not at all limited to homeless veterans) are the least likely to recover. (Hey, researchers. Another thingy for you to do numbers with.)
However, even within the homeless community, there is community. And, the sense of belonging (i.e. to a community) is one of the key measurements for PTSD and a person’s recovery. So, perhaps it may be the more affluent who feel they cannot talk to anyone, who feel more isolated, that may have less hope for recovery. Either way, kindness goes a long way. Compassion is priceless. These are the two weapons that can combat the effects of trauma and save lives.