Taking Away the P and D from PTSD: What Now? TSC

Not that long ago, the military deleted the word "disorder" from PTSD, making the point that post-traumatic stress isn't a disorder in any traditional sense. It is a condition/descriptor to be sure but not a disorder. Out goes the "D." (The comedian George Carlin suggested that the original term "shell shock" had more power and was more personalized in a very funny and true bit he performed. He also bemoans the increase in syllables -- from 2 to 8; my suggestion developed here has 7. Hum.)

Some have suggested adding an "S" -- as in syndrome -- PTSS. Personally, that is no better than a "D" and needs to be deleted too. The deletion of the "D" (or an "S") is also an effort to de-stigmatize. Makes sense to me. PTS is not an illness; there are no cures in any traditional sense. There is a pathology associated with disease, disorders and syndromes too; deletion of the "D" (or "S) deletes that too. Would that more people deleted the "D."

https://nation.time.com/2011/06/05/the-disappearing-disorder-why-ptsd-is-becoming-pts

Even more recently, in a poignant piece published in Black and Smart, there is an argument that the "P" needs to be eliminated from PTS because many black men, women and children experience trauma day in and day out. They are traumatized with each death of a young black man by police for example. Professor Gloria Ladson-Billings makes the same argument -- powerfully. See her piece linked at the end of this blog post. There are others that fall into this category too -- in addition to minorities. Consider soldiers, students (young and old), seniors (in nursing facilities or living alone).... the list of sufferers is long. Add in immigrants.

https://blackandsmart.wordpress.com/2017/05/05/there-is-no-p-in-our-ptsd/

Taking this linked article and the one at the end of this blog into account, that would leave us with a new term "TS," not PTSD, PTSS or PTS. And, if we made the deletion of the letters P and D and S, what would that mean in terms of how we address the very real toxic and traumatic stress suffered by many in today's society?

Here's one positive about the deletion of the letter "P" for Post. It recognizes the currency of the trauma -- and importantly, even past trauma does not go away and in a sense it is in the present even if it occurred in the past. The word "post" signals the past, ignoring the present. Think about it this way: if you suffered trauma, it is part of one's being -- always. Think about Holocaust victims; the events were in the past but the pain persists in the present (whether recognized or not).

That is why I have turned to a different approach for dealing with children with abuse, trauma and toxic stress, namely that these events (occurrences, situations) are not going to be eliminated or erased. One can never remove them because one is affected by them prospectively. A child who is hit or abandoned or witnesses assault lives with that reality -- even if it occurred in the past and yes, for some, the trauma is continuous and very much in the present. And, for some, there is ongoing trauma and toxic stress by virtue of one's race or ethnicity or gender or age or religion or socio-economic class.

That is why, at least as I conceptualize these issues, the term "lasticity" (a new word that needs to enter our lexicon) has such power. This make-up word recognizes that trauma (toxic stress and abuse) change a person forever (an institution or city and its workers too). The term "plasticity" as used in neuroscience and physics recognizes that there are changes that are not reversible but the brain responds for example to damage by creating alternative pathways -- and a new "normal" emerges. That's what happens to those who experience trauma.

I think the deletion of the "P" also is valuable for the person affected; it is not as if there is something that one can overcome by deleting it; instead, the question is how to integrate what happened into one's present and one's future. That is actually a doable task. I should know -- from both personal and professional experience. I worked near Ground Zero; we wrote a book about it; I wrote an article about it. And we shared those writings to integrate the terrible past into the present.

That leaves us with two letters: TS. Perhaps the "T" stands for more than trauma. Perhaps it encompasses toxicity too. And then, if one has experienced TS, the next question is how to deal with it -- and we surely know from experience and empiricism that dealing with it alone is suboptimal. That is where reciprocity comes in. That is where it becomes important for those working with a person with TS to understand them and their past and enable them, with care and empathy, to move forward. That is why, actually, we need a third letter after TS that presents a process, an approach for addressing the realities that accompany toxic stress, trauma and abuse.

What if we added the letter "C" for conundrum? TSC. That is identifying the complexity of dealing with TS -- and suggesting its remarkable potential for both harm and for good. And it is complicated to be sure -- and filled with emotion and challenges.

To that end, in Breakaway Learners, a new book, I have made the argument that, despite the pain of TS, there are positives that emerge from it -- if we pay enough attention and look at the effects differently. This is not easy for many to see (thus the term conundrum) -- and it seems counterintuitive. How can horrible events have a positive? Good question.

The simple answer is to think of Kintsugi, the Japanese pottery and life philosophy. (See image leading off this blog.) This pottery form takes broken pieces and puts them back together with gold. What emerges is a piece of pottery that is stronger and more beautiful than what previously existed. Yes, the breaks are visible by intention but they are illuminated in gold. There is true, profound beauty in being broken and repaired. That's a powerful notion, especially in a discard society like our own. And, our collective job is to highlight that positive and the many forms it can take -- in part because the alternative is unacceptable.

I keep Kintsugi pottery all around me. It reminds me of the importance of repair and the recognition of a broken past. But, it illuminates the room where the pottery sits, especially when the light catches it; it provides benefits. It facilitates moving forward meaningfully and with direction. Taking the "P" and "D" and "S" out of PTSD or PTSS seems to me to be a way of fostering growth, pressing for the present and the marching forward (even if slowly) toward the future.

Here's the message of TSC: acknowledge and incorporate the past; it can enable a rich present and future. How we actually do that is the subject of another post --- and yes, it is the subject of several chapters in Breakaway Learners.